Molecular Detection of Hepatitis B Virus Surface Antigen Mutants

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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.

For additional guidance on the transport of infectious substances in other languages, please click on the link below.


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) 789-6061; HCV (204) 789-5063
Fax: (204) 789-2082
  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.