Use of PCR in Resolving Diagnostic Difficulties Potentially Caused by Genetic Variation of Hepatitis B Virus

Overview

Journal J Clin Pathol

Specialty Pathology

Date 1998 May 29

PMID 9602690

Citations 6

Authors

F J van Deursen

K Hino

D Wyatt

P Molyneaux

P Yates

L A Wallace

B C Dow

W F Carman

Affiliations

Soon will be listed here.

Abstract

Aims: To assess the relevance of genetic variants of hepatitis B virus (HBV) and to demonstrate the usefulness of the polymerase chain reaction (PCR) in cases of HBV diagnostic difficulty.

Methods: Five serum samples from patients that presented diagnostic difficulty in routine laboratories were sent to a research laboratory for PCR, and if appropriate, S gene sequencing, in vitro expression, and antigenic analysis.

Results: The demonstration of HBV in serum by PCR allowed a definitive diagnosis of current infection. One serum sample with poor reactivity in a diagnostic assay had a minor hepatitis B surface antigen (HBsAg) variant and another with very poor reactivity had multiple variants of HBsAg. Transient HBsAg reactivity was observed in a recently vaccinated patient. A hepatitis Be antigen (HBeAg) false positive reaction was noted in a patient from a well defined risk group for HBV. One patient who was strongly HBsAg/HBeAg positive, but anti-hepatitis B core antibody negative, was viraemic.

Conclusions: PCR may become the gold standard for the diagnosis of current HBV infection. HBV variants are responsible for a proportion of diagnostically difficult cases. Modification of commercial assays is necessary to increase the sensitivity of detection of such variants.

Citing Articles

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