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Published on: September 25, 2019
Frequency-dependent selection drives HBeAg seroconversion in chronic hepatitis B virus infection
Brook G Warner1, William G H Abbott, Allen G Rodrigo
1Bioinformatics Institute, University of Auckland, Private Bag 92-019, Auckland, New Zealand; The New Zealand Liver Transplant Unit, Auckland City Hospital, Private Bag 92-024, Auckland, New Zealand; Biology Department, Duke University, 125 Science Drive, Durham, NC 27708, USA.
HBeAg seroconversion in chronic hepatitis B (CHB) is key to controlling viral replication. This study proposes a new hypothesis: HBeAg-negative variants emerge due to metabolic costs, driving immune recognition and seroconversion via frequency-dependent selection.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- HBeAg seroconversion is crucial for controlling chronic hepatitis B (CHB) and reducing liver disease risks.
- Current CHB therapies rarely achieve permanent HBeAg seroconversion, necessitating research into novel therapeutic targets.
- The established hypothesis attributes HBeAg seroconversion to host immune responses against hepatitis B virus (HBV).
Purpose of the Study:
- To propose an alternative hypothesis for HBeAg seroconversion mechanisms in chronic HBV infection.
- To explain the emergence and selection of HBeAg-negative HBV variants.
- To provide a framework for identifying new therapeutic targets for CHB.
Main Methods:
- Review and reinterpretation of published data on HBeAg seroconversion.
- Postulation of a frequency-dependent selection model for HBeAg-negative variants.
- Analysis of the metabolic cost of HBeAg production on HBV replication.
Main Results:
- HBeAg production imposes a metabolic cost on hepatocytes, reducing HBV replicative capacity.
- HBeAg-negative variants possess a replicative advantage and benefit from HBeAg-positive virus immunosuppression.
- Frequency-dependent selection favors HBeAg-negative variants as their prevalence increases, leading to HBeAg seroconversion.
Conclusions:
- HBeAg seroconversion is driven by the emergence and selection of HBeAg-negative HBV variants, not solely by host immunity.
- This model explains variations in seroconversion age, increased rates during treatment, and HBeAg reversions.
- Understanding these mechanisms can guide the development of new therapeutic strategies for CHB.
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