HBsAg Variants: Common Escape Issues

Mutations have been described in all of the four open reading frames of the hepatitis bvirus (hbv), however, from a clinical perspective the surface escape mutant is the mosttroublesome. hepatitis b surface antigen (hbsag) variants may impair diagnosis, or allowthe virus to escape vaccine-induced immunity or passive immunoglobulin therapy.hbv mutants with amino acid substitutions, within the common “a” determinant of hbsaghave been identified, and as a result, the hbsag cannot be detected in some assays(diagnostic-escape). in these situations, the hbsag mutants may arise in patients with ahbv infection, but they have been diagnosed as hbsag negative. this review deals withthe latest results on the performance of hbsag assays, as well as the reactivity of nativeand or recombinant mutants of hbsag.