HBV T1719G mutation reduced HBV replication through mutant Enh II and HBx protein in vitro

High Genetic Variability of Hepatitis B Virus in Blood Donors With Surface Antigen Positive But DNA Negative in Southern China

In our previous studies, 45.2% of donations with HBV HBsAg reactive (+) by ELISA but negative (-) by NAT were confirmed to have HBV infections in Shenzhen Blood Center, China. However, the serological and molecular characteristics of this type of HBV infection remain unclear, and several donations with indeterminate results require further investigation. In this current study, blood donations with HBsAg ELISA+/DNA NAT- results were collected and further characterized by various serological tests, quantitative PCR (qPCR) and nested PCR from January, 2019 to December, 2021. Molecular characterizations of HBV DNAs were performed by DNA sequencing. Additionally, donations with indeterminate results were classified through a follow-up study to confirm whether they contain HBV DNA. Of 278 HBsAg ELISA+/DNA NAT- samples identified from the screening of 165 025 blood donations, 82 (82/278, 29.5%, including 52 males and 30 females) were confirmed HBsAg positive, leaving nine donations (9/278, 3.2%) with indeterminate results and 187 (187/278, 67.3%) as no HBV infections. Three serological patterns were observed among these 82 confirmed HBsAg positive donations: 74 samples were HBsAg+/anti-HBe+/anti-HBc+, seven samples were HBsAg+/anti-HBc+, and one sample was HBsAg+ alone. Sequence analysis showed that 45 (45/50, 90%) were genotype B, while 4 (4/50, 8%) were genotype C and 1 (1/50, 2%) was genotype D. Notable mutations such as Q101R, Q129H, M133L/T, F134L, L175S, V177A, and N-glycosylation mutations in S regions of HBV genotype B were observed. Additionally, high frequency mutations such as T1719G (33/35, 94.3%), A1752G/T (11/35, 31.4%), G1896A (26/35, 74.3%), and A1762T/G1764A (7/35, 20%) in the BCP/PC regions were also identified. All these mutations might contribute to low-level HBsAg and/or extremely low viral loads. Six out of nine donations (6/9, 66.7%) with indeterminate results were tested positive for both HBsAg and HBV DNA during 65-192 days of follow-up, and they were then confirmed as HBV infections. 31.7% donations with HBsAg ELISA+/NAT- results were confirmed as HBV infection. Various notable mutations identified in the BCP/PC and S regions may be responsible for the low viral loads and HBsAg level in these donations. Therefore, assays with high sensitivity, specificity, and ability to detect genetic variants (mutations) are essential for accurate blood screening in HBV-endemic countries/regions to prevent the transmission of HBV through blood transfusion.

High Frequency Occult Hepatitis B Virus Infection Detected in Non-Resolved Donations Suggests the Requirement of Anti-HBc Test in Blood Donors in Southern China

Background

Most Chinese Blood Centers adopted mini pool (MP) nucleic acid testing (NAT) for HBV screening due to high cost of Individual donation (ID) NAT, and different proportions of MP-reactive but ID-non-reactive donations (MP+/ID-, defined as non-resolved donations) have been observed during daily donor screening process. Some of these non-resolved donations are occult HBV infections (OBIs), which pose potential risk of HBV transmission if they are not deferred. This study is aimed to further analyze these non-resolved donations.

Methods

The non-resolved plasma samples were further analyzed by serological tests and various HBV DNA amplification assays including quantitative PCR (qPCR) and nested PCR amplifying the basic core and pre-core promoter regions (BCP/PC; 295 base pairs) and HBsAg (S) region (496 base pairs). Molecular characterizations of HBV DNA+ non-resolved samples were determined by sequencing analysis.

Results

Of 17,226 MPs from 103,356 seronegative blood donations, 98 MPs were detected reactive for HBV. Fifty-six out of these 98 (57.1%) reactive MPs were resolved as HBV DNA+, but the remaining 42 pools (42.9%, 252 donations) were left non-resolved with a high rate (53.2%) of anti-HBc+. Surprisingly, among 42 non-resolved MPs, 17 contained one donation identified as OBIs by alternative NAT assays. Sequence analysis on HBV DNAs extracted from these OBI donations showed some key mutations in the S region that may lead to failure in HBsAg detection and vaccine escape.

Conclusion

A total of 53.2% of the non-resolved donations were anti-HBc+, and OBIs were identified in 40.5% of these non-resolved pools. Therefore, non-resolved donations with anti-HBc+ might pose potential risk for HBV transmission. Our present analysis indicates that anti-HBc testing in non-resolved donations should be used to identify OBIs in order to further increase blood safety in China.

