Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jul 27, 2018; 10(7): 509-516
Published online Jul 27, 2018. doi: 10.4254/wjh.v10.i7.509
Hepatitis B virus subgenotype F3 reactivation with vaccine escape mutations: A case report and review of the literature
Stefan Schlabe, Kathrin van Bremen, Souhaib Aldabbagh, Dieter Glebe, Corinna M Bremer, Tobias Marsen, Walter Mellin, Veronica Di Cristanziano, Anna M Eis-Hübinger, Ulrich Spengler
Stefan Schlabe, Kathrin van Bremen, Souhaib Aldabbagh, Anna M Eis-Hübinger, Ulrich Spengler, German Center of Infectious Diseases Research (DZIF), Partner-Site Cologne-Bonn, Bonn-Cologne35392, Germany
Stefan Schlabe, Kathrin van Bremen, Ulrich Spengler, Department of Internal Medicine I, University Hospital of Bonn, Bonn 53127, Germany
Souhaib Aldabbagh, Anna M Eis-Hübinger, Institute of Virology, University Hospital of Bonn, Bonn 53127, Germany
Dieter Glebe, Corinna M Bremer, Institute of Medical Virology, Justus Liebig University Giessen, National Reference Center for Hepatitis B and D Viruses, Biomedical Research Center Seltersberg, Giessen 35392, Germany
Dieter Glebe, Corinna M Bremer, German Center of Infectious Diseases Research (DZIF), Partner-Site Giessen, Giessen 35392, Germany
Tobias Marsen, Practice of Nephrology and Dialysis, Nephrological Center Cologne-Lindenthal, Cologne 50937, Germany
Walter Mellin, Practice of Pathology and Cytology, Cologne 50931, Germany
Veronica Di Cristanziano, Institute of Virology, University Hospital of Cologne, Cologne 50935, Germany
Author contributions: Schlabe S and van Bremen K wrote the manuscript; Marsen T wrote the nephrological medical history, including transplantation and HBV management before transplantation; Mellin W discussed pathological findings of HBV reactivation; Eis-Hübinger AM, Aldabbagh S, Bremer CM, and Glebe D characterized the resistant virus and performed deep sequencing; Di Cristanziano V, Schlabe S, van Bremen K, Marsen T and Spengler U took care of the patient; escape mechanism and impact of second and third-generation vaccines were discussed and revised by Schlabe S, Spengler U, Eis-Hübinger AM, and Glebe D; the phylogenetic analysis and alignment were done by Eis-Hübinger AM and Aldabbagh S; all authors read and approved the final manuscript.
Informed consent statement: The patient gave informed consent for the publication of his medical history. Identifying details were omitted or anonymized.
Conflict-of-interest statement: Spengler U has consulted for AbbVie and has received a royalty from UpToDate for another study. Marsen T has received speakers honoraria from GHD Gesundheits GmbH and Fresenius Medical Care Nephrology for another study. Schlabe S has received sponsoring for educational events from Janssen for another study. All other authors state no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Stefan Schlabe, MD, Doctor, Resident, Department of Internal Medicine I, University Hospital of Bonn, Sigmund-Freud-Str. 25, Bonn 53127, Germany.stefan.schlabe@ukbonn.de
Telephone: +49-163-7477199
Received: April 6, 2018
Peer-review started: April 7, 2018
First decision: April 23, 2018
Revised: May 8, 2018
Accepted: June 7, 2018
Article in press: June 8, 2018
Published online: July 27, 2018
Core Tip

Core tip:We report the first documented case of hepatitis B virus (HBV) subgenotype F3 reactivation with vaccine escape mutations in a patient after kidney transplantation. We successfully treated this patient with entecavir. This case illustrates a specific clinical situation in which the current World Health Organization HBV vaccine may be unsuccessful, and third generation vaccines should be considered.