Molecular Detection of Hepatitis B Virus Surface Antigen Mutants<<Return to Laboratory
Molecular detection of Hepatitis B virus surface antigen mutants by conventional PCR and sequence analysis.
- Hepatitis B
Serum or plasma sample. Minimum volume required for serum or plasma – 1.0 mL.
Collect blood in serum separator tubes (SST) or EDTA tubes.
Store samples frozen until shipped for testing. Ship frozen on dry ice.
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.
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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).
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.
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.
19 calendar days.
- Osiowy C. Detection of HBsAg mutants. J Med Virol 2006 78:S48-S51.
- 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.