Hepatitis B surface antigen variants in voluntary blood donors in Nanjing, China

Abstract

BackgroundHepatitis B virus (HBV) is still one of the serious infectious risks for the blood transfusion safety in China. One plausible reason is the emergence of the variants in the major antigenic alpha determinant within the major hydrophilic region (MHR) of hepatitis B surface antigen (HBsAg), which have been assumed to evade the immune surveillance and pose a challenge to the disease diagnosis. It is well documented that some commercial ELISA kits could detect the wild-type but not the mutant viruses. The high prevalence of HBV in China also impaired the application of nucleic acid testing (NAT) in the improvement of blood security. Molecular epidemiological study of HBsAg variations in China is still limited. This study was designed to identify the prevalence of mutations in the HBsAg in voluntary blood donors in Nanjing, China.MethodsA total of 20,326 blood units were enrolled in this study, 39 donors were positive for HBV S gene in the nested-PCR. Mutations in the major hydrophilic region (MHR; aa 99-169) were identified by direct sequencing of S region.ResultsAmong of 20,326 blood units in the Red Cross Transfusion Center of Nanjing from October 2008 to April 2009, 296 samples (1.46%, 296/20,326) were HBsAg positive in the 2 successive rounds of the ELISA test. In these HBsAg positive units, HBV S gene could be successfully amplified from 39 donors (13.18%, 39/296) in the nested-PCR. Sequence analysis revealed that 32 strains (82.1%, 32/39) belong to genotype B, 7 strains (17.9%, 7/39) to genotype C. Besides well known G145R, widely dispersed variations in the MHR of S region, were observed in 20 samples of all the strains sequenced.ConclusionsHBV/B and HBV/C are dominant in Nanjing, China. The mutations in the MHR of HBsAg associated with disease diagnosis are common.

Hepatitis B virus reactivation in HBsAg-negative patients is associated with emergence of viral strains with mutated HBsAg and reverse transcriptase

“…2000; Yong- Lin et al, 2012;Simon et al, 2013;Yao et al, 2013;Pezzano et al, 2011;Baclig et al, 2014;Lee et al, 2005;Moradi et al, 2012;Lin et al, 2013;Salpini et al, 2015). In contrast, two substitutions N131A observed here in a patient whose serum sample tested HBsAg-negative at time of HBV-R (pt 10) and S136F (pt 5) were not, to our knowledge, previously described.…”

Serological Patterns and Molecular Characterization of Occult Hepatitis B Virus Infection among Blood Donors

“…In a previous analysis of amino acid mutations in HBsAg-positive blood donors, the mutation ratio was found to be over 50% (51.3%, 20/39) (20). In contrast, in our OBI samples, 30.4% (21/69) of samples harbored mutations, and no G145R was found.…”

“…For example, genotypes A and D are rare in China, whereas genotype B and C are predominant, with genotype B being more frequent in the southern part of China and genotype C being more frequent in the northern part of China (19). Yong-Lin et al (20) investigated 39 HBsAg-positive blood donors from our city; 32 strains (82.1%, 32/39) were classified as genotype B, while seven strains (17.9%, 7/39) were classified as genotype C. No other genotypes were observed. In our OBI samples, the prevalence of genotype C was significantly higher than genotype B in donors with OBIs.…”

Female gender lost protective effect against disease progression in elderly patients with chronic hepatitis B

“…Furthermore, the prevalence of HBsAg in women found in national HBV survey2 or in volunteer blood donors11 actually was lower than that in men, so it is unlikely that the increased female proportion in cirrhosis after 50 years old is caused by gender disparity in prevalence of HBV infection.…”