Coexistence of Hepatitis B Surface Antigen (HBsAg) and Heterologous Subtype-Specific Antibodies to HBsAg among Patients with Chronic Hepatitis B Virus Infection

Zhang, Jiming; Xu, Yu; Wang, Xinyu; Yin, Yong; Xiang-hui, WU; Weng, Xinhua; Lu, Mengji

doi:10.1086/513200

Cited by 89 publications

(133 citation statements)

References 20 publications

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“…This ratio is lower than the 8.9% reported by Lada et al [2006], but is close to the 4.9% of 411 chronic hepatitis B virus carriers investigated in China [Zhang et al, 2007], suggesting possible demographic or geographical variability in these statistical differences. The mechanism of the coexistence of HBsAg and anti-HBs is still not entirely clear, but one explanation might be the selection of the immune escape mutant.…”

Section: Discussioncontrasting

confidence: 47%

PreS deletion mutations of hepatitis B virus in chronically infected patients with simultaneous seropositivity for hepatitis‐B surface antigen and anti‐HBS antibodies

Huang

Qin

Zhang

et al. 2009

Journal of Medical Virology

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Hepatitis B surface antigen (HBsAg) and anti-HBs antibodies (anti-HBs) may coexist in certain chronic hepatitis B (CHB) patients. This study was designed to further explore the relationship between this coexistence and hepatitis B Virus (HBV) preS deletions. Sera of 28 patients carrying both HBsAg and anti-HBs (Group I) and those of another 28 HBsAg positive but anti-HBs negative patients (Group II) were collected from CHB patients. Direct sequencing of polymerase chain reaction products or sequencing of clones was applied to both groups to determine sequences of HBV preS and S genes. Genotyping of the S gene indicated that all sampled HBVs were either Genosubtype Ba or Genosubtype Ce. Seven samples in Group I harbored HBV preS deletion mutations. Three of the seven samples showed large deletion mutations in 3' terminus of preS1 and co-existence of the mutant type and the full-length wild type, and the remaining four samples showed deletion mutations in 5' terminus of preS2. All mutant strains were found to be genosubtype Ce. Only two samples in Group I showed G145R/A mutation. Only one sample in Group II contained preS deletion mutation. It is therefore concluded that HBV preS deletion mutations are likely to be related to the coexistence of HBsAg and anti-HBs in CHB patients (P-value = 0.024). Some immune reactions may select for the preS deletion in CHB patients with anti-HBs, the possible marker for immune selection.

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Section: Discussioncontrasting

confidence: 47%

PreS deletion mutations of hepatitis B virus in chronically infected patients with simultaneous seropositivity for hepatitis‐B surface antigen and anti‐HBS antibodies

Huang

Qin

Zhang

et al. 2009

Journal of Medical Virology

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“…Therefore, routine screening for HBV in schizophrenia patients is advocated, and HBV as well as hepatitis A immunization is recommended. In this study, 38.1% of HBsAg-positive patients showed coexistence of HBsAb, which was significantly higher than previously reported results of 3%-10% [22][23][24][25][26]. The coexistence of HBsAg and antiHBs was regarded simply as superinfection with a different subtype of HBV [27].…”

Section: Discussioncontrasting

confidence: 62%

“…The coexistence of HBsAg and antiHBs was regarded simply as superinfection with a different subtype of HBV [27]. Some studies have suggested that the coexistence of HBsAg and HBsAb is associated with high replicative activity of HBV and mutations in the viral surface gene, which may alter the antigenicity of HBsAg and lead to subsequent failure of HBsAb neutralization [22,23,28]. Additionally, some studies reported that coexistence of HBsAg and HBsAb could be detected in immunosuppressive patients with organ transplantation, HIV infection, and prolonged corticosteroid therapy [29][30][31].…”

Section: Discussionmentioning

confidence: 99%

Seroepidemiology of hepatitis B virus infection among Chinese schizophrenia patients