E3 ubiquitin ligase TRIM21 restricts hepatitis B virus replication by targeting HBx for proteasomal degradation

As a cytosol ubiquitin ligase and antibody receptor, Tripartite motif-containing 21 (TRIM21) has been reported to mediate the restriction of hepatitis B virus (HBV) through an HBx-antibody-dependent intracellular neutralization (ADIN) mechanism. However, whether TRIM21 limits HBV replication by targeting viral proteins remains unclarified. In this study, we demonstrate that TRIM21 inhibits HBV gene transcription and replication in HBV plasmid transfected and HBV-infected hepatoma cells. RING and PRY-SPRY domains are involved in this activity. TRIM21 interacts with HBx protein and targets HBx for ubiquitination and proteasomal degradation, leading to impaired HBx-mediated degradation of structural maintenance of chromosomes 6 (Smc6) and suppression of HBV replication. TRIM21 fails to restrict the replication of an HBx-deficient HBV. And knock-down of Smc6 largely impairs the anti-HBV activity of TRIM21 in HepG2 cells. In a hydrodynamic injection (HDI)-based HBV mouse model, we confirm an in vivo anti-HBV and anti-HBx therapeutic effect of TRIM21 by over-expression or knocking-out strategy. Our findings reveal a novel mechanism that TRIM21 restricts HBV replication through targeting HBx-Smc5/6 pathway, which may have an implication in the future TRIM21-based therapeutic application.

Yin-Yang 1 and HBx protein activate HBV transcription by mediating the spatial interaction of cccDNA minichromosome with cellular chromosome 19p13.11

HBV cccDNA stably exists in the nuclei of infected cells as an episomal munichromosome which is responsible for viral persistence and failure of current antiviral treatments. However, the regulatory mechanism of cccDNA transcription by viral and host cellular factors is not well understood. In this study, we investigated whether cccDNA could be recruited into a specific region of the nucleus via specific interaction with a cellular chromatin to regulate its transcription activity. To investigate this hypothesis, we used chromosome conformation capture (3C) technology to search for the potential interaction of cccDNA and cellular chromatin through rcccDNA transfection in hepatoma cells and found that cccDNA is specifically associated with human chromosome 19p13.11 region, which contains a highly active enhancer element. We also confirmed that cellular transcription factor Yin-Yang 1 (YY1) and viral protein HBx mediated the spatial regulation of HBV cccDNA transcription by 19p13.11 enhancer. Thus, These findings indicate that YY1 and HBx mediate the recruitment of HBV cccDNA minichromosomes to 19p13.11 region for transcription activation, and YY1 may present as a novel therapeutic target against HBV infection.

Molecular characteristics of HBV infection among blood donors tested HBsAg reactive in a single ELISA test in southern China

Background

Hepatitis B virus (HBV) infection is a major concern for blood safety in high-prevalence HBV countries such as China. In Shenzhen, dual hepatitis B surface antigen (HBsAg) enzyme-linked immunosorbent assays (ELISAs) have been adopted in parallel with nucleic acid testing (NAT) for donors for over a decade. A small proportion of blood donors test reactive (R) for HBsAg but negative through routine NAT, which can lead to HBV infection with an extremely low viral load.

Objectives

We aimed to investigate and analyze the molecular characteristics of HBV among blood donors that tested HBsAg R in a single ELISA test.

Methods

Blood donations were evaluated in this study if confirmed HBsAg R through one of two ELISA kits. Samples with non-reactive (NR) results by NAT were collected and tested for HBsAg by chemiluminescent microparticle immunoassay (CLIA) with a neutralization test. The level of HBsAg was further assessed by electrochemiluminescence immunoassay (ECLIA). The viral basic core promoter (BCP) and pre-core (PC) and S regions were amplified by nested PCR. Quantitative real-time PCR (qPCR) for viral load determination and individual donation (ID)-NAT were adopted simultaneously. HBsAg was confirmed with CLIA, ECLIA, nested PCR, qPCR, and ID-NAT.

Results

Of the 100,252 donations, 38 and 41 were identified as HBsAg R with Wantai and DiaSorin ELISA kits, respectively. Seventy-nine (0.077%, 79/100,252) blood samples with ELISA R-NR and NAT NR results were enrolled in the study. Of these, 17 (21.5%,17/79) were confirmed as HBsAg-positive. Of the 14 genotyped cases, 78.6% (11/14) were genotype B, and C and D were observed in two and one sample, respectively. Mutations were found in the S gene, including Y100C, Y103I, G145R, and L175S, which can affect the detection of HBsAg. A high-frequency mutation, T1719G (93.3%), was detected in the BCP/PC region, which reduced the viral replication.

Conclusion

A small number of blood samples with HBsAg ELISA R-NR and NAT NR results were confirmed as HBV infection, viral nucleic acids were found in most of the samples through routine NAT methods. It is necessary to employ more sensitive and specific assays for the detection of HBV infection among blood donors.