Case observation demonstrates breakthrough hepatitis B virus reactivation in a patient with HIV, indicating risks when switching regimens with low surface antibodies.
A patient in Japan with HIV began antiretroviral therapy because of acute hepatitis B virus (HBV) 15 years ago, with low hepatitis B surface antibody, and experienced breakthrough HBV reactivation 4 months after switching from bictegravir/emtricitabine/tenofovir alafenamide to cabotegravir/rilpivirine. An immune escape mutation, E164V, was identified in the isolated HBV DNA.
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Adachi et al. (2024) studied this question.
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