17 December 2017 : Hypothesis
Patients with Coexistence of Circulating Hepatitis B Surface Antigen and Its Antibody May Have a Strong Predisposition to Virus Reactivation During Immunosuppressive Therapy: A HypothesisYu-Lan Chen1ABCDEF*, Ying-Qian Mo1BC, Dong-Hui Zheng1BC, Jian-Da Ma1BD, Jun Jing1BF, Lie Dai1ABCDEFG
Med Sci Monit 2017; 23:5980-5985
ABSTRACT: Hepatitis B virus (HBV) reactivation is a well-recognized complication in patients who undergo immunosuppressive drug therapy. Although the recommendation of antiviral prophylaxis made by the American Gastroenterological Association in 2015 focuses on the risk stratification of different immunosuppressive drugs, risk factors for HBV reactivation are also worth identifying in clinical practice. Recent studies have shown that the uncommon serological pattern of coexistent circulating HBV surface antigen (HBsAg) and its antibody (anti-HBs) was associated with double mutations (A1762T/G1764A) in the basal core promoter (BCP) region of the HBV genome, which is critical for HBV replication. Here, we depicted rheumatoid arthritis (RA) patients with coexistent HBsAg and anti-HBs in our medical center, who developed HBV reactivation during immunosuppressive drug therapy. DNA sequencing analysis of the HBV genome revealed triple mutations (A1762T, G1764A, and T1753V) in the BCP region, which could further enhance the ability of HBV replication. Hence, a novel hypothesis is advanced for the first time that patients with coexistent HBsAg and anti-HBs may have a strong predisposition to HBV reactivation due to specific BCP mutations. This hypothesis would, if correct, justify the concurrent detection of HBsAg and anti-HBs in HBV screening in patients with rheumatic diseases and quickly recognize patients with high risk of HBV reactivation. Further controlled studies are needed to confirm this hypothesis.
Keywords: Hepatitis B Antibodies, Hepatitis B Antigens, Hepatitis B virus, Mutation
01 January 2022 : EditorialEditorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Patients
Med Sci Monit 2022; 28:e935952
11 January 2022 : Clinical ResearchA Remote Questionnaire-Based Study to Compare Alcohol Use in 1030 Final-Year High School Students in Split-...
Med Sci Monit In Press; DOI: 10.12659/MSM.935567
08 November 2021 : Database AnalysisVirtual Screening and Molecular Docking to Study the Mechanism of Chinese Medicines in the Treatment of Cor...
Med Sci Monit In Press; DOI: 10.12659/MSM.934102
31 December 2021 : Clinical ResearchA Prospective Observational Study of 42 Patients with COVID-19 infection and a History of Hepatitis C Virus...
Med Sci Monit 2021; 27:e935075
17 Jan 2022 : Clinical ResearchUnveiling the Differences in Biological Properties of Dental Pulp Stem Cells from Normal and Inflamed Pulp:...
Med Sci Monit In Press; DOI: 10.12659/MSM.934511
14 Jan 2022 : Database AnalysisIdentification of Key Genes Associated with Brain Metastasis from Breast Cancer: A Bioinformatics Analysis
Med Sci Monit In Press; DOI: 10.12659/MSM.935071
13 Jan 2022 : Review articleA Review of Current Clinical Concepts in the Pathophysiology, Etiology, Diagnosis, and Management of Hyperc...
Med Sci Monit In Press; DOI: 10.12659/MSM.935821
Most Viewed Current Articles
30 Dec 2021 : Clinical ResearchRetrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...
Med Sci Monit 2021; 27:e935379
01 Nov 2020 : Review articleLong-Term Respiratory and Neurological Sequelae of COVID-19
Med Sci Monit 2020; 26:e928996
05 Mar 2020 : Clinical ResearchThe Effects of Social Support on Sleep Quality of Medical Staff Treating Patients with Coronavirus Disease ...
Med Sci Monit 2020; 26:e923549