Coexistence of hepatitis B surface antigen and anti-HBs in Chinese chronic hepatitis B virus patients relating to genotype C and mutations in the S and P gene reverse transcriptase region
Coexistence of hepatitis B surface antigen and anti-HBs in Chinese chronic hepatitis B virus patients relating to genotype C and mutations in the S and P gene reverse transcriptase region
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中国慢性乙型肝炎病毒患者乙型肝炎表面抗原与抗-HBs共存与C基因型及S、P基因逆转录酶区突变有关
DOI：
10.1007/s00705-011-1215-5
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发表时间：
2012-04-01
影响因子：
2.7
通讯作者：
Guan, Ming
中科院分区：
文献类型：
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作者：
Liu, Weiwei;Hu, Tingting;Guan, Ming
本研究旨在确定中国慢性B型肝炎（CH B）患者中HBsAg和抗-HBs共存的流行率，并分析感染的临床和病毒学特征，包括S基因和逆转录酶（RT）区的氨基酸（aa）模式。对54例（2.90%）HBsAg和抗-HBs均阳性的CHB患者进行了检测，并从其中52例患者和48例对照组患者中获得序列。使用内部方案扩增S基因和RT区序列并测序。在年龄、性别、丙氨酸氨基转移酶水平、HBeAg和HBcAb阳性率方面，抗-HBs阳性和阴性患者之间无显著差异。C基因型（P = 0.001）和抗-HBe抗体阳性（P = 0.027）在HBsAg+/抗-HBs+个体中的发生率显著增高。在S基因中，HBsAg+/抗-HBs+组的突变残基数明显高于对照组（每100个氨基酸1.88对1.02个取代，P = 0.022）。两组的氨基酸交换主要发生在N端区域（每100个氨基酸2.15对0.87个取代，P = 0.023）和“a”决定簇（每100个氨基酸3.61对1.56个取代，P = 0.049）。在RT区，HBsAg+/抗-HBs+患者每100个氨基酸的平均置换数明显高于对照组（2.34 vs 1.46，P = 0.040）。这项研究表明，在HBsAg阳性患者中抗-HBs共存的患病率和基因型C的频率增加，以及HBsAg和RT中涉及这些蛋白质功能重要区域的aa变异性。
We aimed to determine the prevalence of the coexistence of HBsAg and anti-HBs and to analyze the clinical and virological features of infection, including amino acid (aa) patterns of the S gene and reverse transcriptase (RT) region in Chinese chronic hepatitis B (CHB) patients. Fifty-four (2.90%) CHB patients who were positive for both HBsAg and anti-HBs were tested, and sequences were obtained from 52 of them as well as 48 patients from a control group. S gene and RT region sequences were amplified and sequenced using in-house protocols. There was no significant difference between patients with and without anti-HBs with regard to age, gender, alanine aminotransferase level, and the proportion positive for HBeAg and HBcAb. The occurrence of genotype C (P = 0.001) and anti-HBeAb positivity (P = 0.027) was significantly higher in HBsAg+/anti-HBs+ individuals. In the S gene, the number of mutated residues in the HBsAg+/anti-HBs+ group was markedly higher than in control patients (1.88 versus 1.02 substitutions per 100 amino acids, P = 0.022). The amino acid exchange occurred mostly within the N-terminal region (2.15 versus 0.87 substitutions per 100 amino acids, P = 0.023) and the “a” determinant (3.61 versus 1.56 substitutions per 100 amino acids, P = 0.049) in the two groups. In the RT region, the mean number of substitution per 100 aa showed a tendency to be significantly higher in HBsAg+/anti-HBs+ patients than in controls (2.34 versus 1.46, P = 0.040). This study showed a prevalence of coexistence of anti-HBs in HBsAg-positive patients and an increased frequency of genotype C and aa variability within both HBsAg and RT involving functionally important regions of those proteins.