Virology and Serological Characteristics of Chronic Hepatitis B Patients with the Co-existence of HBsAg and Anti-HBs Antibodies

Zhu, Donglin; Chen, Wen-Si; Xu, Changzhi; Yu, Xiaolin; Xi, Yun

doi:10.7754/clin.lab.2020.200412

Cited by 6 publications

(9 citation statements)

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“…Although HBV DNA was undetectable, the patient had the risk for HBV reactivation and further treatment went into a dilemma. The irregular HBV DNA were also reported in different studies with the coexistence situation [18,96]. Antiviral therapies may decrease serum HBV-DNA levels, concealing the influence of serum HBV DNA levels on HCC development [71].…”

Section: Dilemma For Treatmentmentioning

confidence: 82%

“…A certain proportion of population may be confronted with coexistence of HBsAg and anti-HBs. The emergence of anti-HBs does not demonstrate that HBsAg can be completely or effectively eliminated 96 , the virus can replicate continuously with the presence of anti-HBs. While some individuals are prone to the coexistence in clinical practice.…”

Section: Clinical Characteristics and Significances In Coexistencementioning

confidence: 99%

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Paradoxical HBsAg and anti-HBs coexistence among Chronic HBV Infections: Causes and Consequences

Jiang¹,

Chang²,

Yan³

et al. 2021

Int. J. Biol. Sci.

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Hepatitis B surface antigen (HBsAg) and Hepatitis B surface antibody (anti-HBs) were reported simultaneously among Hepatitis B virus (HBV) infections. HBsAg is a specific indicator of acute or chronic HBV infections, while anti-HBs is a protective antibody reflecting the recovery and immunity of hosts. HBsAg and anti-HBs coexist during seroconversion and then form immune complex, which is rare detected in clinical cases. However, with the promotion of vaccination and the application of various antiviral drugs, along with the rapid development of medical technology, the coexistence of HBsAg and anti-HBs has become more prevalent. Mutations in the viral genomes, immune status and genetic factors of hosts may contribute to the coexistence. Novel HBsAg assays, with higher sensitivity and ability to detect mutations or immune complexes, can also yield HBsAg/anti-HBs coexistence. The discovery of coexistence has shattered the idea of traditional serological patterns and raised questions about the effectiveness of vaccines. Worth noting is that HBsAg/anti-HBs double positivity is strongly associated with progressive liver diseases, especially hepatocellular carcinoma. In conclusion, viral mutations, host factors, and methodology impacts can all lead to the coexistence of HBsAg and anti-HBs. This coexistence is not an indicator of improvement, as an increased risk of adverse clinical outcomes still exists.

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Section: Dilemma For Treatmentmentioning

confidence: 82%

Section: Clinical Characteristics and Significances In Coexistencementioning

confidence: 99%

Paradoxical HBsAg and anti-HBs coexistence among Chronic HBV Infections: Causes and Consequences

Jiang¹,

Chang²,

Yan³

et al. 2021

Int. J. Biol. Sci.

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“…However, some patients still have persistent HBV infection even when anti-HBs are positive. According to the large sample of epidemiological studies in different regions of the world, the prevalence rate of HBV infection with HBsAg and anti-HBs coexisting is about 2–10% [ 8 , 9 , 12 , 26 , 27 , 28 ]. This special phenomenon has important clinical significance.…”

Section: Discussionmentioning

confidence: 99%

T-Cell Receptor β Chain and B-Cell Receptor Repertoires in Chronic Hepatitis B Patients with Coexisting HBsAg and Anti-HBs

Zhan

Chang

Wu³

et al. 2022

Pathogens

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Antibodies in response to antigens are related to the immune repertoire of T- and B-cell receptors. However, some patients with chronic hepatitis B (CHB) have coexisting HBsAg and anti-HBsAg antibodies (anti-HBs) that cannot neutralize HBV. We attempted to investigate the repertoires that produce this response in CHB patients. The T-cell receptor β chain (TRB) and B-cell receptor (BCR) repertoires of peripheral blood genomic DNA were analyzed using MiXCR. T-cell receptor (TCR) cluster analysis was carried out by clusTCR, and motifs prediction was selected by Multiple Em for Motif Elicitation (MEME). A total of 76 subjects were enrolled, including 26 HBsAg and anti-HBs coexisting patients with CHB (DP group), 25 anti-HBs single-positive healthy people (SP group), and 25 CHB patients (CHB group). The clone length of BCR in 39, 90 was significantly different among these groups (p = 0.005, 0.036). The motif “CASSLG” in the DP group was significantly higher than SP and CHB groups and may relate to coexistence, and the motif “GAGPLT” was only shown in the SP group and may relate to anti-HB expression. These provide important insights into vaccine development and CHB treatment.

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“…Two patients had concurrent HBsAg/anti-HBs, a serological profile considered atypical in HBV infection. It is associated with viral mutations and host factors resulting in continuous HBV replication despite the presence of the neutralizing antibody [ 84 , 85 , 86 ]. The docking analysis showed good interaction between the HBsAg construction and HBsAg in all samples, including those with the HBsAg/anti-HBs positive phenotype.…”

Section: Discussionmentioning

confidence: 99%

Genomic Variability of Hepatitis B Virus Circulating in Brazilian Western Amazon

Roca

Villar

Lima

et al. 2022

Viruses

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The emergence of clinically relevant mutations in the hepatitis B virus (HBV) genome has been a matter of great debate because of the possibility of escape from the host’s immune system, the potential to cause more severe progression of liver diseases and the emergence of treatment-resistant variants. Here we characterized the circulating variants of HBV in Rondônia State, in the north of Brazil. Serum samples of 62 chronic HBV carriers were subjected to PCR assays and clinical data were collected. Mutations and genotypes were characterized through direct sequencing. The findings show the presence of subgenotypes A1 (54.83%, 34/62), D3 (16.13%, 10/62), F2 (16.13%, 10/62), A2 (4.84%, 3/62), D2 (3.23%, 2/62), D1 (1.61%, 1/62), D4 (1.61%, 1/62) and F4 (1.61%, 1/62). Deletions in the pre-S2 region were found in 13.79% (8/58) of the samples, mutations in the S gene in 59.68% (37/62) and RT mutations in 48.39% (30/62). We found a variable genotypic distribution in different locations and important mutations related to immune escape and drug resistance in Western Amazonia, which contributed to genetic surveillance and provided important information to help control the disease.

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Virology and Serological Characteristics of Chronic Hepatitis B Patients with the Co-existence of HBsAg and Anti-HBs Antibodies

Cited by 6 publications

References 0 publications

Paradoxical HBsAg and anti-HBs coexistence among Chronic HBV Infections: Causes and Consequences

Paradoxical HBsAg and anti-HBs coexistence among Chronic HBV Infections: Causes and Consequences

T-Cell Receptor β Chain and B-Cell Receptor Repertoires in Chronic Hepatitis B Patients with Coexisting HBsAg and Anti-HBs

Genomic Variability of Hepatitis B Virus Circulating in Brazilian Western Amazon

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