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Journal of Clinical Microbiology, February 1998, p. 531-538, Vol. 36, No. 2
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Amplification of Full-Length Hepatitis B Virus
Genomes from Samples from Patients with Low Levels of Viremia:
Frequency and Functional Consequences of PCR-Introduced
Mutations
Stephan
Günther,*
Gunhild
Sommer,
Franziska
Von Breunig,
Alicja
Iwanska,
Tatyana
Kalinina,
Martina
Sterneck, and
Hans
Will
Heinrich-Pette-Institut für
Experimentelle Virologie und Immunologie an der Universität
Hamburg, 20251 Hamburg, Federal Republic of Germany
Received 2 September 1997/Returned for modification 21 October
1997/Accepted 19 November 1997
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ABSTRACT |
To facilitate the investigation of hepatitis B virus (HBV) sequence
variation, we recently established a method for functional analysis of
PCR-amplified full-length HBV genomes. This study aimed at estimating
the number of mutations introduced during amplification of genomes from
samples from patients with low levels of viremia and their influence on
replication and antigen expression. Wild-type HBV DNA template
molecules in concentrations like those present in samples from patients
with very low levels of viremia were amplified, sequenced (30 kb
total), and functionally tested. We found that Taq
polymerase and a Taq-Pwo polymerase mixture introduced an
average of 5.7 and 3.1 mutations per genome, respectively, corresponding to polymerase error rates of 12.1 × 10
5 and 6.0 × 10
5. One of 8 genomes
(12%) amplified with Taq polymerase, but 7 of 17 genomes
amplified with Taq-Pwo polymerases (41%), remained replication competent. All replication-competent genomes expressed HBs
and HBe antigens and had an average of only 0.9 mutations per genome.
In contrast, replication-defective genomes had an average of 5.4 mutations, which frequently also disturbed viral antigen expression.
From these data we conclude that many of the replication-competent HBV
genomes from a clinical specimen will retain their replication and
antigen expression phenotypes even after extensive amplification with
Taq-Pwo polymerases. Because replication competence is
highly sensitive to random mutations, it is the best marker for the
identification of HBV genomes with few or no PCR-introduced mutations.
 |
INTRODUCTION |
Hepatitis B virus (HBV) sequence
variability is increasingly recognized as a factor which modulates the
course and outcome of HBV infection. Variants with disturbed hepatitis
B e antigen (HBeAg) synthesis (24, 30), large deletions in
the nucleocapsid gene (12, 20), or novel hepatocyte nuclear
factor 1 binding sites in the core promoter (14, 25) were
found to be associated with severe liver disease. Furthermore,
mutations in the major antigenic determinant of the hepatitis B surface
antigen (HBsAg) are probably responsible for the failure of
immunization (4, 21), and mutations in the virus polymerase
protein render HBV resistant to therapy with nucleoside analogs
(1, 19, 38).
To facilitate the analysis of natural HBV isolates, we recently
established a method for efficient PCR amplification of full-length HBV
genomes which allows the isolation of a large number of genomes even
from clinical samples from patients with low levels of viremia (13). Only a single cloning step is required before the
phenotype of an amplified genome can be tested by transfection into
hepatoma cell lines. Alternatively, the cloning step can be omitted and the phenotype of the whole HBV genome population can be studied by
directly transfecting the amplified genomes. Application of this method
to structural analysis of HBV in clinical samples has already led to
the identification of novel and highly diverse types of genomes with
deletions of up to 2 kb in serum and liver samples (15, 31).
