Abstract: A male patient with severe systemic diseases, positive for anti-
HBc and anti-
HBs and negative for all other HBV markers, including
HBsAg, since at least 4 years, showed a positivity for
HBeAg at a follow-up control in November 2008; HBV-DNA testing by real-time PCR evidenced very low levels of viremia (<40 IU/ml), direct sequencing of the
surface antigen-coding and
Pol/
RT coding regions allowed the identification of genotype D, serotype adw2, one immune escape mutation (
G145R) and no drug resistance mutations.