The D144N mutation (aspartic acid to asparagine) is a recently identified, rare mutation that has been reported only four times previously: a vaccine breakthrough infection (genotype A2) in a patient who received a liver transplant from an anti-HBc positive donor, and in three HBV infected individuals from Iran, Tanzania, and China (genotypes D, A1, and C, respectively) [5, 20–22]. The gene discussed is KRT88P; the disease is infection.