To extend knowledge of the molecular features of natural virus
isolates, other research groups have also established full-length genome PCRs for human immunodeficiency virus type 1 (6, 8, 28,
29), human T lymphotropic virus type 1 (34), human
papillomavirus (33), hepatitis A virus (35, 36),
hepatitis C virus (35), tick-borne encephalitis virus
(11), simian virus 40 (18), and simian foamy
virus (17) by taking advantage of long-range PCR conditions
described recently (2). A major concern noted in these
studies as well as in our previous study is the introduction of
artificial sequence errors during PCR (7) which may alter the phenotypes of the amplified genomes or even render them defective. In two studies this problem was addressed by sequencing amplified genomes of human papillomavirus (33) and human
immunodeficiency virus type 1 (28), which revealed an error
frequency of about one error per 700 bases. The functional consequences
of PCR-introduced mutations have so far been analyzed only in a recent
study with PCR-amplified simian virus 40 genomes which found no
functional deficiencies in the amplified clones (18).
However, the consequences of random mutations in HBV may be quite
different.
Therefore, prior to application of our PCR method to clinical samples
we aimed in this study to evaluate the frequency and possible
functional relevance of PCR-introduced mutations and to elucidate the
optimal amplification system. Because problems with artificial
mutations are particularly likely to arise if virus genomes are present
in small amounts and require a high number of cycles, the test
conditions were chosen appropriately. A few wild-type molecules in
concentrations like those present in samples from patients with low
levels of viremia were extensively amplified in different PCR systems,
and the replication competence as well as the antigen expression of the
amplified genomes was tested. Furthermore, a large number of amplified
and cloned genomes were sequenced, the error frequencies were
correlated with the functional phenotypes, and the error rates of the
polymerases used in the PCR were determined.
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MATERIALS AND METHODS |
Amplification, cloning, and sequencing of complete HBV
genomes.
Plasmid pSM2, containing a dimeric wild-type HBV genome
(10), was linearized, and defined amounts of it were
amplified in 50-µl PCR assay mixtures containing 50 mM Tris-HCl (pH
8.3), 50 mM KCl, 1.5 mM MgCl2, 200 µM deoxynucleoside
triphosphate (dNTP), 0.01% gelatin, 5 U of Taq polymerase
(Boehringer Mannheim, Mannheim, Germany), and 0.3 µM (each) primers
P1 (5'-CCGGAAAGCTTGAGCTCTTCTTTTTCACCTCTGCCTAATCA) and P2
(5'-CCGGAAAGCTTGAGCTCTTCAAAAAGTTGCATGGTGCTGG)
(HBV positions 1821 to 1841 and 1823 to 1806, respectively;
SstI and SapI sites are underlined) or by using
the Expand high-fidelity PCR assay (Boehringer Mannheim) containing 1.5 mM MgCl2, 200 µM dNTP, 2.6 U of Taq and
Pwo polymerase mixture, and 0.3 µM (each) primers P1 and
P2 (13). PCRs with Pfu polymerase (Stratagene)
and Pwo polymerase (Boehringer Mannheim) were performed in
the commercial buffers supplemented with 200 µM (each) dNTP and 0.3 µM (each) primers P1 and P2. The PCR was run for 40 cycles at 94°C
for 40 s, 60°C for 1.5 min, and 68°C for 3 min, with an
increment of 2 min after every 10 cycles, in a Robocycler (Stratagene).
For cloning, the amplified HBV genomes were digested with
SstI within the heterologous primer sequences, gel purified,
and inserted into vector pUC19. The HBV DNA insert was sequenced with
vector- and HBV-specific primers (2357 to 2380, GGCAGGTCCCCTAGAAGAAGAACT; 477 to 455, GGACAAACGGGCAACATACCTTG; 1121 to 1100, AGAAAGGCCTTGTAAGTTGGCG; 676 to 699, TTTACTAGTGCCATTTGTTCAGTG; 66 to 90, GCTCCAGTTCAGGAACAGTAAACCC; and 2432 to 2408, ATTGAGATCTTCTGCGACGCGGCGA), using the SequiTherm sequencing
kit (Epicentre Technologies, Madison, Wis.) and an automated sequencer
(LI-COR, Lincoln, Nebr.).
Preparation of PCR products for transfection.
HBV genomes
were amplified for 35 cycles from HBV DNA from the serum of a patient
or from plasmid-integrated wild-type HBV DNA with the Expand
high-fidelity PCR assay. The 3.2-kb PCR products were gel purified with
the QIAquick gel extraction kit (Qiagen, Hilden, Germany).
