Journal of Investigative Medicine High Impact Case Reports (Sep 2021)

A Case of S-Variant Hepatitis B Virus: An Immune System Escape Artist

  • Amar S. Shah MD,
  • Valerie F. Civelli MD,
  • Varun Bali MD,
  • Royce H. Johnson MD,
  • Arash Heidari MD

DOI
https://doi.org/10.1177/23247096211045450
Journal volume & issue
Vol. 9

Abstract

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Genomic variants of the hepatitis B virus (HBV) preS/S protein are well-known to occur. Typically, immunity is gained through recovered HBV infection or by immunization. Very rarely, there are certain mutations that may enable HBV escape from the immune detection. PreS/S mutants may present with unpredictable pathobiologic, clinical, and transmittable implications. Standard laboratory testing for genomic HBV variants is not routinely performed by reference guidelines. s-variant HBV management remains challenging. Herein is a case of s-variant chronic HBV infection in a 55-year-old man. Diagnosis and treatment are described.