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Ultra-deep sequencing reveals high prevalence and broad structural diversity of hepatitis B surface antigen mutations in a global population.

 Mikael Genca  ;  Kirsten HuÈbner  ;  Peter Gohl  ;  Anja Seffner  ;  Michael Weizenegger  ;  Dionysios Neofytos  ;  Richard Batrla  ;  Andreas Woeste  ;  Hyon-suk Kim  ;  Gaston Westergaard  ;  Christine Reinsch Eva Brill  ;  Pham Thi Thu Thuy  ;  Bui Huu Hoang  ;  Mark Sonderup  ;  C. Wendy Spearman  ;  Stephan Pabinger  ;  JeÂreÂmie Gautier  ;  Giuseppina Brancaccio  ;  Massimo Fasano  ;  Teresa Santantonio  ;  Giovanni B. Gaeta  ;  Markus Nauck  ;  Wolfgang E. Kaminski 
 PLoS One, Vol.12(5) : e0172101, 2017 
Journal Title
 PLoS One 
Issue Date
Amino Acid Substitution ; Genotype ; Global Health* ; Hepatitis B Surface Antigens/chemistry ; Hepatitis B Surface Antigens/genetics* ; Hepatitis B virus/immunology* ; High-Throughput Nucleotide Sequencing* ; Humans ; Hydrophobic and Hydrophilic Interactions ; Mutation*
The diversity of the hepatitis B surface antigen (HBsAg) has a significant impact on the performance of diagnostic screening tests and the clinical outcome of hepatitis B infection. Neutralizing or diagnostic antibodies against the HBsAg are directed towards its highly conserved major hydrophilic region (MHR), in particular towards its "a" determinant subdomain. Here, we explored, on a global scale, the genetic diversity of the HBsAg MHR in a large, multi-ethnic cohort of randomly selected subjects with HBV infection from four continents. A total of 1553 HBsAg positive blood samples of subjects originating from 20 different countries across Africa, America, Asia and central Europe were characterized for amino acid variation in the MHR. Using highly sensitive ultra-deep sequencing, we found 72.8% of the successfully sequenced subjects (n = 1391) demonstrated amino acid sequence variation in the HBsAg MHR. This indicates that the global variation frequency in the HBsAg MHR is threefold higher than previously reported. The majority of the amino acid mutations were found in the HBV genotypes B (28.9%) and C (25.4%). Collectively, we identified 345 distinct amino acid mutations in the MHR. Among these, we report 62 previously unknown mutations, which extends the worldwide pool of currently known HBsAg MHR mutations by 22%. Importantly, topological analysis identified the "a" determinant upstream flanking region as the structurally most diverse subdomain of the HBsAg MHR. The highest prevalence of "a" determinant region mutations was observed in subjects from Asia, followed by the African, American and European cohorts, respectively. Finally, we found that more than half (59.3%) of all HBV subjects investigated carried multiple MHR mutations. Together, this worldwide ultra-deep sequencing based genotyping study reveals that the global prevalence and structural complexity of variation in the hepatitis B surface antigen have, to date, been significantly underappreciated.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실)
Yonsei Authors
김현숙(Kim, Hyon Suk)
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