[A novel stop codon mutation in S gene: the molecular basis of a patient with cryptogenic cirrhosis].

Objective: To explore the pathogen and molecular basis of cryptogenic cirrhosis in a patient.
Methods: Serum was collected from a patient, male, aged 56, with cryptogenic cirrhosis. HBV serologic markers were qualitatively tested, and HBsAg, HBeAg, and anti-HBc were quantitatively determined again. HBV DNA in serum was qualitatively tested using PCR, and quantified using fluorescence quantitative PCR. S gene was amplified, cloned, and sequenced.
Results: HbsAg and anti-Hbe were negative, and anti-HBs, HBeAg, anti-HBc, and HBV DNA were all positive. HBsAg (S/N) was 0.77 (cutoff of S/N: >/= 2.00), HbeAg (S/N) was 56.43 (cutoff of S/N: >/= 2.10), anti-HBc (S/C(O)) was 0.03 (cutoff of S/C(O): </= 1.00); HBV DNA was 1.54 x 10(9) copies/ml. An uncommon point mutation at nucleotide 336 (C to A) in S gene was found, resulting in the change of the 61st codon into a novel stop codon and failure of synthesis of HbsAg.
Conclusion: HBV proves the pathogen of this case. This special mutation well explains the patient's unusual serologic pattern. Moreover, this finding possesses important clinical and theoretical significance.