Clinical Implications of Concurrent HBsAg/HBsAb Positivity (scape mutants) in patients with Chronic Hepatitis B infection
Abstract
AIM: Concurrent positivity for HBsAg and HBs antibody, a phenomenon closely related to HBsAg escape mutants, is an unusual serological pattern in hepatitis B virus (HBV) infection. There is limited information on the clinical course of patients with this serological pattern. Here, we aimed to describe and compare clinical features of patients with chronic HBV infection presented simultaneous HBsAg+/HBsAb+.
MATERIAL AND METHODS: This was a retrospective study on 309 patients with chronic HBV. The patients received either tenofovir, lamivudine, or no treatment based on the levels of liver enzymes. Serological profiles were recorded at and after six months of diagnosis. Statistical analysis was performed in SPSS 19.
RESULTS: From 309 chronically HBsAg positive patients, 10 (3.2%) showed concurrent positivity for HBsAg and HBsAb in their sera. There were no statistically significant associations between this pattern with either gender, age, and HBeAg status. However, there was a close association between HBsAg+/HBsAb+ status with seropositivity for anti-HBeAg (P=0.05). There were also no significant differences between AST and ALT levels (neither at the diagnosis and nor at the end of six months of diagnosis) between the distinct serological patterns.
CONCLUSION: It seems that patients with chronic HBV infection and persistent concurrent reactivity for HBsAg and HBsAb render comparable clinical course with those patients with single HBsAg positivity.
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