Seroconversion of HBsAG coincides with hepatitis A super-infection: A case report

Table 1 Clinical course of chronic hepatitis B virus infection

	September 2015	May 2016	June 2017	November 2018	June 2019	September 2019
	Start of NUC-therapy			Acute HAV-superinfection	Clearance of HBs antigen	Clearance of HBs antigen
HBs-antigen QL	Positive	Low	Low	Low	Negative	Negative
HBs antigen (IU/mL)	1 986.0	1 956.0	64.12	0.04	0.00	0.00
anti-HBs QL	Negative	Negative	Negative	Negative	Positive	Positive
anti-HBs (IU/mL)	Negative	Negative	Negative	Negative	159.21	380.29
anti-HBc IgM QL	Positive	Negative	Negative	Negative	Negative	Negative
HBe-antigen QL	Positive	Positive	Negative	Negative	Negative	Negative
anti-HBe	4371.0	2.94	1.37	Negative	Negative	Negative
HBV-PCR QL	Positive	Low	Low	Positive	Negative	Negative
HBV-PCR (IU/mL)	380000	20	150	< 10	BDL	BDL
GOT (U/L)	78	25	19	1334	14	13
GPT (U/L)	148	40	25	3387	20	20

Glutamic oxalacetic transaminase and glutamate pyruvate transaminase (Reference: 10-50 U/L). BDL: Below detection limit; HAV: Hepatitis A virus; GOT: Glutamic oxalacetic transaminase; GPT: Glutamate pyruvate transaminase; HBs: Hepatitis B surface; HBV: Hepatitis B virus; IgM: Immunoglobulin M; PCR: Polymerase chain reaction.