A 54-year-old male was admitted to our hospital because of general malaise and jaundice. He had been an asymptomatic hepatitis B surface antigen (HBsAg) carrier and persistently positive for anti-hepatitis B e antigen (HBeAg) and negative for HBV DNA polymerase. His serological examination on admission revealed negative for HBeAg and positive for HVB DNA polymerase (2930 cpm) and the stop codon point mutation from G to A at uncleotide 83 in the precore region (mutant HBV83) was detected by MSSA method. Fluminant hepatitis developed, but the he gradually recovered with a support of intensive treatment, including a plasma exchange procedure. Afterward interferon treatment was performed, which finally normalized his liver function and a mutant HBV was disappeared from his serum. In this case, we could not approve any trigger for occurence of fluminant hepatitis associated with a HBV mutant.
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