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Infections acquired under these conditions often persist, like those acquired perinatally or during early infancy. We studied the long\u2010term clinical outcomes, viral characteristics, and virus\u2010specific T\u2010cell immunity of chronic HBV infection acquired during chemotherapy. We examined 16 chronically HBV\u2010infected former paediatric oncology patients who were infected during cytostatic treatment in the 1980s. Patients underwent physical examination, laboratory liver function testing, non\u2010invasive measurement of liver stiffness, and determination of HBV serology and DNA levels. If the material was sufficient, HBV sub\u2010genotype, drug resistance and immune escape mutations, and mutations associated with HBeAg negativity were analysed. The frequency of HBV core\u2010specific CD8+ T cells was measured after in\u00a0vitro antigen\u2010specific expansion. All but one patient were chronically infected with detectable HBsAg but were HBeAg\u2010negative, mostly with low viraemia. Four patients were under ongoing effective antiviral therapy, and four required treatment initiation due to high viraemia or advanced liver disease. Hepatic effects were predominantly observed in highly viraemic patients. No drug resistance or immune escape mutations were observed. In two highly viraemic patients, basal core promoter and precore region mutations reducing HBeAg expression were identified. HBV core\u2010specific CD8+ T cells were detected in all patients, but their frequency was low. In conclusion, more than 30\u2009years after primary HBV infection was acquired during chemotherapy, the course of infection still resembles that of perinatally acquired infections.<\/jats:p>","DOI":"10.1111\/jvh.70111","type":"journal-article","created":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T08:25:57Z","timestamp":1765009557000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Chronic Hepatitis B Virus Infection Acquired Under Cytostatic Treatment in Childhood \u2014 Clinical, Virological and Immunological Long\u2010Term Follow\u2010Up"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0796-9845","authenticated-orcid":false,"given":"Thomas","family":"Baumgarten","sequence":"first","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine University Hospital Erlangen &amp; Friedrich\u2010Alexander\u2010Universit\u00e4t Erlangen\u2010N\u00fcrnberg (FAU)  Erlangen Germany"},{"name":"Department of Paediatric Haematology and Oncology University Children's Hospital Tuebingen  Tuebingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Lehmann","sequence":"additional","affiliation":[{"name":"Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Zu Berlin Institute of Virology  Berlin Germany"},{"name":"Institute of Medical Virology Justus Liebig University Giessen  Giessen Germany"},{"name":"National Reference Centre for Hepatitis B and D Viruses  Giessen Germany"},{"name":"German Center for Infection Research (DZIF), partner Site Giessen\u2010Marburg\u2010Langen  Giessen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tina","family":"Senff","sequence":"additional","affiliation":[{"name":"Institute of Pathology and Molecular Pathology, Helios University Clinic Wuppertal Witten\/Herdecke University  Witten Germany"},{"name":"Institute of Virology, Medical Faculty and University Hospital D\u00fcsseldorf Heinrich\u2010Heine\u2010University D\u00fcsseldorf  Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heiko","family":"Slanina","sequence":"additional","affiliation":[{"name":"Institute of Medical Virology Justus Liebig University Giessen  Giessen Germany"},{"name":"National Reference Centre for Hepatitis B and D Viruses  Giessen Germany"},{"name":"German Center for Infection Research (DZIF), partner Site Giessen\u2010Marburg\u2010Langen  Giessen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian G.","family":"Sch\u00fcttler","sequence":"additional","affiliation":[{"name":"Institute of Medical Virology Justus Liebig University Giessen  Giessen Germany"},{"name":"National Reference Centre for Hepatitis B and D Viruses  Giessen Germany"},{"name":"German Center for Infection Research (DZIF), partner Site Giessen\u2010Marburg\u2010Langen  Giessen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Walker","sequence":"additional","affiliation":[{"name":"Institute of Virology, Medical Faculty and University Hospital D\u00fcsseldorf Heinrich\u2010Heine\u2010University D\u00fcsseldorf  Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfram H.","family":"Gerlich","sequence":"additional","affiliation":[{"name":"Institute of Medical Virology Justus Liebig University Giessen  Giessen Germany"},{"name":"National Reference Centre for Hepatitis B and D Viruses  Giessen Germany"},{"name":"German Center for Infection Research (DZIF), partner Site Giessen\u2010Marburg\u2010Langen  Giessen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reinald","family":"Repp","sequence":"additional","affiliation":[{"name":"Children's Hospital Fulda  Fulda Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rg","family":"Timm","sequence":"additional","affiliation":[{"name":"Institute of Virology, Medical Faculty and University Hospital D\u00fcsseldorf Heinrich\u2010Heine\u2010University D\u00fcsseldorf  Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5039-0252","authenticated-orcid":false,"given":"Dieter","family":"Glebe","sequence":"additional","affiliation":[{"name":"Institute of Medical Virology Justus Liebig University Giessen  Giessen Germany"},{"name":"National Reference Centre for Hepatitis B and D Viruses  Giessen Germany"},{"name":"German Center for Infection Research (DZIF), partner Site Giessen\u2010Marburg\u2010Langen  Giessen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4523-1676","authenticated-orcid":false,"given":"Markus","family":"Metzler","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine University Hospital Erlangen &amp; 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