Acute hepatitis B virus infection despite vaccination in a patient treated by infliximab: a case report

BMC Gastroenterology

Table 1 Outcome of patient’s biological analyses over several follow-ups

	June 2011 Pre-infliximab evaluation	April 2019	January 2020 M-6	June 2020 HBV infection Diagnosis D0	July 2020 M + 1	February 2021	September 2021	March 2022
						Under HBV treatment (Since 09/2020)
						M + 8	M + 15	M + 21
Place of consultation	Gastroenterology	General practitioner	CeGIDD	CeGIDD	Infectious disease	Infectious disease	Infectious disease	Infectious disease
Infliximab treatment	−	+	+	+	+	+	+	+
Serology and HBV markers
HBV
HBsAg	Negative	Negative	Positive*	Positive	Positive	ND	ND	ND
HBsAg (IU/mL)	ND	ND	Positive (3.3)*	Positive (18,000)*	Positive (18,000)	Positive (5,100)	Negative (< 0.03)	Negative (< 0.03)
Anti-HBs Ab (IU/L)	Positive (15.4)	Positive (15)	Negative (5.3)	Negative (< 2)	Negative (< 2)	Negative (< 2)	Negative (8.3)	Positive (17.4)
Anti-HBc Ab	ND	Negative	Negative*	Positive	Positive	ND	ND	ND
Anti-HBc IgM Ab	ND	ND	Negative*	Positive*	Positive	ND	ND	ND
HBeAg	ND	ND	Positive*	Positive*	Positive	Positive	Negative	Negative
Anti-HBe Ab	ND	ND	Negative*	Negative*	Negative	Negative	Positive	Positive
HBV-DNA VL (log₁₀ IU/mL)	ND	ND	5.0*	8.0*	8.2	3.84	< 1 Detected HBV-DNA	< 1 Not detected HBV-DNA
Anti-HDV Ab	ND	ND	ND	Negative*	Negative	Negative	ND	ND
Anti-HCV Ab	Negative	ND	Negative	Negative	Negative	Negative	ND	Negative
Anti-HAV	ND	ND	ND	ND	Negative	Positive	ND	ND
Anti-HIV	ND	ND	Negative	Negative	Negative	Negative	Negative	Negative
Syphilis	ND	ND	ND	Prior syphilis treated or untreated, early syphilis or false positive		Negative	Negative	Negative
Liver function tests
ALT (ULN)	ND	ND	ND	4.2	3.8	3.4	1.1	1.8
AST (ULN)	ND	ND	ND	2.8	2	1.8	1	1.3

Qualitative HBs Antigen (Roche Cobas® Elecsys HBsAg II), Quantitative HBs Antigen (DiaSorin LIAISON® XL Murex HBsAg Quant), anti-HBs Antibodies (Roche Cobas® Elecsys Anti-HBs II), anti-HBc antibodies (Roche Cobas® Elecsys Anti-HBc II), anti-HBc antibodies IgM (Roche Cobas® Elecsys Anti-HBc IgM and DiaSorin LIAISON® XLHBc IgM), HBe Antigen and Antibodies (Roche Cobas® Elecsys HBeAg and anti-HBe). HBV viral load (HBV-VL) was determined by PCR (Xpert HBV viral load; Cepheid). Anti-HCV, HAV and HIV antibodies were detected using Elecsys anti-HCV II, anti-HAV II and HIV combi PT assays respectively (Roche Cobas®). Anti-HDV and syphilis antibodies were detected using Murex anti-HDV and Treponema screen assays respectively (DiaSorin LIAISON® XL)
ULN times over the upper limit of normal range. CeGIDD: free center for information, screening and diagnosis of HIV and STI; ND not determined
*Analyses added retrospectively after the HBV diagnosis in June 2020

ISSN: 1471-230X