HBsAg-negative mono-infection with hepatitis B virus genotype G

• Published in: Journal of viral hepatitis 2011-11, Vol.18 (11), p.815-819
• Main Authors: Zaaijer, H. L., Boot, H. J., van Swieten, P., Koppelman, M. H. G. M., Cuypers, H. T. M.
• Format: Article
• Language: English
• Subjects: Antiviral Agents - pharmacology; Blood Donors; co-infection; DNA, Viral - blood; Drug Resistance, Viral - genetics; Genotype; genotype G; Hepatitis B - diagnosis; Hepatitis B - immunology; Hepatitis B Antibodies - blood; Hepatitis B Antibodies - immunology; Hepatitis B Surface Antigens - blood; Hepatitis B Surface Antigens - genetics; hepatitis B virus; Hepatitis B virus - classification; Hepatitis B virus - genetics; Hepatitis B virus - immunology; Humans; Lamivudine - pharmacology; Male; occult infection; Phylogeny; Serotyping
• ISSN: 1352-0504; 1365-2893
• DOI: 10.1111/j.1365-2893.2010.01397.x

Infection with a genotype G strain of hepatitis B virus (HBV‐G) often occurs as a co‐infection with HBV genotype A. In mono‐infection with HBV‐G, the production of hepatitis B surface antigen (HBsAg), HBe antigen and anti‐HBe seems diminished, hampering the serological diagnosis of HBV‐G mono‐infection. To corroborate this notion, we studied in detail a series of samples of a blood donor with transient HBV‐G infection. In this donor, during the temporary presence of HBV DNA and the seroconversion to HBcore antibodies (anti‐HBc), no HBsAg or hepatitis B e antigen was detected. During follow‐up, no anti‐HBe appeared. Multiple resistance mutations to lamivudine were present, demonstrating primary infection with a resistant HBV strain. Cloning and sequencing indicated that no other HBV genotype but genotype G was present. Like other HBV‐G isolates, the DNA sequence of the HBsAg a‐determinant showed no mutations that could explain the failure to detect HBsAg. Our findings demonstrate that HBV genotype G mono‐infection occurs and that routine serology is unsuitable for its detection.