Coppola N, Onorato L, Minichini C, Di Caprio G, Starace M, Sagnelli C, Sagnelli E. Clinical significance of hepatitis B surface antigen mutants. World J Hepatol 2015; 7(27): 2729-2739 [PMID: 26644816 DOI: 10.4254/wjh.v7.i27.2729]
Corresponding Author of This Article
Nicola Coppola, MD, PhD, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Via: L. Armanni 5, 80131 Naples, Italy. nicola.coppola@unina2.it
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Nov 28, 2015; 7(27): 2729-2739 Published online Nov 28, 2015. doi: 10.4254/wjh.v7.i27.2729
Clinical significance of hepatitis B surface antigen mutants
Nicola Coppola, Lorenzo Onorato, Carmine Minichini, Giovanni Di Caprio, Mario Starace, Caterina Sagnelli, Evangelista Sagnelli
Nicola Coppola, Lorenzo Onorato, Carmine Minichini, Giovanni Di Caprio, Mario Starace, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy
Caterina Sagnelli, Department of Clinical and Experimental Medicine and Surgery “F. Magrassi e A. Lanzara”, Second University of Naples, 80131 Naples, Italy
Author contributions: Coppola N has contributed to conception of the paper and draft the article; Onorato L has analyzed the role of HBsAg mutants associated with HCC development; Minichini C has analyzed the HBV virology and HBsAg structure; Di Caprio G has analyzed the role of HBsAg mutants associated with immune escape; Starace M has analyzed the HBV virology and HBsAg structure; Sagnelli C has analyzed the role of HBsAg mutants associated with failed HBsAg detection; Sagnelli E has contributed to conception of the paper and draft the article.
Conflict-of-interest statement: The authors declare no conflicts of interest regarding this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Nicola Coppola, MD, PhD, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Via: L. Armanni 5, 80131 Naples, Italy. nicola.coppola@unina2.it
Telephone: +39-8-15666719 Fax: +39-8-15666013
Received: June 30, 2015 Peer-review started: June 30, 2015 First decision: September 18, 2015 Revised: September 27, 2015 Accepted: November 13, 2015 Article in press: November 17, 2015 Published online: November 28, 2015
Core Tip
Core tip: Antibodies to the hepatitis B surface antigen (HBsAg) produced in response to hepatitis B virus infection or vaccination and those used in diagnostic assays to detect this antigen in serum are both directed against the ‘‘a’’ determinant region, common to all subtypes of the virus. Mutations occurring on the loops of the “a” determinant may be responsible for the lack of protection in immunized patients and in those individuals receiving hepatitis B immune globulin or for failed detection of HBsAg using commercial diagnostic assays. There is growing evidence in the last decade of the association between HBsAg mutations and the development of hepatocellular carcinoma (HCC), suggesting that the pre-S1 or pre-S2 large deletions are those prevalently associated with the development of HCC. This review article will focus on the clinical impact of the various HBsAg mutants.
