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Hepatitis B surface antigen variants in vaccinees, blood donors and an interferon‐treated patient

Variants of hepatitis B virus (HBV), with amino acid substitutions in the major antigenic ‘a’ determinant of hepatitis B surface antigen (HBsAg), have been described mainly in vaccinated children. In the present study in addition to vaccinated children, we have investigated Chinese blood donors positive for anti‐HBc alone, and a patient with continuing liver disease after interferon‐induced seroconversion to anti‐HBs. Variants were detected in two of four children with break‐through infections. One child had a double mutation (P142S and G145R) and the other a G145A substitution. Three of seven anti‐HBc positive Chinese blood donors had a T131I substitution, whilst the interferon‐treated patient had a treble amino acid substitution (P142S, G145R and N146D). The present results indicate that HBsAg variants may exist in individuals other than vaccinated children.