{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T15:44:12Z","timestamp":1767109452168,"version":"3.37.3"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T00:00:00Z","timestamp":1656460800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T00:00:00Z","timestamp":1656460800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Despite an effective vaccine, hepatitis B remains a major global health problem due to its significant morbidity and mortality. Vaccination in immunosuppressed patients such as those treated for an inflammatory bowel disease (IBD) can be less effective. This case describes an uncommon original diagnosis of an acute hepatitis B infection occurring in a vaccinated but immunocompromised IBD patient under long-term infliximab treatment. A low anti-HBs titer and the presence of HBsAg escape mutations are possible hypotheses to explain this unexpected infection.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 28-year-old Caucasian male, regularly followed-up for a Crohn\u2019s disease treated by infliximab, was regularly screened for sexually transmissible infections because of at-risk behaviors. Despite a correct immunization scheme against hepatitis B virus (HBV), an active HBV infection was diagnosed during one of those screenings. Retrospective testing of a sample collected 6\u00a0months earlier was in favor of an evolution from an acute hepatitis B toward a chronic hepatitis B. The patient has always had a low anti-HBs antibody levels (near the threshold of 10\u00a0IU\/L) possibly explaining his infection. In addition, HBV sequencing revealed a genotype A2 HBV strain, carrying the sD144A substitution on the S protein, known as a potential immune escape variant. Dual therapy combining tenofovir disoproxil fumarate and emtricitabine, active against HBV but also efficient as an HIV pre-exposure prophylaxis, was initiated. Ten months after treatment initiation, all surrogate biochemical and virological endpoints for HBV functional cure were achieved. Treatment and periodical monitoring are being maintained.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Emphasis should be placed on HBV screening, vaccination and regular monitoring of patients under long-term immunosuppressive therapy, particularly those with at-risk behaviors.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12876-022-02397-5","type":"journal-article","created":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T13:04:58Z","timestamp":1656507898000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Acute hepatitis B virus infection despite vaccination in a patient treated by infliximab: a case report"],"prefix":"10.1186","volume":"22","author":[{"given":"Juliette","family":"Besombes","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faouzi","family":"Souala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guillaume","family":"Bouguen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominique","family":"Guyader","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Grolhier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Thibault","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7873-2752","authenticated-orcid":false,"given":"Charlotte","family":"Pronier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,6,29]]},"reference":[{"issue":"4","key":"2397_CR1","doi-asserted-by":"publisher","first-page":"992","DOI":"10.1093\/clinids\/20.4.992","volume":"20","author":"KC Hyams","year":"1995","unstructured":"Hyams KC. Risks of chronicity following acute hepatitis B virus infection: a review. Clin Infect Dis. 1995;20(4):992\u20131000. https:\/\/doi.org\/10.1093\/clinids\/20.4.992.","journal-title":"Clin Infect Dis"},{"key":"2397_CR2","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1111\/liv.12055","volume":"33","author":"S Pol","year":"2013","unstructured":"Pol S. Management of HBV in immunocompromised patients. Liver Int. 2013;33:182\u20137. https:\/\/doi.org\/10.1111\/liv.12055.","journal-title":"Liver Int"},{"issue":"2","key":"2397_CR3","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1016\/j.jhep.2017.03.021","volume":"67","author":"P Lampertico","year":"2017","unstructured":"Lampertico P, Agarwal K, Berg T, Buti M, Janssen HLA, Papatheodoridis G, et al. EASL 2017 clinical practice guidelines on the management of hepatitis B virus infection. J Hepatol. 2017;67(2):370\u201398. https:\/\/doi.org\/10.1016\/j.jhep.2017.03.021.","journal-title":"J Hepatol"},{"issue":"6","key":"2397_CR4","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1016\/0923-2516(96)80899-5","volume":"146","author":"F Ni","year":"1995","unstructured":"Ni F, Fang D, Gan R, Li Z, Duan S, Xu Z. A new immune escape mutant of hepatitis B virus with an Asp to Ala substitution in aa144 of the envelope major protein. Res Virol. 1995;146(6):397\u2013407. https:\/\/doi.org\/10.1016\/0923-2516(96)80899-5.","journal-title":"Res Virol"},{"key":"2397_CR5","doi-asserted-by":"publisher","first-page":"S10","DOI":"10.1016\/j.cmi.2017.12.025","volume":"24","author":"JW Baddley","year":"2018","unstructured":"Baddley JW, Cantini F, Goletti D, G\u00f3mez-Reino JJ, Mylonakis E, San-Juan R, et al. ESCMID study group for infections in compromised hosts (ESGICH) consensus document on the safety of targeted and biological therapies: an infectious diseases perspective (Soluble immune effector molecules [I]: anti-tumor necrosis factor-\u03b1 agents). Clin Microbiol Infect. 