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Molecular Detection of Hepatitis B Virus Surface Antigen Mutants

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Requisition Forms

Reference Details


Molecular detection of Hepatitis B virus surface antigen mutants by conventional PCR and sequence analysis.

Test Category:
Molecular Detection
Hepatitis B virus (HBV)
Illnesses and Diseases:
  • Hepatitis B

Serum or plasma sample. Minimum volume required for serum or plasma – 1.0 mL.

Collection Method:

Collect blood in serum separator tubes (SST) or EDTA tubes.

Specimen Processing, Storage and Shipping:

Store samples frozen until shipped for testing. Ship frozen on dry ice.

Transportation of Dangerous Goods:

Shipping of specimens shall be done by a TDG certified individual in accordance with TDG regulations. For additional information regarding classification of specimens for the purposes of shipping, consult either Part 2 Appendix 3 of the TDG Regulations or section 3.6.2 of the IATA Dangerous Goods Regulations as applicable.


Patient Criteria:

Suspected Hepatitis B infection.  Serology results must show markers consistent with a possible immune or diagnostic escape (i.e., HBsAg positive/anti-HBs positive; HBsAg non-confirmatory/discrepant diagnostic results) or the patient is suspected of having an immune escape (post-vaccine breakthrough infection; post-OLT reactivation despite HBIg; etc.). HBV DNA results must be positive (i.e., must have detectable viral load).

Accompanying Documentation:

Completed Viral Hepatitis and Bloodborne Pathogens requisition including sender name, address and telephone number.  Patient name or identifier (referring specimen lab #), date of birth, suspected exposure, test(s) requested and the reason for a suspected immune escape.  Type of specimen and date collected.  If possible, include the clinical history (particularly vaccine history) and lab results (particularly HBsAg primary and confirmatory S/CO results) that have already been done at local or provincial laboratories.



Methods and Interpretation of Results:

Conventional PCR followed by sequence alignment and analysis in comparison to HBV reference sequences. Specific known amino acid substitutions within the antigenic determinant and/or preS deletions may indicate immune escape/loss of HBsAg expression. 


Turnaround Time:

19 calendar days.

Phone #: (204) 789-6512
Fax: (204) 318-2222
  1. Osiowy C. Detection of HBsAg mutants. J Med Virol 2006 78:S48-S51.
  2. Coppola N, Onorato L, Minichini C, Di Caprio G, Starace M, Sagnelli C, Sagnelli E. Clinical significance of hepatitis B surface antigen mutants. World J Hepatol 2015 7:2729-2739.