The hepatitis B virus (HBV) is an enveloped virus with an outer diameter of approximately 42 nm contained within a nucleocapsid. Capsids enclose a single copy of the 3.2-kb, partially double-stranded DNA genome, which is covalently linked to the viral polymerase at the 5’ end of the full-length minus strand. Coding regions in the HBV genome are organized into four overlapping reading frames (ORFs) designated C (core), P (polymerase), S (surface), and X (a regulatory protein), which are subsequently translated into the corresponding viral proteins (
1).
The HBV envelope proteins can be translated from a single ORF: L (large), M (middle), and S (small) or the hepatitis B surface antigen (HBsAg) (
1). The HBsAg is composed of four transmembrane helices that are involved in the integration of protein into the endoplasmic reticulum (ER) membrane. Other regions of the HBsAg are highly coiled, and the coil is responsible for protein’s antigenicity (
2). There is a major hydrophilic region (MHR) that encompasses amino acid residues 99 and 160, which contains the major epitopes for the induction of a humoral immune response (
3,
4). The “a” determinant domain (amino acid positions 121 - 147), which is a highly conserved region of the HBsAg, is located on the exterior surface of the MHR and is involved in the binding of antibodies (anti-HBs) against HBsAg (
4,
5). Several HBV mutations within the ”a” determinant of the HBsAg have been reported as immune escape mutations, which can potentially be involved in vaccine-induced immunity and diagnostic-escape variants (
4). The commonest type of these mutations, G145R, is created by the substitution of arginine for glycine has been shown to exhibit various degrees of altered binding of HBsAg to antibodies in different commercial assays (
6,
7). G145R mutant has been reported in many cases of occult hepatitis B infection (OBI) because it decreases the HBsAg levels (
8,
9), often going undetected by routine assays (
10) and in patients who suffer from lamivudine-resistant mutants (
11). HBV has been classified into eight genotypes (A - H) based on sequence divergence in the genome (
12). G145R mutants have mainly been found in genotypes B, C, and D (
13). Naturally occurring G145R mutants are often detectable with monoclonal antibody-based assays, albeit at a reduced sensitivity (
14).
Previous studies have indicated that the “a” determinant region interacts with the antibodies from patient serum (
15) or the mouse monoclonal antibody produced against HBsAg (
16). One of the obstacles to detecting a variant critically depends on the choice of the antibody. In contrast, the fundamental difficulty in the in vitro characterization of all this variation is the difficulty in the quantitation of the expressed HBsAg in a way that does not depend on its antigenicity. One approach involves the use of an antibody that binds to a common region away from the variant domains being tested, but how can one be sure that the structural conformation is not affected? Moreover, due to a lack of crystallization of wild-type HBsAg molecules and membrane-spanning (
17,
18), no template structure exists in the protein data bank (PDB) library for the HBsAg (
19).