Abstract
The detection of a fatal case of reactivation of hepatitis B, in a previously vaccinated Indonesian patient after withdrawal of chemotherapy for lymphoma, was delayed because HBsAg was negative in a widely used monoclonal-antibody-based ELISA. The serum was later found to be strongly reactive for HBsAg by the polyclonal radioimmunoassay and for HBV DNA. PCR sequencing revealed a substitution of arginine for glycine at position 145 of HBsAg in the major neutralising epitope cluster, the a determinant, as well as a 2-aminoacid insertion of asparagine and threonine between positions 122 and 123, immediately upstream of this determinant.
Publication types
-
Case Reports
-
Research Support, Non-U.S. Gov't
MeSH terms
-
Amino Acid Sequence
-
Enzyme-Linked Immunosorbent Assay
-
Fatal Outcome
-
Hepacivirus / immunology
-
Hepatitis Antibodies / isolation & purification
-
Hepatitis B / virology*
-
Hepatitis B Surface Antigens / genetics*
-
Hepatitis B Surface Antigens / isolation & purification
-
Hepatitis B virus / genetics*
-
Hepatitis B virus / immunology
-
Hepatitis C Antibodies
-
Humans
-
Male
-
Middle Aged
-
Molecular Sequence Data
-
Mutation
-
Polymerase Chain Reaction
-
Viral Envelope Proteins / genetics
Substances
-
Hepatitis Antibodies
-
Hepatitis B Surface Antigens
-
Hepatitis C Antibodies
-
Viral Envelope Proteins