The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Case of Acute Hepatitis B by Occult HBV Infection without HbsAg Seroconversion

잠재감염에 의한 HBsAg 음성 B형 간염 급성 악화 1예

  • Jung, Hye Mi (Department of Internal Medicine, Hanyang University School of Medicine) ;
  • Jun, Dae Won (Department of Internal Medicine, Hanyang University School of Medicine) ;
  • Min, Ji Yeon (Department of Internal Medicine, Hanyang University School of Medicine) ;
  • Doo, Eun Young (Department of Internal Medicine, Hanyang University School of Medicine) ;
  • Nam, Kil Woo (Department of Internal Medicine, Hanyang University School of Medicine) ;
  • Kwon, Young Il (Department of Internal Medicine, Hanyang University School of Medicine) ;
  • Kwon, Oh Wan (Department of Internal Medicine, Hanyang University School of Medicine)
  • 정혜미 (한양대학교 의과대학 내과학교실) ;
  • 전대원 (한양대학교 의과대학 내과학교실) ;
  • 민지연 (한양대학교 의과대학 내과학교실) ;
  • 두은영 (한양대학교 의과대학 내과학교실) ;
  • 남길우 (한양대학교 의과대학 내과학교실) ;
  • 권영일 (한양대학교 의과대학 내과학교실) ;
  • 권오완 (한양대학교 의과대학 내과학교실)
  • Published : 2012.11.01
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Abstract

Many studies have recently reported reactivation in hepatitis B surface antigen (HBsAg)-negative subjects with the use of biologic agents such as rituximab. However, occult hepatitis B virus infection itself has little clinical impact. We experienced a case of acute exacerbation caused by occult hepatitis B infection without HBsAg seroconversion. No mutation was found on the major hydrophilic loop of the S protein. The patient recovered from acute exacerbation after antiviral therapy. In conclusion, acute exacerbation can be induced by occult hepatitis B virus infection itself without reactivation. In such a case, antiviral therapy should be considered.

최근 면역억제제의 사용이 증가함에 따라 B형 잠재감염의 재활성화로 인한 간염의 빈도가 증가하고 있다. 하지만 잠재감염 자체의 임상적 의미는 거의 알려지지 않았다. 저자들은 B형 잠재감염이 재활성화 없이 간염 급성 악화를 일으킨 증례를 경험하였다. 환자는 항바이러스제의 투약 이후에 합병증 없이 회복되었다. 이 증례는 향후에 면역억제제를 사용하는 환자에서 간염이 생겼을 때 B형 잠재감염 자체도 원인이 될 수 있으며, 경우에 따라서는 이에 대한 항바이러스제의 치료를 필요하다는 것을 시사한다.

Keywords

References

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  2. A Case of Reactivation of Hepatitis B and Fulminant Hepatitis which developed 3 months following Chemotherapy Including Rituximab in a Patient with Lymphoma vol.29, pp.2, 2012, https://doi.org/10.7180/kmj.2014.29.2.161
  3. Case of Suspected Occult Hepatitis B Virus Infection Mistaken for a Transfusion-Transmitted Infection in a Hemodialysis Patient vol.32, pp.1, 2021, https://doi.org/10.17945/kjbt.2021.32.1.49