PMID- 37124041
OWN - NLM
STAT- MEDLINE
DCOM- 20230502
LR  - 20230503
IS  - 2235-2988 (Electronic)
IS  - 2235-2988 (Linking)
VI  - 13
DP  - 2023
TI  - Case report: An occult hepatitis B virus infection reactivation in an HIV/HCV 
      coinfected patient during an immune reconstitution inflammatory syndrome.
PG  - 1143346
LID - 10.3389/fcimb.2023.1143346 [doi]
LID - 1143346
AB  - The natural history of occult hepatitis B virus infection (OBI) and the mechanism 
      involved in HBV reactivation are only partially understood. As regards people 
      living with HIV (PLWH), HBV reactivation is estimated to occur with an incidence 
      ratio of 0.019 cases per 100 person-year. Here we report the case of OBI 
      reactivation in a HIV/HCV co-infected patient followed for 25 years at our 
      Infectious Diseases Unit, but, unfortunately, lost to follow-up about 19 months 
      after Direct-acting antivirals (DAAs) treatment. At re-engagement, blood tests 
      showed high replication of plasmatic HIV-RNA along with severe immunosuppression 
      and normal levels of liver enzymes. However, 3 months after ART reintroduction, 
      an immune reconstitution inflammatory syndrome (IRIS) was diagnosed with high 
      detectable HBV-DNA load and transaminase elevation. Our case report shows how the 
      balance between the virus and the host immune system is quite a dynamic process 
      that might significantly impact the course of the disease. The aim of this case 
      report is to bring to the attention of physicians that, although OBI reactivation 
      is a rather rare occurrence, even amongst PLWH, its potential consequences compel 
      to a high alertness on the matter. Therefore, especially in patients with an 
      impaired immune system and on a tenofovir or lamivudine-sparing regimen, HBV 
      serological and virological markers should always be strictly monitored, even in 
      the absence of a hepatitis flare.
CI  - Copyright (c) 2023 Zaltron, Cambianica, Di Gregorio, Colangelo, Storti, Tiecco, 
      Castelli and Quiros-Roldan.
FAU - Zaltron, Serena
AU  - Zaltron S
AD  - Unit of Infectious and Tropical Diseases, ASST Spedali Civili di Brescia, 
      Brescia, Italy.
FAU - Cambianica, Anna
AU  - Cambianica A
AD  - Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental 
      Sciences, ASST Spedali Civili di Brescia and University of Brescia, Brescia, 
      Italy.
FAU - Di Gregorio, Marco
AU  - Di Gregorio M
AD  - Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental 
      Sciences, ASST Spedali Civili di Brescia and University of Brescia, Brescia, 
      Italy.
FAU - Colangelo, Cosimo
AU  - Colangelo C
AD  - Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental 
      Sciences, ASST Spedali Civili di Brescia and University of Brescia, Brescia, 
      Italy.
FAU - Storti, Samuele
AU  - Storti S
AD  - Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental 
      Sciences, ASST Spedali Civili di Brescia and University of Brescia, Brescia, 
      Italy.
FAU - Tiecco, Giorgio
AU  - Tiecco G
AD  - Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental 
      Sciences, ASST Spedali Civili di Brescia and University of Brescia, Brescia, 
      Italy.
FAU - Castelli, Francesco
AU  - Castelli F
AD  - Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental 
      Sciences, ASST Spedali Civili di Brescia and University of Brescia, Brescia, 
      Italy.
FAU - Quiros-Roldan, Eugenia
AU  - Quiros-Roldan E
AD  - Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental 
      Sciences, ASST Spedali Civili di Brescia and University of Brescia, Brescia, 
      Italy.
LA  - eng
PT  - Case Reports
DEP - 20230414
PL  - Switzerland
TA  - Front Cell Infect Microbiol
JT  - Frontiers in cellular and infection microbiology
JID - 101585359
RN  - 0 (Antiviral Agents)
RN  - 0 (DNA, Viral)
SB  - IM
MH  - Humans
MH  - Hepatitis B virus/physiology
MH  - *Hepatitis B, Chronic
MH  - Antiviral Agents/therapeutic use
MH  - *Coinfection/drug therapy
MH  - *Immune Reconstitution Inflammatory Syndrome/diagnosis/drug therapy
MH  - *HIV Infections/complications/drug therapy
MH  - Symptom Flare Up
MH  - *Hepatitis C, Chronic/drug therapy
MH  - *Hepatitis B/complications/diagnosis/drug therapy
MH  - DNA, Viral/genetics
PMC - PMC10145166
OTO - NOTNLM
OT  - HBV/HIV coinfection
OT  - hepatitis B virus
OT  - immune reconstitution inflammatory syndrome (IRIS)
OT  - occult HBV
OT  - reactivation
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/05/01 06:42
MHDA- 2023/05/02 06:42
PMCR- 2023/01/01
CRDT- 2023/05/01 03:37
PHST- 2023/01/27 00:00 [received]
PHST- 2023/03/24 00:00 [accepted]
PHST- 2023/05/02 06:42 [medline]
PHST- 2023/05/01 06:42 [pubmed]
PHST- 2023/05/01 03:37 [entrez]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fcimb.2023.1143346 [doi]
PST - epublish
SO  - Front Cell Infect Microbiol. 2023 Apr 14;13:1143346. doi: 
      10.3389/fcimb.2023.1143346. eCollection 2023.