Zhenge Han1, Yong Liu2, Jinshun Pan2, Yongchun Bi3, Jingli Liu2, Yi-Hua Zhou4. 1. Department of Laboratory Medicine, East China Sanatorium, Wuxi 214065, Jiangsu Province, China; Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China. 2. Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China; Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing 210008, China. 3. Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China. 4. Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China; Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China; Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing 210008, China. Electronic address: yzh20061111@yahoo.com.
Abstract
BACKGROUND: Hepatitis B e antigen (HBeAg) is a marker to indicate active replication of hepatitis B virus (HBV). Occult HBV infection (OBI), referred to persistence of HBV DNA in serum and/or liver without detectable serum hepatitis B surface (HBsAg), usually has low HBV DNA levels. The presence of HBeAg in OBI is unusual. METHODS: We report 2 patients who presented negative for HBsAg but positive for HBeAg and HBV DNA. HBV markers were quantified in the longitudinal sera in a period of 1-2years. The HBV DNA sequences were analyzed in 2 patients' sera and 1 patient's liver. RESULTS: Both patients were also positive for total anti-HBs and anti-HBc but negative for anti-HBe and anti-HBc IgM. HBV DNA levels were 234-567IU/ml in case 1 and 42-1130IU/ml in case 2. The alignment analysis of the S gene showed that HBV in both patients was genotype C, serotype adr. Cloning analysis of the a determinant of HBsAg showed that the immune escape mutants were predominant in both patients over the follow-up period. The HBV had double mutations (A1762T and G1764A) in the basal core promoter but had no mutation in the pre C/C gene in both patients. CONCLUSIONS: The patients with negative HBsAg but positive HBeAg may represent a unique type of OBI. Test for HBeAg would be critical to identifying such type of OBI.
BACKGROUND:Hepatitis B e antigen (HBeAg) is a marker to indicate active replication of hepatitis B virus (HBV). Occult HBV infection (OBI), referred to persistence of HBV DNA in serum and/or liver without detectable serum hepatitis B surface (HBsAg), usually has low HBV DNA levels. The presence of HBeAg in OBI is unusual. METHODS: We report 2 patients who presented negative for HBsAg but positive for HBeAg and HBV DNA. HBV markers were quantified in the longitudinal sera in a period of 1-2years. The HBV DNA sequences were analyzed in 2 patients' sera and 1 patient's liver. RESULTS: Both patients were also positive for total anti-HBs and anti-HBc but negative for anti-HBe and anti-HBc IgM. HBV DNA levels were 234-567IU/ml in case 1 and 42-1130IU/ml in case 2. The alignment analysis of the S gene showed that HBV in both patients was genotype C, serotype adr. Cloning analysis of the a determinant of HBsAg showed that the immune escape mutants were predominant in both patients over the follow-up period. The HBV had double mutations (A1762T and G1764A) in the basal core promoter but had no mutation in the pre C/C gene in both patients. CONCLUSIONS: The patients with negative HBsAg but positive HBeAg may represent a unique type of OBI. Test for HBeAg would be critical to identifying such type of OBI.
Authors: Julio Cesar Rendon; Fabian Cortes-Mancera; Juan Carlos Restrepo-Gutierrez; Sergio Hoyos; Maria-Cristina Navas Journal: PLoS One Date: 2017-07-07 Impact factor: 3.240
Authors: Francisca Sosa-Jurado; Daniel Meléndez-Mena; Nora H Rosas-Murrieta; Belinda Guzmán-Flores; Miguel A Mendoza-Torres; Roberto Barcenas-Villalobos; Luis Márquez-Domínguez; Paulina Cortés-Hernández; Julio Reyes-Leyva; Verónica Vallejo-Ruiz; Gerardo Santos-López Journal: PLoS One Date: 2018-10-10 Impact factor: 3.240