Serological Characteristics and S-region Mutation Sites of Chronic Hepatitis B Patients with Coexistence of HBsAg and HBsAb
Objective To explore the serological differences between HBsAg/HBsAb double-positive patients and HBsAg single-positive patients,and to compare and analyze HBV S-region mutation sites between the two groups of patients,and to further uncover the underlying molecular mechanisms in HBsAg/HBsAb co-positive patients.Methods A total of 284 HBsAg/HBsAb double-positive patients and 519 HBsAg single-positive patients from Beijing Youan Hospital affiliated with Capital Medical University from June, 2021 to March,2023 were selected for the study.Age,ALT,AST,AST/ALT,TBiL,ALb,r-GT,HBsAg and HBsAg titer,as well as HBsAb,HBeAg,HBeAb,HBcAb and WBC were statistically analyzed,and the serological indexes of the two groups were then compared.Nineteen HBsAg/HBsAb double-positive patients and 19 HBsAg single-positive patients with successful amplification of HBV S region were sequenced and analyzed,and high-frequency mutation sites were counted to evaluate the characteristics of the mutations in the HBV S region,and to further identify the molecular mechanisms in HBsAg/HBsAb double-positive patients.Results HBsAg/HBsAb double-positive patients and HBsAg single-positive patients showed significant differences in gender,HBeAg,ALT,AST,TBiL,r-GT (P<0.05).There was no significant difference in age,HBeAb,HBcAb,AST/ALT,Alb and WBC between the two groups (P>0.05).The C genotype of HBsAg/HBsAb double-positive group accounted for 78.95％ (15/19),among which the mutation frequency of A113D/T,A317C/S,A45T,A86G,A87T,A96V,A97P were higher,and the C genotype of HBsAg single-positive group accounted for 84.21％ (16/19 ).The mutation frequencies of V159A,M47T,I213L,A317S,E44G and Q267L were higher,and the high-frequency mutation sites of the two groups were significantly different.Conclusion There are significant differences in serological and genetic mutation sites between double-positive and single-positive CHB patients.It is recommended to further investigate the underlying mechanism of co-existence of HBsAg and HBsAb by targeting different mutation sites in HBV S region.
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