Reactivation of a vaccine escape hepatitis b virus mutant in a cambodian patient during anti-hepatitis c virus therapy

Abstract

©2018 Fusco, Ganova-Raeva, Khudyakov, Punkova, Mohamed, Cheon, Koirala, Andersson, Jourdain, Sureau, Chung and Lauer. A 76-year-old Cambodian man co-infected with hepatitis B virus (HBV) and hepatitis C virus (HCV) 6c-1 presented for care. HBV DNA was intermittently detectable despite anti-HBs levels being above the protective threshold. During treatment for HCV, HBV DNA levels increased. Sequencing revealed multiple mutations including vaccine escape mutation and mutations predicted to enhance fitness. This case represents exacerbation of an HBV vaccine escape mutant during a direct-acting antiviral therapy.Background:Hepatitis B virus (HBV) reactivation has been reported during hepatitis C virus (HCV) treatment, leading to a need for close surveillance of HBV-infected patients undergoing HCV therapy. We here report a case of HBV reactivation during HCV treatment, with the finding that the reactivated HBV was a vaccine escape mutant.