Zhu

Liu

Xue

et al. 2015

J Infect Dev Ctries

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Introduction: This study aimed to analyze the characteristics of HBsAg, HBsAb, coexistence of HBsAg and HBsAb, and the genotypic distribution of HBV in Chinese schizophrenia patients. Methodology: A total of 1,694 schizophrenia patients, 9-85 years of age, were recruited for the present study. HBsAg, HBsAb, and HBV DNA were detected with commercial methods. ALT, AST, γ-GT, TBIL, and IBIL were measured by an automatic biochemistry analyzer. All statistical analyses were performed with SPSS 13.0. Results: The seroprevalence of HBsAg and HBsAb in 1,649 schizophrenia patients was 11.0% and 54.6%, respectively. HBsAb seroprevalence significantly decreased with the duration of the disease (p = 0.0009). The lowest seroprevalence of HBsAg was determined in 9.4% of the patients who had had the illness for < 1 year, and then increased to 11.7%, 11.3% and 11.7% in the patients who had had the illness for 1-5 years, 6-10 years and > 10 years. HBsAg and HBsAb coexisted in 69 individuals, which comprised 4.2% of the total subjects, and in 38.1% of the HBsAg-positive patients. Additionally, HBV titers were quantified in 64 HBsAg-positive samples; the highest virus titer was 6.14×10 8 copies/mL, while 12 patients had less than 500 copies/mL. Moreover, among 48 HBV strains isolated from 62 HBsAg-positive samples, 33 and 15 strains belonged to genotypes C and B, respectively. Conclusion: Genotypes B and C HBV were the dominant genotypes distributed in schizophrenia patients, and the HBsAb seroprevalence significantly decreased with illness duration. Effective prevention strategies for against HBV transmission are required.

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“…Though the step of reverse transcription from pregenomic RNA to the minus DNA strand by HBV polymerase may produce a large number of viral variants, only the variants with selective advantages would grow. It is interesting that substitutions at aa residue 126 of HBsAg occurred frequently in patients with chronic HBV infection [42] . At least 5 different residues were found at aa position 126: I, T, S, A and, less frequently, N [33,35,36] .…”

Section: Discussionmentioning

confidence: 99%

“…PCR was performed over 30 cycles, with 1 min at 94 ° , 1 min at 50 ° and 2 min at 72 ° . Sequence analysis was performed directly with PCR products, using the primers 6DC 5 -GCACACGGAATTCCGAGGACTGGGGAC C-CTG-3 (nt 131-148) and S7D 5 -GACACCAAGCTTGGTTAGG-GTTTAAATGTATACC-3 (nt 845-825) [42] .…”

Section: Amplification and Sequence Analysis Of S Genementioning

confidence: 99%

Reduced Antigenicity of Naturally Occurring Hepatitis B Surface Antigen Variants with Substitutions at the Amino Acid Residue 126

et al. 2008

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Background: Substitutions at amino acid residue 126 of hepatitis B surface antigen (HBsAg) occur frequently in hepatitis B virus (HBV) isolates from patients with chronic HBV infection. These substitutions occur naturally, but their significance for viral persistence is unclear and requires further investigation. Methods: We amplified coding regions of HBsAg by PCR using sera from 1 patient chronically infected with HBV. Three representative clones of HBsAg with amino acid residues 126Ile (I), 126Thr (T) and 126Ser (S) were selected from sequenced clones. HBsAg 126Ala (A) mutants of subtype C/adr and D/adw were generated by site-directed mutagenesis. The HBsAg expression vectors were constructed and transiently transfected into HepG2 cells. The binding reactivity of HBsAg to anti-HBs antibodies was tested by chemiluminescent microparticle immunoassay and by immunofluorescence staining with polyclonal and monoclonal anti-HBs antibodies. Results: Diverse HBsAg variants with substitutions at amino acid residue 126 co-existed in a chronically infected HBV patient. HBsAg with the substitution 126S showed a significantly low antigenicity, while the binding reactivity to anti-HBs of other HBsAg with 126I, 126T and 126A were comparable. Conclusion: HBsAg with the 126S substitution has a reduced antigenicity, which may contribute to immune escape in chronic HBV infection.

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Coexistence of Hepatitis B Surface Antigen (HBsAg) and Heterologous Subtype-Specific Antibodies to HBsAg among Patients with Chronic Hepatitis B Virus Infection

Cited by 89 publications

References 20 publications

PreS deletion mutations of hepatitis B virus in chronically infected patients with simultaneous seropositivity for hepatitis‐B surface antigen and anti‐HBS antibodies

PreS deletion mutations of hepatitis B virus in chronically infected patients with simultaneous seropositivity for hepatitis‐B surface antigen and anti‐HBS antibodies

Seroepidemiology of hepatitis B virus infection among Chinese schizophrenia patients

Reduced Antigenicity of Naturally Occurring Hepatitis B Surface Antigen Variants with Substitutions at the Amino Acid Residue 126

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