HBsAg-negative mono-infection with hepatitis B virus genotype G

J Viral Hepat. 2011 Nov;18(11):815-9. doi: 10.1111/j.1365-2893.2010.01397.x. Epub 2010 Nov 29.


Infection with a genotype G strain of hepatitis B virus (HBV-G) often occurs as a co-infection with HBV genotype A. In mono-infection with HBV-G, the production of hepatitis B surface antigen (HBsAg), HBe antigen and anti-HBe seems diminished, hampering the serological diagnosis of HBV-G mono-infection. To corroborate this notion, we studied in detail a series of samples of a blood donor with transient HBV-G infection. In this donor, during the temporary presence of HBV DNA and the seroconversion to HBcore antibodies (anti-HBc), no HBsAg or hepatitis B e antigen was detected. During follow-up, no anti-HBe appeared. Multiple resistance mutations to lamivudine were present, demonstrating primary infection with a resistant HBV strain. Cloning and sequencing indicated that no other HBV genotype but genotype G was present. Like other HBV-G isolates, the DNA sequence of the HBsAg a-determinant showed no mutations that could explain the failure to detect HBsAg. Our findings demonstrate that HBV genotype G mono-infection occurs and that routine serology is unsuitable for its detection.

MeSH terms

  • Antiviral Agents / pharmacology
  • Blood Donors
  • DNA, Viral / blood
  • Drug Resistance, Viral / genetics
  • Genotype
  • Hepatitis B / diagnosis
  • Hepatitis B / immunology
  • Hepatitis B Antibodies / blood*
  • Hepatitis B Antibodies / immunology
  • Hepatitis B Surface Antigens* / blood
  • Hepatitis B Surface Antigens* / genetics
  • Hepatitis B virus / classification
  • Hepatitis B virus / genetics*
  • Hepatitis B virus / immunology
  • Humans
  • Lamivudine / pharmacology
  • Male
  • Phylogeny
  • Serotyping


  • Antiviral Agents
  • DNA, Viral
  • Hepatitis B Antibodies
  • Hepatitis B Surface Antigens
  • Lamivudine