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Molecular mechanisms underlying HBsAg negativity in occult HBV infection

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Abstract

Although genomic detection is considered the gold standard test on HBV infection identification, the HBsAg investigation is still the most frequent clinical laboratory request to diagnose HBV infection in activity. However, the non-detection of HBsAg in the bloodstream of chronic or acutely infected individuals has been a phenomenon often observed in clinical practice, despite the high sensitivity and specificity of screening assays standardized commercially and adopted in routine. The expansion of knowledge about the hepatitis B virus biology (replication/life cycle, genetic variability/mutability/heterogeneity), their biochemical and immunological properties (antigenicity and immunogenicity), in turn, has allowed to elucidate some mechanisms that may explain the occurrence of this phenomenon. Therefore, the negativity for HBsAg during the acute or chronic infection course may become a fragile or at least questionable result. This manuscript discusses some mechanisms that could explain the negativity for HBsAg in a serological profile of individuals with HBV infection in activity, or factors that could compromise its detection in the bloodstream during HBV infection.

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The authors declares that have no competing interests (financial or non-financial) related to the content of the specific article. The author further states that this paper comprises a review article and that for its compilation it did not require research involving human participants and/or animals.

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  1. Laboratory of Human Virology, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil

    R. A. A. Pondé

  2. Central Goiana de Sorologia, Imuno-hematologia e Biologia Molecular, Goiânia, Goiás, Brazil

    R. A. A. Pondé

  3. SUVISA – Superintendência de Vigilância em Saúde, Secretaria Estadual de Saúde, Coordenação Estadual de Controle das Hepatites Virais/CECHV, Goiás, Brazil

    R. A. A. Pondé

  4. Rua 7A Edifício RIOL, N° 158, 1° andar, sala 101, setor aeroporto, Goiânia, Goiás, Brazil, CEP: 74-075-030

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Pondé, R.A.A. Molecular mechanisms underlying HBsAg negativity in occult HBV infection. Eur J Clin Microbiol Infect Dis 34, 1709–1731 (2015). https://doi.org/10.1007/s10096-015-2422-x

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