AUTHOR=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 

TITLE=Reactivation of a Vaccine Escape Hepatitis B Virus Mutant in a Cambodian Patient During Anti-Hepatitis C Virus Therapy

JOURNAL=Frontiers in Medicine

VOLUME=Volume 5 - 2018

YEAR=2018

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2018.00097

DOI=10.3389/fmed.2018.00097

ISSN=2296-858X

ABSTRACT=A 76 year old Cambodian man co-infected with HBV and 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 HBV-vaccine escape mutant during direct acting antiviral therapy.