Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Oct 27, 2024; 16(10): 1199-1207
Published online Oct 27, 2024. doi: 10.4254/wjh.v16.i10.1199
Hepatitis B surface antigen-negative but hepatitis B envelope antigen-positive false occult hepatitis B virus infection: A case report
Shu-Sheng Yang, Fei Fu, Qian-Kun Xuan, Zhou-Xiang Zhang, Zhi-Jun Li, Guang-Bo Li, Xiao-Yu Yu
Shu-Sheng Yang, Qian-Kun Xuan, Zhi-Jun Li, Guang-Bo Li, Xiao-Yu Yu, Department of Laboratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200123, China
Fei Fu, Zhou-Xiang Zhang, Department of Obstetrics and Gynecology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200123, China
Co-first authors: Shu-Sheng Yang and Fei Fu.
Co-corresponding authors: Guang-Bo Li and Xiao-Yu Yu.
Author contributions: Yang SS, Li GB, and Yu XY contributed to conceptualization and methodology; Fu F contributed to data curation and writing the original draft; Xuan QK, Zhang ZX, and Li ZJ contributed to data collection and investigation; Fu F and Yu XY contributed to manuscript writing, reviewing, and editing.
Supported by the Shanghai Municipal Commission of Health and Family Planning, No. PKJ2018-Y05.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this case report.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Yu Yu, PhD, Associate Chief Technician, Department of Laboratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, No. 1800 Yuntai Road, Pudong District, Shanghai 200123, China. flyyuxx@163.com
Received: March 9, 2024
Revised: August 13, 2024
Accepted: September 14, 2024
Published online: October 27, 2024
Processing time: 225 Days and 11.1 Hours
Core Tip

Core Tip: We report a hepatitis B surface antigen-negative but hepatitis B envelope antigen-positive patient who had a significant hepatitis B virus (HBV) DNA level. The patient was initially diagnosed as having OBI. However, sequence analysis revealed a unique insertion of amino acid residues at positions 120-124 in the S protein, which affects the formation of a disulfide bond that is associated with the formation of a loop. It is well known that there is an overlap between the S protein and Pol protein. We found that this new insertion site occurred in polymerase/reverse transcriptase domain, indicating that this insertion might be involved in HBV pathogenicity. The patient was finally diagnosed with a false OBI.