Korean J Med.  2012 Nov;83(5):619-623.

A Case of Acute Hepatitis B by Occult HBV Infection without HbsAg Seroconversion

  • 1Department of Internal Medicine, Hanyang University School of Medicine, Seoul, Korea. noshin@hanyang.ac.kr


Many studies have recently reported reactivation in hepatitis B surface antigen (HBsAg)-negative subjects with the use of biologic agents such as rituximab. However, occult hepatitis B virus infection itself has little clinical impact. We experienced a case of acute exacerbation caused by occult hepatitis B infection without HBsAg seroconversion. No mutation was found on the major hydrophilic loop of the S protein. The patient recovered from acute exacerbation after antiviral therapy. In conclusion, acute exacerbation can be induced by occult hepatitis B virus infection itself without reactivation. In such a case, antiviral therapy should be considered.


Hepatitis B Surface Antigens; Hepatitis B; Rituximab
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