2018;24:S10-20. https:\/\/doi.org\/10.1016\/j.cmi.2017.12.025.","journal-title":"Clin Microbiol Infect"},{"issue":"6","key":"2397_CR6","doi-asserted-by":"publisher","first-page":"1297","DOI":"10.1053\/j.gastro.2017.02.009","volume":"152","author":"R Loomba","year":"2017","unstructured":"Loomba R, Liang TJ. Hepatitis B reactivation associated with immune suppressive and biological modifier therapies: current concepts, management strategies, and future directions. Gastroenterology. 2017;152(6):1297\u2013309. https:\/\/doi.org\/10.1053\/j.gastro.2017.02.009.","journal-title":"Gastroenterology"},{"issue":"9","key":"2397_CR7","doi-asserted-by":"publisher","first-page":"1363","DOI":"10.1136\/gut.2004.040675","volume":"53","author":"M Esteve","year":"2004","unstructured":"Esteve M. Chronic hepatitis B reactivation following infliximab therapy in Crohn\u2019s disease patients: need for primary prophylaxis. Gut. 2004;53(9):1363\u20135. https:\/\/doi.org\/10.1136\/gut.2004.040675.","journal-title":"Gut"},{"issue":"1","key":"2397_CR8","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1007\/s10620-005-1295-8","volume":"50","author":"Y Ueno","year":"2005","unstructured":"Ueno Y, Tanaka S, Shimamoto M, Miyanaka Y, Hiyama T, Ito M, et al. Infliximab therapy for crohn?s Disease in a patient with chronic hepatitis B. Dig Dis Sci. 2005;50(1):163\u20136. https:\/\/doi.org\/10.1007\/s10620-005-1295-8.","journal-title":"Dig Dis Sci"},{"issue":"1","key":"2397_CR9","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1053\/j.gastro.2014.10.039","volume":"148","author":"KR Reddy","year":"2015","unstructured":"Reddy KR, Beavers KL, Hammond SP, Lim JK, Falck-Ytter YT. American gastroenterological association institute guideline on the prevention and treatment of hepatitis B virus reactivation during immunosuppressive drug therapy. Gastroenterology. 2015;148(1):215\u20139. https:\/\/doi.org\/10.1053\/j.gastro.2014.10.039.","journal-title":"Gastroenterology"},{"issue":"25","key":"2397_CR10","doi-asserted-by":"publisher","first-page":"3762","DOI":"10.3748\/wjg.v27.i25.3762","volume":"27","author":"G Axiaris","year":"2021","unstructured":"Axiaris G, Zampeli E, Michopoulos S, Bamias G. Management of hepatitis B virus infection in patients with inflammatory bowel disease under immunosuppressive treatment. World J Gastroenterol. 2021;27(25):3762\u201379. https:\/\/doi.org\/10.3748\/wjg.v27.i25.3762.","journal-title":"World J Gastroenterol"},{"issue":"5","key":"2397_CR11","doi-asserted-by":"publisher","first-page":"1485","DOI":"10.1002\/hep.23674","volume":"51","author":"AJ Hall","year":"2010","unstructured":"Hall AJ. Boosters for hepatitis B vaccination? Need for an evidence-based policy. Hepatology. 2010;51(5):1485\u20136. https:\/\/doi.org\/10.1002\/hep.23674.","journal-title":"Hepatology"},{"issue":"5","key":"2397_CR12","doi-asserted-by":"publisher","first-page":"1177","DOI":"10.1080\/21645515.2019.1574151","volume":"15","author":"SA Haykir","year":"2019","unstructured":"Haykir SA, Eser F. High dose hepatitis B vaccine is not effective in patients using immunomodulatory drugs: a pilot study. Hum Vaccines Immunother. 2019;15(5):1177\u201382. https:\/\/doi.org\/10.1080\/21645515.2019.1574151.","journal-title":"Hum Vaccines Immunother"},{"issue":"2","key":"2397_CR13","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1093\/ibd\/izx001","volume":"24","author":"PK Pratt","year":"2018","unstructured":"Pratt PK, David N, Weber HC, Little FF, Kourkoumpetis T, Patts GJ, et al. Antibody response to hepatitis B virus vaccine is impaired in patients with inflammatory bowel disease on infliximab therapy. Inflamm Bowel Dis. 2018;24(2):380\u20136. https:\/\/doi.org\/10.1093\/ibd\/izx001.","journal-title":"Inflamm Bowel Dis"},{"key":"2397_CR14","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.jcv.2017.02.001","volume":"89","author":"V Thibault","year":"2017","unstructured":"Thibault V, Servant-Delmas A, Ly TD, Roque-Afonso A-M, Laperche S. Performance of HBsAg quantification assays for detection of hepatitis B virus genotypes and diagnostic escape-variants in clinical samples. J Clin Virol. 2017;89:14\u201321. https:\/\/doi.org\/10.1016\/j.jcv.2017.02.001.","journal-title":"J Clin Virol"},{"issue":"10","key":"2397_CR15","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1038\/s41575-020-0296-6","volume":"17","author":"PA Revill","year":"2020","unstructured":"Revill PA, Tu T, Netter HJ, Yuen LKW, Locarnini SA, Littlejohn M. The evolution and clinical impact of hepatitis B virus genome diversity. Nat Rev Gastroenterol Hepatol. 2020;17(10):618\u201334. https:\/\/doi.org\/10.1038\/s41575-020-0296-6.","journal-title":"Nat Rev Gastroenterol Hepatol"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-022-02397-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12876-022-02397-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-022-02397-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T13:07:19Z","timestamp":1656508039000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-022-02397-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,29]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["2397"],"URL":"https:\/\/doi.org\/10.1186\/s12876-022-02397-5","relation":{},"ISSN":["1471-230X"],"issn-type":[{"type":"electronic","value":"1471-230X"}],"subject":[],"published":{"date-parts":[[2022,6,29]]},"assertion":[{"value":"20 January 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 June 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 June 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the case patient for publication of this report. A copy of the written consent is available for review by the Editor of this journal. '","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"322"}}