HBsAg-negative mono-infection with hepatitis B virus genotype G.
Infection with a genotype G strain of hepatitis B virus (HBV-G) often occurs as a co-infection with HBV genotype A. In mono-infection with HBV-G, the production of hepatitis B surface antigen (HBsAg), HBe antigen and anti-HBe seems diminished, hampering the serological diagnosis of HBV-G mono-infection. To corroborate this notion, we studied in detail a series of samples of a blood donor with transient HBV-G infection. In this donor, during the temporary presence of HBV DNA and the seroconversion to HBcore antibodies (anti-HBc), no HBsAg or hepatitis B e antigen was detected. During follow-up, no anti-HBe appeared. Multiple resistance mutations to lamivudine were present, demonstrating primary infection with a resistant HBV strain. Cloning and sequencing indicated that no other HBV genotype but genotype G was present. Like other HBV-G isolates, the DNA sequence of the HBsAg a-determinant showed no mutations that could explain the failure to detect HBsAg. Our findings demonstrate that HBV genotype G mono-infection occurs and that routine serology is unsuitable for its detection.
Department of Blood-borne Infections, Sanquin, Plesmanlaan 125, Amsterdam, the Netherlands. h.l.zaaijer@amc.uva.nl
H L
HL
Zaaijer
H J
HJ
Boot
P
P
van Swieten
M H G M
MH
Koppelman
H T M
HT
Cuypers
D000998:Antiviral Agents / Q000494:pharmacology; D001782:Blood Donors; D004279:DNA, Viral / Q000097:blood; D024882:Drug Resistance, Viral / Q000235:genetics; D005838:Genotype; D006509:Hepatitis B / Q000175:diagnosis / Q000276:immunology; D006510:Hepatitis B Antibodies / Q000097:blood* / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000097:blood / Q000235:genetics; D006515:Hepatitis B virus / Q000145:classification / Q000235:genetics* / Q000276:immunology; D006801:Humans; D019259:Lamivudine / Q000494:pharmacology; D008297:Male; D010802:Phylogeny; D012703:Serotyping
D000998:Antiviral Agents; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D019259:Lamivudine