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2025, Vol: 15, Issue: 4
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Research Article


Overlapping polymerase and surface gene mutations in Turkish patients with chronic hepatitis B

Mohamed Abdulsamad, Ashraf Zaied, Esmhan Omar, Hafsa Alemam, Inas Alhudiri, Murat Sayan.


Abstract
Background:
Chronic hepatitis B (CHB) remains widely encountered in Turkey. We profiled mutations in the overlapping polymerase (pol) and surface (S) genes among adults with chronic hepatitis B virus (HBV) receiving or eligible for nucleos(t)ide analogs (NAs).

Aim:
To characterize pol/S overlap mutations in patients with chronic HBV receiving or eligible for NA therapy.

Methods:
In 2018, 93 hepatitis B surface antigen positive patients were enrolled at Kocaeli University Hospital in 2018. The pol/S overlap was amplified by nested polymerase chain reaction (PCR) and sequenced using Sanger methods. Genotypes and resistance/escape variants were inferred from the sequences. Comparisons were performed using Pearson’s chi-square or Mann–Whitney U tests (α = 0.05).

Results:
Genotyping was successful in 73/93 (78.5%). Genotype D predominated (n = 72); subgenotype were D1 (88.9%), D2 (6.9%), D3 (1.3%), and A2 (2.7%); one case belonged to genotype A. Pol variants were detected in 25/93 (26.9%), notably Q149K, L91I, V173L, L180M, M204I/V, S202G, and N236D. Sgene substitutions occurred in 20/93 (21.5%), most often W196L/S, E164D, G130R, Y134N, Q129H/R, and N131D. Mutation patterns were not associated with sex, age, or HBeAg status (all p > 0.05).

Conclusion:
In this Turkish cohort, genotype Debye was dominant, and pol and S substitutions were frequent. Routine regional genotyping with sustained molecular surveillance and, where possible, next-generation sequencings should inform antiviral selection and resistance monitoring.

Key words: Antiviral agents; Drug resistance; Gene mutations; Genotype D; Hepatitis B.


 
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How to Cite this Article
Pubmed Style

Abdulsamad M, Zaied A, Omar E, Alemam H, Alhudiri I, Sayan M. Overlapping polymerase and surface gene mutations in Turkish patients with chronic hepatitis B. J Microbiol Infect Dis. 2025; 15(4): 172-182. doi:10.5455/JMID.2025.v15.i4.6

Web Style

Abdulsamad M, Zaied A, Omar E, Alemam H, Alhudiri I, Sayan M. Overlapping polymerase and surface gene mutations in Turkish patients with chronic hepatitis B. https://www.jmidonline.org/?mno=276414 [Access: November 29, 2025]. doi:10.5455/JMID.2025.v15.i4.6

AMA (American Medical Association) Style

Abdulsamad M, Zaied A, Omar E, Alemam H, Alhudiri I, Sayan M. Overlapping polymerase and surface gene mutations in Turkish patients with chronic hepatitis B. J Microbiol Infect Dis. 2025; 15(4): 172-182. doi:10.5455/JMID.2025.v15.i4.6


Vancouver/ICMJE Style

Abdulsamad M, Zaied A, Omar E, Alemam H, Alhudiri I, Sayan M. Overlapping polymerase and surface gene mutations in Turkish patients with chronic hepatitis B. J Microbiol Infect Dis. (2025), [cited November 29, 2025]; 15(4): 172-182. doi:10.5455/JMID.2025.v15.i4.6


Harvard Style

Abdulsamad, M., Zaied, . A., Omar, . E., Alemam, . H., Alhudiri, . I. & Sayan, . M. (2025) Overlapping polymerase and surface gene mutations in Turkish patients with chronic hepatitis B. J Microbiol Infect Dis, 15 (4), 172-182. doi:10.5455/JMID.2025.v15.i4.6


Turabian Style

Abdulsamad, Mohamed, Ashraf Zaied, Esmhan Omar, Hafsa Alemam, Inas Alhudiri, and Murat Sayan. 2025. Overlapping polymerase and surface gene mutations in Turkish patients with chronic hepatitis B. Journal of Microbiology and Infectious Diseases, 15 (4), 172-182. doi:10.5455/JMID.2025.v15.i4.6


Chicago Style

Abdulsamad, Mohamed, Ashraf Zaied, Esmhan Omar, Hafsa Alemam, Inas Alhudiri, and Murat Sayan. "Overlapping polymerase and surface gene mutations in Turkish patients with chronic hepatitis B." Journal of Microbiology and Infectious Diseases 15 (2025), 172-182. doi:10.5455/JMID.2025.v15.i4.6


MLA (The Modern Language Association) Style

Abdulsamad, Mohamed, Ashraf Zaied, Esmhan Omar, Hafsa Alemam, Inas Alhudiri, and Murat Sayan. "Overlapping polymerase and surface gene mutations in Turkish patients with chronic hepatitis B." Journal of Microbiology and Infectious Diseases 15.4 (2025), 172-182. Print. doi:10.5455/JMID.2025.v15.i4.6


APA (American Psychological Association) Style

Abdulsamad, M., Zaied, . A., Omar, . E., Alemam, . H., Alhudiri, . I. & Sayan, . M. (2025) Overlapping polymerase and surface gene mutations in Turkish patients with chronic hepatitis B. Journal of Microbiology and Infectious Diseases, 15 (4), 172-182. doi:10.5455/JMID.2025.v15.i4.6


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