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Successful combination therapy of polyarteritis nodosa associated with a pre-core promoter mutant hepatitis B virus infection.
- Source :
-
Journal of hepatology [J Hepatol] 2001 May; Vol. 34 (5), pp. 774-9. - Publication Year :
- 2001
-
Abstract
- Background/aims: To describe the clinical and virological evolution of a polyarteritis nodosa (PAN) case associated with a hepatitis B virus (HBV) pre-core promoter mutant infection that was successfully treated with plasma exchanges, corticosteroids, and interferon alpha (IFN-alpha).<br />Methods: Viral markers were used, including HBV DNA quantified by the branched DNA assay and detected by PCR, the HBV genome sequence, pre-S1Ag and anti-HBC IgM which were studied throughout the treatment period and the entire follow-up in the serum, while the presence of virus in extrahepatic sites was detected by immuno-staining.<br />Results: The patient was infected with a typical pre-core promoter mutant harboring four point mutations. Pre-S1Ag was cleared rapidly from serum, most likely via the formation of immune complexes since HBV DNA declined more progressively. Viral infection was then cleared after a second episode of hepatocyte lysis. This was accompanied by a recovery from all clinical manifestations.<br />Conclusions: The favorable treatment outcome observed in this first case of pre-core promoter HBV mutant associated PAN underlines that combination therapy based on IFN-alpha can clear pre-core promoter HBV infection and cure PAN. It also provides new insight in the pathogenesis of HBV associated PAN.
- Subjects :
- Adrenal Cortex Hormones therapeutic use
Aged
Base Sequence genetics
Hepatitis B therapy
Humans
Interferon-alpha therapeutic use
Male
Molecular Sequence Data
Plasma Exchange
Polyarteritis Nodosa pathology
Hepatitis B complications
Hepatitis B genetics
Hepatitis B virus genetics
Point Mutation
Polyarteritis Nodosa virology
Promoter Regions, Genetic genetics
Subjects
Details
- Language :
- English
- ISSN :
- 0168-8278
- Volume :
- 34
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of hepatology
- Publication Type :
- Academic Journal
- Accession number :
- 11434628
- Full Text :
- https://doi.org/10.1016/s0168-8278(00)00088-x