Fulminant hepatitis B associated with a specific insertion in the basal core promoter region of hepatitis B virus DNA after immunosuppressive treatment.

@article{Grolami2005FulminantHB,
  title={Fulminant hepatitis B associated with a specific insertion in the basal core promoter region of hepatitis B virus DNA after immunosuppressive treatment.},
  author={Ren{\'e} G{\'e}rolami and Mireille Henry and Patrick Borentain and Philippe Colson and Dani{\`e}le Botta and Catherine Tamalet},
  journal={Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
  year={2005},
  volume={40 4},
  pages={e24-7}
}
We report a case of hepatitis B virus reactivation that occurred after immunosuppressive treatment in a hepatitis B surface antigen-negative patient with detectable antibodies to hepatitis B core antigen and hepatitis B surface antigen. Sequence analysis revealed an 11-bp insertion in the core promoter region of hepatitis virus DNA, creating a novel hepatocyte nuclear factor-1 binding site. This led to enhanced viral replication and fulminant hepatitis. 

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