case_images: PMC5936758_01
case_images: Chronological results for hepatitis B virus (HBV) and hepatitis C virus (HCV) studies. Y-axis indicates HBV (left) and HCV (right) viral load over time (X-axis). HCV RNA is indicated in yellow, HBV DNA in blue. HBV surface antibody (Anti-HBs), surface antigen (HBsAg), E antibody (anti-HBe), E antigen (HBeAg), and core antibody (anti-HBc) results are presented corresponding to the day of collection.
case_images: fmed-05-00097-g001.jpg
case_images: PMC5936758_01_fmed-05-00097-g001.jpg
case_images: F1
case_images: Prior to treatment initiation, HBV viral load was found to be <20 IU/ml (Figure 1). HBV monitoring of patients on direct-acting antiviral therapy (DAA). HBV viral load was checked and found to be 287 IU/ml (up from <20 IU/ml 1.5 and 3 months earlier) (Figure 1). HCV viral load was <15 IU/ml. Two weeks later, the patient returned for follow-up and was found to have undetectable HCV RNA and HBV viral load of 486 IU/ml (up from 287 IU/ml) (Figure 1). Center for Disease Control, Division of Viral Hepatitis Laboratory. Complete sequence results are presented (Figure S1 in Supplementary Material).
case_images: Schematic of the mutant genome. The in-frame deletion is not affecting the ORFS, but shortens pre-S2 and Pol by the corresponding two amino acids. A total of 1,380 truncates the polymerase to 82 amino acids.
case_images: fmed-05-00097-g002.jpg
case_images: PMC5936758_01_fmed-05-00097-g002.jpg
case_images: F2
case_images: Ag mutation, (3-5) T118M, P120T, P142T: S Ag mutations affecting the a-determinant, (6) polymerase: V173A, (7) nt 1380: frameshift mutation in 50% of reads, (8) X gene: frameshift mutation at 1,581 in 52% of reads, (9) premature stop codon at 1,619, truncating X from 154 to 71 aa, (10) core: basal core promoter mutation A1762T, and (11) core: basal core promoter mutation G1764A. A summary of the mutations and prior literature describing these mutations (Table 1; Table S2 in Supplementary Material) and a schematic of the mutations (Figure 2) are presented.