title: Hepatitis B surface antigen variant with multiple mutations in the a determinant in an agammaglobulinemic patient.
abstract: 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.
authors.affiliation: Academic Department of Medicine, Hippokration General Hospital, Athens, Greece.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Alexopoulou
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Baltayiannis
authors.forename: Saffie
authors.initials: S
authors.lastname: Jammeh
authors.forename: Jenny
authors.initials: J
authors.lastname: Waters
authors.forename: Spyros P
authors.initials: SP
authors.lastname: Dourakis
authors.forename: Peter
authors.initials: P
authors.lastname: Karayiannis
mesh_terms: 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
chemical_list: D000911:Antibodies, Monoclonal; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens