Use of PCR in resolving diagnostic difficulties potentially caused by genetic variation of hepatitis B virus.

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.

journal_name

J Clin Pathol

authors

van Deursen FJ,Hino K,Wyatt D,Molyneaux P,Yates P,Wallace LA,Dow BC,Carman WF

doi

10.1136/jcp.51.2.149

subject

Has Abstract

pub_date

1998-02-01 00:00:00

pages

149-53

issue

2

eissn

0021-9746

issn

1472-4146

journal_volume

51

pub_type

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