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Acute hepatitis B virus infection with delayed appearance of hepatitis B core antibody in an immunocompromised patient: a case report

Overview of attention for article published in Journal of Medical Case Reports, April 2017
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About this Attention Score

  • Above-average Attention Score compared to outputs of the same age (54th percentile)
  • High Attention Score compared to outputs of the same age and source (81st percentile)

Mentioned by

twitter
4 tweeters

Citations

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6 Dimensions

Readers on

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24 Mendeley
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Title
Acute hepatitis B virus infection with delayed appearance of hepatitis B core antibody in an immunocompromised patient: a case report
Published in
Journal of Medical Case Reports, April 2017
DOI 10.1186/s13256-017-1264-9
Pubmed ID
Authors

Nicholas Brousseau, Donald G. Murphy, Vladimir Gilca, Jacynthe Larouche, Sema Mandal, Richard S. Tedder

Abstract

Despite the introduction of universal hepatitis B immunization programs worldwide, outbreaks of acute infection still occur in unimmunized individuals. A timely diagnosis of hepatitis B is necessary to ensure adequate clinical care and public health interventions that will reduce transmission. Yet, interpretation of hepatitis B serological markers can be complex. We present a case of hepatitis B with atypical markers, including delayed appearance of hepatitis B core antibody. A 62-year-old white woman was identified as a sexual contact of a male individual with acute hepatitis B virus infection. She had a history of recurrent low-grade non-Hodgkin lymphoma and had recently received immunosuppressive therapy. At baseline she had a negative serology and received three double doses (40 μg) of Engerix-B vaccine (hepatitis B vaccine) with a 0-month, 1-month, and 6-month schedule. One month following the last dose, hepatitis B surface antigen was positive in the absence of hepatitis B core antibody. The only sign of infection was a slight elevation of alanine aminotransferase enzymes a few months after first sexual contacts with the male individual. Hepatitis B virus infection was later confirmed despite the absence of hepatitis B core antibody. The development of hepatitis B core antibody was finally noted more than 6 months after the first positive hepatitis B surface antigen and more than 12 months after elevation of alanine aminotransferase enzymes. Immunosuppression including rituximab treatment was the most likely explanation for this serological profile. On her last medical assessment, she had not developed HBeAg seroconversion despite lower hepatitis B virus deoxyribonucleic acid levels with tenofovir treatment. When confronted with positive hepatitis B surface antigen in the absence of hepatitis B core antibody, consideration should be given to the possibility of both acute and persistent infection particularly in the setting of immunosuppression so that appropriate clinical management and public health interventions can take place. Given the increasing use of biologicals such as anti-tumor necrosis factor therapies either alone or with other immunosuppressive agents, this phenomenon may be encountered more frequently.

Twitter Demographics

The data shown below were collected from the profiles of 4 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 24 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 24 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 7 29%
Student > Bachelor 4 17%
Student > Ph. D. Student 3 13%
Student > Postgraduate 2 8%
Researcher 1 4%
Other 1 4%
Unknown 6 25%
Readers by discipline Count As %
Medicine and Dentistry 6 25%
Immunology and Microbiology 3 13%
Nursing and Health Professions 2 8%
Economics, Econometrics and Finance 2 8%
Computer Science 1 4%
Other 4 17%
Unknown 6 25%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 May 2017.
All research outputs
#6,240,831
of 11,330,364 outputs
Outputs from Journal of Medical Case Reports
#404
of 1,684 outputs
Outputs of similar age
#116,294
of 264,187 outputs
Outputs of similar age from Journal of Medical Case Reports
#15
of 86 outputs
Altmetric has tracked 11,330,364 research outputs across all sources so far. This one is in the 43rd percentile – i.e., 43% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,684 research outputs from this source. They receive a mean Attention Score of 3.4. This one has gotten more attention than average, scoring higher than 74% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 264,187 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 54% of its contemporaries.
We're also able to compare this research output to 86 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 81% of its contemporaries.