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Hepatitis B Surface Antigen Variant with Multiple Mutations in the a Determinant in an Agammaglobulinemic Patient

By Alexandra Alexopoulou, Gerasimos Baltayiannis, Saffie Jammeh, Jenny Waters, Spyros P. Dourakis and Peter Karayiannis


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

Topics: Case Reports
Publisher: American Society for Microbiology
Year: 2004
DOI identifier: 10.1128/JCM.42.6.2861-2865.2004
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Provided by: PubMed Central
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