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Basic Characteristics of Mutations
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Mutation Site
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E2G |
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Mutation Site Sentence
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A further 14 mutations were detected in HBsAg outside the HBs antigenic determinant region: E2G, I4T, A5S, T23I, Y100C, S167L, V168A, L175S, V177A, T189I, M198T, S204N, C221Y, and Y225S. |
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Mutation Level
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Amino acid level |
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Mutation Type
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Nonsynonymous substitution |
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Gene/Protein/Region
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S |
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Standardized Encoding Gene
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S
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Genotype/Subtype
|
- |
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Viral Reference
|
AB073832
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Functional Impact and Mechanisms
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Disease
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Hepatitis B Virus Infection
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Immune
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- |
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Target Gene
|
-
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Clinical and Epidemiological Correlations
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Clinical Information
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Y |
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Treatment
|
Ibrutinib |
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Location
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- |
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Literature Information
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PMID
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32978866
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Title
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Case of hepatitis B virus reactivation after ibrutinib therapy in which the patient remained negative for hepatitis B surface antigens throughout the clinical course
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Author
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Tsuruya K,Anzai K,Shioyama S,Ito A,Arase Y,Hirose S,Tanaka Y,Suzuki H,Kagawa T
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Journal
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Hepatology research : the official journal of the Japan Society of Hepatology
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Journal Info
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2021 Feb;51(2):239-244
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Abstract
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A 71-year-old man was diagnosed with B-cell chronic lymphocytic leukemia. He was negative for hepatitis B surface antigen (HBsAg), positive for antibodies against the hepatitis B surface and core, and negative for hepatitis B virus (HBV)-DNA before starting chemotherapy. A total of 13 months after the initiation of ibrutinib (a Bruton's tyrosine kinase inhibitor), the patient's alanine aminotransferase levels suddenly increased to 427 U/L. As the level of serum HBV-DNA increased to 5.2 logIU/mL, a diagnosis of HBV reactivation was made, whereas the patient remained negative for HBsAg. The patient's serum alanine aminotransferase levels normalized after the initiation of entecavir at a dose of 1 mg/day. However, it took >1 year to achieve an undetectable level of HBV-DNA, even with an add-on therapy of tenofovir disoproxil fumarate. Interestingly, the patient remained negative for HBsAg throughout the clinical course owing to triple HBsAg escape mutations: Q101K, M133L, and G145A.
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Sequence Data
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-
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