{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T07:29:21Z","timestamp":1791444561102,"version":"4.3.3"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2019,2,11]],"date-time":"2019-02-11T00:00:00Z","timestamp":1549843200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2019,2,11]],"date-time":"2019-02-11T00:00:00Z","timestamp":1549843200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:p>Acute hepatitis B virus (HBV) infection remains a frequent cause of acute liver failure (ALF) worldwide. ALF occurs in 0.1%\u20100.5% of infected patients. The aim of this study was to scrutinize the outcome of patients with HBV\u2010induced ALF and mutational patterns of HBV variants, which might contribute to ALF. From 2005 to 2016, 42 patients were treated for HBV\u2010induced ALF in the University Hospital Essen, Germany. Clinical and virological data from these patients were collected. As a control, 38 patients with acute hepatitis B (AHB) without liver failure were included. The HBV genome was sequenced by next\u2010generation sequencing (NGS). Mutations that were found by NGS were analyzed <jats:italic toggle=\"yes\">in vitro<\/jats:italic>. Of 42 patients, 8 had ALF without spontaneous recovery (NSR): Seven patients underwent liver transplantation (LT) and one patient died before LT. Of 42 patients, 34 (81%) had spontaneous recovery (SR) and cleared the infection, achieving either anti\u2010HBs seroconversion or hepatitis B surface antigen (HBsAg) loss. HBV genotype (GT)\u2010D was the most frequent GT in patients with ALF. Mutations in HBV core, preS2, and small hepatitis B surface antigen (SHB) were more frequent in patients with ALF\u2010NSR compared with those with ALF\u2010SR or AHB. Amino acid deletions (del; 16\u201022 and 20\u201022) in preS2 and SHB mutation L49R were exclusively detected in patients with ALF\u2010NSR. <jats:italic toggle=\"yes\">In vitro <\/jats:italic>analyses reveal that these mutations did not influence HBsAg secretion or infectivity. <jats:italic toggle=\"yes\">Conclusion: <\/jats:italic>HBV GT\u2010D and increased variability in HBV core, preS2 region, and SHB are associated with a worse clinical outcome of acute HBV infection.<\/jats:p>","DOI":"10.1002\/hep.30279","type":"journal-article","created":{"date-parts":[[2018,9,19]],"date-time":"2018-09-19T10:35:57Z","timestamp":1537353357000},"page":"993-1003","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":26,"title":["Clinical Outcome and Viral Genome Variability of Hepatitis B Virus\u2013Induced Acute Liver Failure"],"prefix":"10.1097","volume":"69","author":[{"given":"Olympia E.","family":"Anastasiou","sequence":"first","affiliation":[{"name":"Institute of Virology,University Hospital of Essen, University of Duisburg\u2010Essen,Essen,Germany"},{"name":"Department of Gastroenterology and Hepatology,University Hospital of Essen,Essen,Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5417-9307","authenticated-orcid":false,"given":"Marek","family":"Widera","sequence":"additional","affiliation":[{"name":"Institute of Virology,University Hospital of Essen, University of Duisburg\u2010Essen,Essen,Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Westhaus","sequence":"additional","affiliation":[{"name":"Institute of Virology,University Hospital of Essen, University of Duisburg\u2010Essen,Essen,Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lejla","family":"Timmer","sequence":"additional","affiliation":[{"name":"Institute of Virology,University Hospital of Essen, University of Duisburg\u2010Essen,Essen,Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Korth","sequence":"additional","affiliation":[{"name":"Institute of Virology,University Hospital of Essen, University of Duisburg\u2010Essen,Essen,Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Gerken","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology,University Hospital of Essen,Essen,Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6069-7899","authenticated-orcid":false,"given":"Ali","family":"Canbay","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology,University Hospital of Magdeburg,Magdeburg,Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Todt","sequence":"additional","affiliation":[{"name":"Department of Molecular and Medical Virology,Ruhr University,Bochum,Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eike","family":"Steinmann","sequence":"additional","affiliation":[{"name":"Department of Molecular and Medical Virology,Ruhr University,Bochum,Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatjana","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Institute of Virology,University Hospital of D\u00fcsseldorf, University of D\u00fcsseldorf,D\u00fcsseldorf,Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Timm","sequence":"additional","affiliation":[{"name":"Institute of Virology,University Hospital of D\u00fcsseldorf, University of D\u00fcsseldorf,D\u00fcsseldorf,Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Verheyen","sequence":"additional","affiliation":[{"name":"Institute of Virology,University Hospital of Essen, University of Duisburg\u2010Essen,Essen,Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Ciesek","sequence":"additional","affiliation":[{"name":"Institute of Virology,University Hospital of Essen, University of Duisburg\u2010Essen,Essen,Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,2,11]]},"reference":[{"key":"hep30279-bib-0001-20241017","first-page":"714","article-title":"Acute liver failure: a life\u2010threatening disease","volume":"108","year":"2011","journal-title":"Dtsch Arztebl Int"},{"key":"hep30279-bib-0002-20241017","doi-asserted-by":"crossref","first-page":"2525","DOI":"10.1056\/NEJMra1208937","article-title":"Acute liver failure","volume":"369","year":"2013","journal-title":"N Engl J Med"},{"key":"hep30279-bib-0003-20241017","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1111\/j.1478-3231.2008.01782.x","article-title":"Aetiology and outcome of acute hepatic 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