# Molecular Characterization of Atypical Hepatitis B Serological Profiles in HBsAg-Negative Women of Childbearing Age in Gabon

## TL;DR

This study investigates unusual hepatitis B virus profiles in women in Gabon who test negative for HBsAg but show other signs of infection.

## Contribution

The study identifies a high prevalence of atypical HBV serological profiles in HBsAg-negative women and highlights the need for improved molecular diagnostics.

## Key findings

- Atypical serological profiles were found in 23% of HBsAg-negative women.
- None of the atypical profiles tested positive for HBV DNA via real-time PCR.
- Atypical profiles were more common in younger women and those in antenatal care.

## Abstract

Occult hepatitis B infection (OBI) and mutated forms of the hepatitis B virus (HBV) represent diagnostic challenges, especially in individuals with atypical serological profiles. This study explores the molecular characteristics of HBV in HBsAg-negative women of childbearing age exhibiting atypical serological markers. We selected 100 HBsAg-negative sera from a cohort of 433 women aged 15–45 years. Additional HBV serological markers (anti-HBc, anti-HBs, HBeAg, anti-HBe) were assessed. Real-time PCR targeting the HBV S gene was performed on samples presenting atypical profiles. Socio-demographic and clinical correlates were also analyzed. Atypical serological profiles were identified in 23% of HBsAg-negative women, including combinations such as isolated anti-HBe positivity and anti-HBe with anti-HBc. Among these, none tested positive for HBV DNA by real-time PCR. Atypical profiles were more prevalent among women attending antenatal consultations and those aged under 25 years. The absence of detectable HBV DNA suggests either very low viral loads, resolved past infections, or serological artifacts due to mutated HBV strains. The high frequency of atypical serological patterns among HBsAg-negative women underscores the need to refine molecular diagnostic tools for detecting occult or mutated HBV. Further sequencing and genotypic characterization studies are warranted.