Clinical and virological significance of the co-existence of HBsAg and anti-HBs antibodies in hepatitis B chronic carriers.
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.
Colson
Philippe
P
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
Borentain
Patrick
P
Motte
Anne
A
Henry
Mireille
M
Moal
Valérie
V
Botta-Fridlund
Danielle
D
Tamalet
Catherine
C
Gérolami
René
R
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
D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D054303:HIV Reverse Transcriptase