Evolution of Hepatitis B virus in an acute hepatitis B patient co-infected with genotypes B and C.
The interactions between different genotypes of Hepatitis B virus (HBV) in co-infected patients remain largely unknown, especially in acute infection. Here, the evolution of HBV strains was studied in an acute, self-limited hepatitis B patient co-infected with genotypes Ba (B2) and C. Virological analyses were performed at four time points after admission: T1 (5 days), T2 (11 days), T3 (22 days) and T4 (260 days). A dominant-genotype change from genotype C to Ba was found after anti-HBV e antigen (anti-HBe) seroconversion. Further clonal and phylogenetic analyses of the pre-S and pre-core/core regions of HBV were carried out to clarify the interactions between genotypes Ba and C. All clones propagated from T1 and T2 were of genotype C. In contrast, clones propagated from T3 (after anti-HBe seroconversion) were of genotype Ba, C and/or recombinant within the pre-S region. At T4, all clones were of genotype Ba with a 123 bp (from nt 3147 of the pre-S1 region to nt 54 of the pre-S2 region) in-frame pre-S deletion and had lost the start codon of the middle envelope protein and the nucleocapsid-binding site. Phylogenetic analysis showed that genetic distance was greater at T3 after seroconversion to anti-HBe. By using SimPlot, the breakpoint of one pre-S recombinant was located at nt 3069-3100 and the other two at nt 49-87. In conclusion, HBV genotype Ba may overtake genotype C as the predominant strain after anti-HBe seroconversion in acute hepatitis B. Recombination within the pre-S region emerged transiently and the pre-S deletion mutant was finally cleared.
Chen
Bing-Fang
BF
School of Medicine, Fu Jen Catholic University, Taipei, Taiwan.
Liu
Chun-Jen
CJ
Division of Gastroenterology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Jow
Guey-Mei
GM
School of Medicine, Fu Jen Catholic University, Taipei, Taiwan.
Chen
Pei-Jer
PJ
Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan.|Graduate Institute of Clinical Medicine, National Taiwan University Hospital, Taipei, Taiwan.|Division of Gastroenterology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Kao
Jia-Horng
JH
Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan.|Graduate Institute of Clinical Medicine, National Taiwan University Hospital, Taipei, Taiwan.|Division of Gastroenterology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.|Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan.
Chen
Ding-Shinn
DS
Graduate Institute of Clinical Medicine, National Taiwan University Hospital, Taipei, Taiwan.|Division of Gastroenterology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
D000208:Acute Disease; D000328:Adult; D000595:Amino Acid Sequence; D004279:DNA, Viral / Q000235:genetics; D019143:Evolution, Molecular; D005260:Female; D005838:Genotype; D006508:Hepatitis Antibodies / Q000097:blood*; D006509:Hepatitis B / Q000150:complications / Q000821:virology*; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000145:classification / Q000235:genetics*; D006526:Hepatitis C / Q000150:complications / Q000821:virology; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008969:Molecular Sequence Data; D010802:Phylogeny; D011401:Promoter Regions, Genetic; D011995:Recombination, Genetic; D014758:Viral Core Proteins / Q000235:genetics*
D004279:DNA, Viral; D006508:Hepatitis Antibodies; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies; D014758:Viral Core Proteins