Hepatitis B surface antigen variant with multiple mutations in the a determinant in an agammaglobulinemic patient |
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Authors: | Alexopoulou Alexandra Baltayiannis Gerasimos Jammeh Saffie Waters Jenny Dourakis Spyros P Karayiannis Peter |
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Institution: | Academic Department of Medicine, Hippokration General Hospital, Athens, Greece. |
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Abstract: | 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. |
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