<abstract xmlns="http://www.w3.org/1999/xhtml"><p>Hepatitis B virus (HBV) is an important pathogen responsible for serious diseases like chronic hepatitis, cirrhosis and liver cancer. Turkey is located in the intermediate endemic region based on the average HBV surface antigen positivity. The high replication capacity of HBV and the lack of proofreading activity of the reverse transcriptase (RT) enzyme makes the virus prone to mutations. In this study, S gene mutation which is detected in a chronic HBV case without any follow-up and treatment is presented. Although patient was HBsAg negative and anti-HBs positive in the examinations, the mutation analysis was performed upon the high level of HBV DNA load and sG145R (vaccine escape) mutation in S gene region and rtI169F, rtV173L, rtA181G and rtT184R mutations in pol gene region were detected. S gene region mutations may cause false negatives in diagnostic assays that detect HBsAg. At the same time, it is a public health problem because these HBV variants can also be transmitted by vertical and horizontal routes. Therefore, when atypical serological profiles are encountered, it is of utmost importance to remember S gene mutations and perform necessary analyses.</p></abstract>

Hepatitis B virus (HBV) is an important pathogen responsible for serious diseases like chronic hepatitis, cirrhosis and liver cancer. Turkey is located in the intermediate endemic region based on the average HBV surface antigen positivity. The high replication capacity of HBV and the lack of proofreading activity of the reverse transcriptase (RT) enzyme makes the virus prone to mutations. In this study, S gene mutation which is detected in a chronic HBV case without any follow-up and treatment is presented. Although patient was HBsAg negative and anti-HBs positive in the examinations, the mutation analysis was performed upon the high level of HBV DNA load and sG145R (vaccine escape) mutation in S gene region and rtI169F, rtV173L, rtA181G and rtT184R mutations in pol gene region were detected. S gene region mutations may cause false negatives in diagnostic assays that detect HBsAg. At the same time, it is a public health problem because these HBV variants can also be transmitted by vertical and horizontal routes. Therefore, when atypical serological profiles are encountered, it is of utmost importance to remember S gene mutations and perform necessary analyses.

A chronic hepatitis B patient infected with HBsAg diagnostic-escape strain in the presence of anti-HBs positivity

Department of Infectious Diseases and Clinical Microbiology

PCR Unit, Kocaeli University Faculty of Medicine

Research Center of Experimental Health Sciences

Department of Internal Medicine, Okmeydani Training and Research Hospital

Revista Romana de Medicina de Laborator

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Hepatitis B virus (HBV) is an important pathogen responsible for serious diseases like chronic hepatitis, cirrhosis and liver cancer. Turkey is located in the...

A chronic hepatitis B patient infected with HBsAg diagnostic-escape strain in the presence of anti-HBs positivity

Published Online: Nov 04, 2019

Page range: 421 - 426

Received: May 15, 2019

Accepted: Oct 07, 2019

DOI: https://doi.org/10.2478/rrlm-2019-0038

Keywords
HBsAg diagnostic test, vaccine-escape HBV variant, false negative HBsAg

© 2019 Serkan Aydemir et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

A chronic hepatitis B patient infected with HBsAg diagnostic-escape strain in the presence of anti-HBs positivity

Published Online: Nov 04, 2019

Page range: 421 - 426

Received: May 15, 2019

Accepted: Oct 07, 2019

DOI: https://doi.org/10.2478/rrlm-2019-0038

KeywordsHBsAg diagnostic test, vaccine-escape HBV variant, false negative HBsAg

© 2019 Serkan Aydemir et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
HBsAg diagnostic test, vaccine-escape HBV variant, false negative HBsAg