Smith P R, Zampino R, Gutteridge C, Karayiannis P, Aitken C
Department of Virology, Barts and the London NHS Trust, London, England.
J Med Virol. 2001 Nov;65(3):470-2.
Reactivation of hepatitis B e antigen (HBeAg) negative chronic hepatitis B virus (HBV) infection due to selection of precore variant virus is an uncommon complication of previous hepatitis B infection, and virtually unrecognised in children and adolescents. A child who had received treatment with methylprednisolone and antilymphocyte globulin for severe aplastic anaemia developed high levels of detectable HBV DNA associated with hepatitis B e antibody (anti-HBe) positivity. HBV DNA was extracted, amplified and the core and precore regions sequenced from 2 samples. A mixture of wild-type and the precore variants A(1896) and A(1899) was detected in both samples, with the wild-type predominating in the second sample. Reinfection was excluded by phylogenetic analysis using Phylip and the neighbour-joining method. Precore variant Hepatitis B virus can be transmitted to children as a primary infection, and it is important that aggressive liver disease, particularly in the presence of the anti-HBe phenotype, be investigated. Further studies are needed to determine the frequency of these variants.
由于前核心变异病毒的选择导致乙肝e抗原（HBeAg）阴性慢性乙型肝炎病毒（HBV）感染的再激活是既往乙肝感染的一种罕见并发症，在儿童和青少年中几乎未被认识到。一名因严重再生障碍性贫血接受甲基强的松龙和抗淋巴细胞球蛋白治疗的儿童出现了与乙肝e抗体（抗-HBe）阳性相关的高水平可检测HBV DNA。从2份样本中提取、扩增HBV DNA并对核心区和前核心区进行测序。在两份样本中均检测到野生型与前核心变异A(1896)和A(1899)的混合，野生型在第二个样本中占主导。使用Phylip和邻接法进行系统发育分析排除了再感染。前核心变异型乙型肝炎病毒可作为原发性感染传播给儿童，对侵袭性肝病进行调查很重要，尤其是在存在抗-HBe表型的情况下。需要进一步研究以确定这些变异的频率。