Subsequently, 0.5 µl (1%) of each product was reamplified for 20 cycles in five 50-µl assay mixtures with the same primers and
conditions described above. The amplification products were pooled,
extracted with phenol-chloroform (1:1) and chloroform, and washed five
times with water in Centricon-100 concentrators (Amicon, Beverly,
Mass.) to remove residual dNTPs and primers. The DNA was then
quantified spectrophotometrically (a ratio of the optical density at
260 nm to that at 280 nm of 1.7 to 1.8) and by fluorescence intensity
measurement of the ethidium bromide-stained 3.2-kb DNA fragments
separated on agarose gels. For standardization, defined amounts of
3.2-kb HBV DNA fragments were used.
Transfection of HBV DNA by calcium phosphate precipitation.
Linear HBV monomers with SapI sticky ends were released by
cleavage with 1 U of SapI/µg of DNA for 12 h from
plasmids containing P1- and P2-amplified HBV genomes and from plasmid
pHBV-SapI (13). The latter (designated WT) contains the HBV
wild-type genome (10) flanked by the primers P1 and P2. For
direct transfection of amplified 3.2-kb HBV genomes, the heterologous
primer sequences were cleaved with 1.5 U of SapI (New
England Biolabs) per µg of PCR product for 12 h. HuH7 cells were
plated at a density of 1.3 × 106 per 50-mm-diameter
petri dish (Falcon) 1 day before transfection. The medium was changed
4 h before transfection. Without further purification the
SapI-digested DNA (5 µg/dish in 0.1 volume of the final
transfection mix) was mixed with CaCl2, added dropwise to
2× HEPES-buffered saline (pH 7.05), and transfected into confluent HuH7 cells. The medium was changed again 16 h after transfection, and 500 U of alpha interferon (IFN-
)/ml of medium was added where appropriate. The cells were harvested 3 to 4 days after transfection. Transfection efficiency was measured by cotransfection of 1 µg of
reporter plasmid expressing secreted alkaline phosphatase and determination of secreted alkaline phosphatase enzymatic activity in
the cell culture supernatant (5). HBsAg and HBeAg in the cell culture supernatant were assayed with commercially available kits
(Abbott).
Purification of HBV DNA from intracellular core particles and
Southern blot analysis.
Cells were washed and lysed in 1 ml of
lysis buffer (50 mM Tris-HCl [pH 7.4], 1 mM EDTA, 1% Nonidet P-40)
per dish (14). The lysate was incubated on ice for 15 min,
and nuclei were pelleted by centrifugation. The supernatant was treated
with 10 mM MgCl2-100 µg of DNase I/ml for 30 min at
37°C, adjusted to 25 mM EDTA, and digested with 1% sodium dodecyl
sulfate-0.5 mg of proteinase K/ml for 2 h at 37°C. Nucleic
acids were phenol-chloroform extracted and ethanol precipitated after
the addition of 20 µg of tRNA. DNAs were separated on a 1.5% agarose
gel, blotted onto Hybond N membranes (Amersham), and hybridized with a
32P-labelled full-length HBV probe. Autoradiography was
analyzed with FUJIX BAS 2000 (Fuji, Tokyo, Japan), and signals were
quantified with TINA software (Raytest, Straubenhardt, Germany).
Calculation of polymerase error rates and distribution of
mutations.
The calculations were based on the following simplified
PCR model. During one PCR cycle an individual single-stranded HBV genome is duplicated, and Pgen is the likelihood
that the polymerase introduced an error into the newly polymerized
strand. One of the two strands present at the end of this reaction
(template or polymerized strand) is chosen by chance (the probability
of choosing the polymerized strand with an error introduced in this cycle is Pgen/2) and is used as the template in
the next duplication cycle. After repeating this procedure n
times (n = number of duplication cycles) the likelihood
that a genome has accumulated k mutations (0
k
n) is described by the binomial
distribution b(k;n;Pgen/2). The mean number of
mutations that accumulate per genome (µgen) after
n cycles is therefore given by the equation
µgen = nPgen/2. Division of this
equation by the nucleotide number of the HBV genome reveals the
relation µpos = nPpos/2, where
µpos is the mean number of mutations that accumulate per
nucleotide position and Ppos is the error rate
of the polymerase (errors per polymerized position) (7).
