Concurrent HBsAg and Anti-HBs Induced by a PreS Deletion Mutant in a Chronic Hepatitis B Patient

Wu W1, Chen Y2, Hollinger FB3, Huang X1*

1Department of Transfusion Medicine, The 960th Hospital of the PLA Joint Logistics Support Force, China
2Department of Clinical Laboratory, The 960th Hospital of the PLA Joint Logistics Support Force, China
3Departments of Molecular Virology and Microbiology and Medicine, Baylor College of Medicine, USA

^*Correspondance to: Xiangyan Huang 

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Abstract:

Background: Hepatitis B Virus (HBV) infection is a serious global health problem. This coexistence of HBsAg and anti-HBs is generally considered to be the result of immune-associated escape mutations which include deletion and point mutations within the preS/S region of the genome. This case report reveals another mechanism. Case Report: This study was designed to analyze the reasons for concurrent HBsAg and anti-HBs in a patient with chronic HBV infection. Serological markers of HBV infection were determined by ELISA. The preS/S gene were analyzed by gene amplification and sequencing. The tests revealed that HBsAg and anti-HBs coexisted in this patient with mixed infections of full-length preS/S virus strain and preS1 183 bp deletion mutant, and the mutant disappeared along with the anti-HBs after one year, which means that the mutant strain was cleared by the detected antibodies. Conclusion: It is speculated that the production of anti-HBs targeted specifically to the preS1 deletion mutant strain instead of the strain with full-length large S protein. This is quite different from the other immunopathogenetic mechanism for concurrent HBsAg and anti-HBs.

Keywords:

Hepatitis B virus; Chronic Hepatitis B; HBsAg; anti-HBs; preS deletion mutant

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