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S3497 A Case of Hepatitis B Virus Reactivation Triggered by an Acute Epstein-Barr Virus Infection

Beran, Azizullah MD1; Haghbin, Hossein MD, MPH2; Sample, Jack2; Ghazaleh, Sami MD1; Aburayyan, Kanana MD1; Matar, Reem3; Burlen, Jordan MD1; Javaid, Toseef MD2; Nawras, Ali MD, FACG1

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The American Journal of Gastroenterology: October 2020 - Volume 115 - Issue - p S1
doi: 10.14309/ajg.0000000000000904
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Reactivation of Hepatitis B virus (HBV) is not an uncommon condition. It is known to occur with immunosuppressive therapy, especially with rituximab. There are several viral infections that can trigger HBV reactivation such as human immunodeficiency virus (HIV) infection. However, there is no reported case of HBV reactivation triggered by Epstein-Barr virus (EBV) infection in the literature. To date, we report the first case of reactivation of HBV secondary to acute EBV infection.


A 47-year-old Caucasian male with a remote history of resolved acute Hepatitis B virus infection, who presented to our hospital with severe acute hepatitis which manifested as epigastric pain, jaundice, dark urine, light-colored stools, hyperbilirubinemia, and transaminitis in the 1000s. Ultimately, the patient was diagnosed with reactivation of HBV triggered by acute EBV infection. After several days of supportive treatment, his hepatic function normalized. He was discharged with a scheduled follow-up at a hepatology clinic.


To date, this is the first case of HBV reactivation triggered by acute EBV infection described in the literature. In conclusion, EBV infection should be suspected as a trigger in cases with HBV reactivation, particularly when common etiologies are excluded.

© 2020 by The American College of Gastroenterology