PMID- 36092833
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220913
IS  - 2328-8957 (Print)
IS  - 2328-8957 (Electronic)
IS  - 2328-8957 (Linking)
VI  - 9
IP  - 9
DP  - 2022 Sep
TI  - Hepatitis B-Related Hepatic Flare During Immune Reconstitution Syndrome After 
      Antiretroviral Treatment Initiation in an HBV Surface Antigen-Positive Patient 
      With HIV: Viroimmunological and Histological Characterization.
PG  - ofac451
LID - 10.1093/ofid/ofac451 [doi]
LID - ofac451
AB  - HIV and hepatitis B virus (HBV) coinfection is relatively common. Initiation of 
      antiretroviral therapy (ART) in people with HIV (PWH) causes a progressive 
      restoration of cell-mediated immune functions. In the presence of overt or occult 
      coinfections, immune restoration might lead to immune reconstitution inflammatory 
      syndrome (IRIS). Here, we describe the clinical, immunological, virological, and 
      histological characterization of a case of HBV-related IRIS hepatitis in a PWH 
      after ART initiation. A liver biopsy was performed during HBV-related IRIS 
      hepatic flare, and liver samples were analyzed through immunohistochemistry and 
      molecular techniques, with the assessment of intrahepatic HBV-DNA, covalently 
      closed circular DNA, and HBV pregenomic RNA through a droplet digital polymerase 
      chain reaction system. Immune activation and senescence were also longitudinally 
      assessed. In this clinical case, the hepatic flare occurred 6 weeks after ART 
      initiation with a therapeutic regimen including tenofovir alafenamide (TAF) and 
      emtricitabine (FTC). The episode was self-limiting, characterized by 
      hyperactivation of peripheral blood CD4+ and CD8+ T-lymphocytes, and resolved 
      without ART discontinuation, leading to the achievement of HBsAg seroconversion 
      (HBsAg-/HBsAb+) and HBV-DNA plasma undetectability. Notably, hyperactivation of 
      the immune system plays a pivotal role in promoting the control of HBV 
      replication, thus triggering the achievement of HBsAg seroconversion during 
      treatment with TAF/FTC.
CI  - (c) The Author(s) 2022. Published by Oxford University Press on behalf of 
      Infectious Diseases Society of America.
FAU - Iannetta, Marco
AU  - Iannetta M
AUID- ORCID: 0000-0002-6938-8627
AD  - Department of System Medicine, Tor Vergata University, Rome, Italy.
FAU - Crea, Angela M A
AU  - Crea AMA
AD  - Department of System Medicine, Tor Vergata University, Rome, Italy.
FAU - Di Lorenzo, Andrea
AU  - Di Lorenzo A
AD  - Department of System Medicine, Tor Vergata University, Rome, Italy.
FAU - Campogiani, Laura
AU  - Campogiani L
AD  - Department of System Medicine, Tor Vergata University, Rome, Italy.
FAU - Teti, Elisabetta
AU  - Teti E
AD  - Department of System Medicine, Tor Vergata University, Rome, Italy.
FAU - Malagnino, Vincenzo
AU  - Malagnino V
AUID- ORCID: 0000-0002-6561-5298
AD  - Department of System Medicine, Tor Vergata University, Rome, Italy.
FAU - Compagno, Mirko
AU  - Compagno M
AD  - Department of System Medicine, Tor Vergata University, Rome, Italy.
FAU - Coppola, Luigi
AU  - Coppola L
AD  - Department of System Medicine, Tor Vergata University, Rome, Italy.
FAU - Piermatteo, Lorenzo
AU  - Piermatteo L
AD  - Department of Experimental Medicine, Tor Vergata University, Rome, Italy.
FAU - Palmieri, Giampiero
AU  - Palmieri G
AD  - Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy.
FAU - Cimino, Carolina
AU  - Cimino C
AD  - Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy.
FAU - Salpini, Romina
AU  - Salpini R
AD  - Department of Experimental Medicine, Tor Vergata University, Rome, Italy.
FAU - Zingaropoli, Maria A
AU  - Zingaropoli MA
AD  - Department of Public Health and Infectious Diseases, Sapienza University, Rome, 
      Italy.
FAU - Ciardi, Maria R
AU  - Ciardi MR
AUID- ORCID: 0000-0002-0894-6496
AD  - Department of Public Health and Infectious Diseases, Sapienza University, Rome, 
      Italy.
FAU - Mastroianni, Claudio M
AU  - Mastroianni CM
AUID- ORCID: 0000-0002-1286-467X
AD  - Department of Public Health and Infectious Diseases, Sapienza University, Rome, 
      Italy.
FAU - Parisi, Saverio G
AU  - Parisi SG
AD  - Department of Molecular Medicine, University of Padova, Padua, Italy.
FAU - Svicher, Valentina
AU  - Svicher V
AUID- ORCID: 0000-0002-2377-504X
AD  - Department of Experimental Medicine, Tor Vergata University, Rome, Italy.
AD  - Department of Biology, Tor Vergata University, Rome, Italy.
FAU - Andreoni, Massimo
AU  - Andreoni M
AD  - Department of System Medicine, Tor Vergata University, Rome, Italy.
FAU - Sarmati, Loredana
AU  - Sarmati L
AD  - Department of System Medicine, Tor Vergata University, Rome, Italy.
LA  - eng
PT  - Case Reports
DEP - 20220829
PL  - United States
TA  - Open Forum Infect Dis
JT  - Open forum infectious diseases
JID - 101637045
PMC - PMC9454030
OTO - NOTNLM
OT  - AIDS
OT  - HBV
OT  - IRIS
OT  - biopsy
OT  - cccDNA
OT  - immune activation
OT  - pgRNA
EDAT- 2022/09/13 06:00
MHDA- 2022/09/13 06:01
PMCR- 2022/08/29
CRDT- 2022/09/12 04:22
PHST- 2022/07/12 00:00 [received]
PHST- 2022/08/26 00:00 [accepted]
PHST- 2022/09/12 04:22 [entrez]
PHST- 2022/09/13 06:00 [pubmed]
PHST- 2022/09/13 06:01 [medline]
PHST- 2022/08/29 00:00 [pmc-release]
AID - ofac451 [pii]
AID - 10.1093/ofid/ofac451 [doi]
PST - epublish
SO  - Open Forum Infect Dis. 2022 Aug 29;9(9):ofac451. doi: 10.1093/ofid/ofac451. 
      eCollection 2022 Sep.