Hepatitis B surface antigen variant with multiple mutations in the a determinant in an agammaglobulinemic patient.
A patient with agammaglobulinemia developed acute hepatitis that progressed to chronic liver disease with high levels of hepatitis B virus (HBV) DNA in the absence of detectable HBsAg. Sequencing of the a determinant region of HBsAg revealed multiple amino acid substitutions that, unusually, also included a substitution at position 122 that defines subtype specificity. All of these mutations had a profound effect on the antigenicity of this region, which led to the complete failure of variant detection by commercially available routine diagnostic assays or laboratory-based monoclonal antibody assays.
Alexopoulou
Alexandra
A
Academic Department of Medicine, Hippokration General Hospital, Athens, Greece.
Baltayiannis
Gerasimos
G
Jammeh
Saffie
S
Waters
Jenny
J
Dourakis
Spyros P
SP
Karayiannis
Peter
P
D000361:Agammaglobulinemia / Q000821:virology*; D000911:Antibodies, Monoclonal / Q000276:immunology; D001483:Base Sequence; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000737:chemistry / Q000235:genetics* / Q000276:immunology; D006515:Hepatitis B virus / Q000145:classification / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009154:Mutation; D017422:Sequence Analysis, DNA
D000911:Antibodies, Monoclonal; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens