Diagnostic and clinical relevance of HBV mutations

Abstract

Despite vaccinations, hepatitis B virus (HBV) infections are still very common worldwide. The virus replicates by reverse transcription using a viral polymerase lacking proof-reading ability. This results in the emergence of mutant viruses that can be selected out by host immunity or viral therapeutic agents. Several well-characterized HBV variants have been identified that challenge the effectiveness of the current vaccines. Other mutations result in a change within the HBV surface antigen, resulting in a loss of detection by some diagnostic assays. Additionally, a number of mutations have evolved in response to antiviral therapy. This report is an overview of the HBV mutations leading to vaccine failure, loss of HBV detection by diagnostic assays, increased viral replication, and resistance to antiviral agents.