Abstract

Occult hepatitis B infections (OBI) represent a reservoir of undiagnosed and untreated hepatitis B virus (HBV), hence the need to identify mutations that lead to this phenotype. Functionally characterizing these mutations by in vitro studies is time-consuming and expensive. To bridge this gap, in silico approaches, which predict the effect of amino acid (aa) variants on HBV protein function, are necessary. We developed an algorithm for determining the relevance of OBI-associated mutations using in silico approaches. A 3 kb fragment of subgenotypes A1 and D3 from 24 chronic HBV-infected (CHB) and 24 OBI participants was analyzed. To develop and validate the algorithm, the effects of 68 previously characterized occult-associated mutations were determined using three computational tools: PolyPhen2, SNAP2, and PROVEAN. The percentage of deleterious mutations (with impact on protein function) predicted were 52 (76.5%) by PolyPhen2, 55 (80.9%) by SNAP2, and 65 (95.6%) by PROVEAN. At least two tools correctly predicted 59 (86.8%) mutations as deleterious. To identify OBI-associated mutations exclusive to Botswana, study sequences were compared to CHB sequences from GenBank. Of the 43 OBI-associated mutations identified, 26 (60.5%) were predicted by at least two tools to have an impact on protein function. To our knowledge, this is the first study to use in silico approaches to determine the impact of OBI-associated mutations, thereby identifying potential candidates for functional analysis to facilitate mechanistic studies of the OBI phenotype.

Highlights

  • Occult hepatitis B infections (OBI) represent a significant reservoir of undiagnosed and untreated hepatitis B virus (HBV) infection

  • The HBV viral loads were low in the OBI group with the median of 57.4 copies per mL versus 3.1600 copies per mL in the chronic HBV-infected (CHB) group and 68.1% of OBI patients having HBV viral loads

  • Multiple OBI-associated mutations have been identified in several studies

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Summary

Introduction

Occult hepatitis B infections (OBI) represent a significant reservoir of undiagnosed and untreated hepatitis B virus (HBV) infection. OBI is described as detectable HBV deoxyribonucleic acid (DNA) in the absence of detectable hepatitis B surface antigen (HBsAg) in the liver or serum [1,2]. OBI is characterized by very low viral loads, 200 IU/mL are deemed false OBI [2]. OBI prevalence ranges from 0% to 89.5%, these cannot be compared directly because of differences in the sensitivity of laboratory tests used and testing algorithms [3,4,5,6,7,8,9]. In Botswana, HBsAg positivity rates ranging from 3.1% to 10.6%

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