title: Clinical and virological significance of the co-existence of HBsAg and anti-HBs antibodies in hepatitis B chronic carriers.
abstract: The co-existence of hepatitis B surface antigen (HBsAg) and anti-HBs antibodies (HBsAb) in serum of hepatitis B virus (HBV)-chronic carriers has been previously associated with HBsAg-amino acid (aa) substitutions. However, the aa pattern of HBV-reverse transcriptase (RT) and the clinical settings associated with this serological profile remain largely unknown. We studied thirteen HBsAg-positive/HBsAb-positive patients. Newly diagnosed HBsAg-positive/HBsAb-negative patients (n=51) served as controls. HBsAg/RT sequences were obtained using in-house protocols. HBsAg-positive/HBsAb-positive patients were predominantly immunosuppressed (69%). Five presented advanced liver fibrosis. HBV DNA >5.0 log(10) copies/ml was significantly more frequent than in controls. A significantly higher aa variability was observed versus controls within HBsAg major hydrophilic region (MHR), especially the a-determinant, and within RT for regions overlapping the MHR, the a-determinant, and HBsAg C terminal region where drug resistance mutations occur. Further studies are needed to determine whether this higher HBsAg/HBV-RT variability might favor dissemination of anti-HBsAb escape HBV mutants and concomitantly alter nucleos(t)ide analogs efficacy.
authors.affiliation: Laboratoire de Virologie, Fédération Hospitalière de Bactériologie-Virologie Clinique et d'Hygiène, Centre Hospitalier Universitaire Timone, 264 rue Saint-Pierre 13385, Marseille Cedex 05, France. philippe.colson@ap-hm.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Colson
authors.forename: Patrick
authors.initials: P
authors.lastname: Borentain
authors.forename: Anne
authors.initials: A
authors.lastname: Motte
authors.forename: Mireille
authors.initials: M
authors.lastname: Henry
authors.forename: Valérie
authors.initials: V
authors.lastname: Moal
authors.forename: Danielle
authors.initials: D
authors.lastname: Botta-Fridlund
authors.forename: Catherine
authors.initials: C
authors.lastname: Tamalet
authors.forename: René
authors.initials: R
authors.lastname: Gérolami
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019943:Amino Acid Substitution; D002353:Carrier State / Q000453:epidemiology / Q000276:immunology / Q000503:physiopathology / Q000821:virology; D005260:Female; D005602:France / Q000453:epidemiology; D005838:Genotype; D054303:HIV Reverse Transcriptase / Q000235:genetics; D006510:Hepatitis B Antibodies / Q000097:blood*; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D019694:Hepatitis B, Chronic / Q000453:epidemiology / Q000276:immunology / Q000503:physiopathology / Q000821:virology; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D054303:HIV Reverse Transcriptase