ABSTRACT
Objective To analyze the mutation characteristics of immune escape-associated mutations in the main hydrophilic region (MHR) of HBsAg in patients with drug-resistant mutations in HBV RT. Methods The clinical data were analyzed from 6917 patients with C-genotype HBV infection attending to the hospital from July 2007 to August 2017. And these patients were treated with nucleoside/nucleotide analogs (NAs) and received drug resistance tests. The detection rate of drugresistant mutations in HBV RT was determined and the mutation characteristics of MHR immune escape-related mutations in HBsAg between drug-resistant mutations of HBV RT group and wild-type of HBV RT group were compared. Results Classical drug-resistant mutations in HBV RT occurred in 2585 chronic hepatitis B (CHB) patients treated with antiviral therapy, and the overall detection rate was 37.37% (2585/6917). The overall mutation rate of MHR in the drug-resistant mutations group of HBV RT was significantly higher than that in the wild-type group (30.00% vs. 17.13%, P<0.05). It was found that the detection rates of sQ101K/R/H, sS114T/A/L, sT/I126S/N/A, sG130N/R/K/A, sM133T/I, sS143T/L, sA159V/G, sE164D/G in HBV RT drug-resistant mutations group were higher than those in RT wild-type group (P<0.05). Conclusions Patients with HBV RT resistant mutations have a higher detection rate of MHR immune escape mutations in HBsAg, which suggested that MHR immune escape related mutations were closely related to HBV RT drug-resistant mutations.
ABSTRACT
Hepatitis B virus (HBV) infection could lead to different clinical presentations and disease progresses, including acute and chronic hepatitis B, liver cirrhosis, hepatocellular carcinoma, and occult HBV infection, in which the interaction between virus and host plays an important role. Because HBV reverse transcriptase is lack of correction function, HBV is prone to generate mutations under the pressure of host immune response and antiviral drug treatment. Some mutations in the HBV S gene-encoding region can significantly attenuate antibody immune response against HBV and therefore affect clinical presentations and disease progression. Such mutations are termed immune escape-related mutations. In this paper, we mainly review the structure and functional characteristics of HBV S gene, the causes and forms of the immune escape-related mutation, its influence on clinical presentations and antiviral treatment response, as well as clinical detection methods.