S遺伝子変異株が検出され急性増悪後にHBs抗原が持続陰性化したpre‐C変異型B型漫性肝炎の1例

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タイトル別名
  • A case of pre-C mutant type B chronic hepatitis with S mutation found to become HBs-Ag-negative after acute aggravation.

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説明

The patient was a 48-year-old male. Examination performed in July 1990 indicated hepatic dysfunction, and serological tests showed the patient to be HBs-antigen-positive, HBe-antigen negative and anti-HBe-antibody-positive. In May 1991, in the absence of any specific inducing factor, marked elevatoin of the transaminase levels was detected. Analysis of the RFLP method revealed that the patient was infected by HBV pre-C mutant in which codon No. 28 in the pre-C region of the HBV genome was altered from TGG to TGA. After hospitalization, there was no development of hepatic failure, and the transaminase values showed transient elevation and then returned to normal. A liver biopsy yielded findings of CAH2b. After the acute aggravation, the HBs antigen level was continuously low, and it became negative after about 1.5 years, in October 1992. The PCR method also showed that the patient had became negative for HBV-DNA, and the histological findings for the liver were also strikingly improved. It was concluded that there had been clinical cure of the hepatitis. However, the patient remained negative for anti-HBs antibody, and for this reason analysis was performed of the genes in the HBs antigen region. It was found that there has been substitution and insertion of several kinds of amino acids in the HBs antigen protein.

収録刊行物

  • 肝臓

    肝臓 37 (11), 632-637, 1996

    一般社団法人 日本肝臓学会

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