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为探讨乙型肝炎病毒（ＨＢＶ）感染血清学不典型表现的分子病毒学基础，用聚合酶链反应（ＰＣＲ）产物直接序列分析测定中国人感染的ＨＢＶＳ基因核背酸序列。结果发现：１５例ＨＢｓＡｇ阴性ＨＢＶ感染者中，１例第５５２位碱基胸腺嘧啶（Ｔ）被胞嘧啶（Ｃ）替换，导致ＨＢｓＡｇ第１３３位蛋氨酸被苏氨酸替代；３例第５４６位碱基Ｃ被Ｔ替换，导致ＨＢｓＡｇ第１３１位苏氨酸异亮氨酸替代；３例“Ａ”决定簇前密码子１２２～１２４间氨基酸插入。１例ＨＢｓＡｇ／抗ＨＢｓ共存个例可见ＨＢＶ第５８７位碱基鸟嘌呤（Ｇ）被腺嘌呤（Ａ）替换，导致ＨＢｓＡｇ第１４５位甘氨酸被精氨酸替代。结果说明ＨＢＶ感染血清学的不典型可能与感染ＨＢＶＳ基因插入和点突变变异株有关。研究同时提示：在中国这一ＨＢＶ感染高发区，血清学诊断的所谓的“非甲～戊”型肝炎中至少有部分病人为感染了ＨＢＶ变异株所致。
To explore the molecular virology basis of atypical serological manifestations of hepatitis B virus (HBV) infection, the nucleotide sequence of HBV S gene in Chinese was detected by polymerase chain reaction (PCR) direct sequence analysis. The results showed that among the 15 cases of HBsAg-negative HBV infection, 1 case of base pyrimidine (T) at position 552 was replaced by cytosine (C), resulting in the substitution of methionine at position 133 of HBsAg by threonine; 3 cases of base 546 Substitution of base C by T resulted in the substitution of threonine isoleucine at position 131 of HBsAg, and insertion of the amino acids 122-124 of the pre-codon for the 3 “A” determinants. A case of HBsAg / anti-HBs co-existence of a case can be seen HBV first 587 base guanine (G) is replaced by adenine (A), resulting in 145 glycine HBsAg arginine replacement. The results showed that atypical HBV infection serology may be related to infection with HBVS gene insertion and point mutation variants. The study also suggests that in China, a high-risk area of HBV infection, at least some of the so-called “non-A-hepatitis E” serologically diagnosed patients are infected with HBV mutants.