Fusco Dahlene N, Ganova-Raeva Lilia, Khudyakov Yury, Punkova Lili, Mohamed Aisha, Cheon Scarlett Se Yun, Koirala Prapti, Andersson Karin L, Jourdain Gonzague, Sureau Camille, Chung Raymond T, Lauer Georg
Medicine/General Internal Medicine and Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
Laboratory of Systems Pharmacology, Harvard Medical School, Boston, MA, United States.
Front Med (Lausanne). 2018 Apr 30;5:97. doi: 10.3389/fmed.2018.00097. eCollection 2018.
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.
一名76岁的柬埔寨男子同时感染了乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）6c-1型，前来就医。尽管抗-HBs水平高于保护阈值，但HBV DNA仍可间歇性检测到。在丙肝治疗期间，HBV DNA水平升高。测序显示存在多个突变，包括疫苗逃逸突变和预计会增强适应性的突变。该病例代表了在直接抗病毒治疗期间HBV疫苗逃逸突变体的病情加重。