µpos corresponds to the experimentally determined mean
error frequency f (mutations per bases sequenced), and
n was calculated by using the equation 2n = Nf/Ni, where Ni
is the initial template number and Nf is the final copy number at the end of the PCR (both estimated from the mass
and the molecular weight of the template and the PCR product). For
calculation of Ppos the equations were combined
as Ppos = 0.6 × f/log10(Nf/Ni).
 |
RESULTS |
Influence of the type of DNA polymerase on PCR sensitivity.
To
determine which PCR system can be used for amplification of HBV genomes
in sera from patients with low levels of viremia, defined copy numbers
of plasmid-integrated HBV genomes were amplified with Pwo
polymerase, which possesses proofreading activity (9), Taq polymerase, which lacks proofreading activity
(37), and a Taq-Pwo polymerase mixture. The
Pwo polymerase did not amplify less than 105
template molecules to a level detectable in an ethidium bromide-stained gel (Fig. 1A). In contrast, reactions
with Taq polymerase and Taq-Pwo polymerases
efficiently amplified as few as 102 and 10 molecules,
respectively (Fig. 1A). To confirm these enzyme type-dependent
differences in sensitivity, a PCR kinetic was performed with
approximately 105 to 106 HBV virion DNA
molecules as a template. The same set of enzymes as described above and
the proofreading activity-possessing Pfu polymerase were
used. Pwo and Pfu polymerases did not amplify the
HBV virion DNA to levels detectable in an ethidium bromide-stained gel
even after 35 cycles, whereas Taq and Taq-Pwo
polymerases produced a signal after 25 cycles (Fig. 1B). These data
indicate that amplification of HBV genomes from sera from patients with low levels of viremia requires Taq polymerase either alone
or in combination with a thermostable polymerase with proofreading activity.

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FIG. 1.
Sensitivity of the HBV full-length genome PCR with
different thermostable polymerases. (A) Defined amounts of cloned HBV
DNA (plasmid pSM2) were amplified for 40 cycles. The 3.2-kb PCR
products were resolved in an agarose gel and stained with ethidium
bromide. (B) HBV DNA from virus particles in the supernatant of HBV
DNA-transfected hepatoma cells was amplified (105 to
106 template molecules). After 20, 25, 30, and 35 cycles an
aliquot was removed from the PCR mixture, separated in an agarose gel,
and stained with ethidium bromide. All assays produced a signal with 1 ng of HBV DNA as a positive control.
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Influence of PCR-introduced mutations on the phenotypes of the
amplified HBV genomes.
The impact of PCR-introduced mutations was
studied by extensive amplification of wild-type HBV genomes with both
PCR systems which efficiently amplify HBV genomes and by functional
testing of the amplified genomes as follows. From a cloned dimeric
wild-type HBV genome, 900 and 90 molecules were amplified with
Taq polymerase and Taq-Pwo polymerase mixture,
respectively. An aliquot of the PCR products was cloned, and 8 Taq polymerase-amplified and 17 Taq-Pwo
polymerase-amplified HBV genomes were randomly selected for functional
analysis. After transfection of these genomes into HuH7 hepatoma cells,
core particle-associated replicative HBV DNA was analyzed by Southern
blotting and the secretion of HBsAg and HBeAg into the cell culture
supernatant was determined by enzyme immunoassays.
Only 1 of the 8 Taq polymerase-amplified genomes (12%) was
replication competent (Fig. 2A and
3A), whereas 7 of the 17 Taq-Pwo polymerase-amplified HBV genomes (41%) produced
replicative HBV DNA in amounts comparable to that of the nonamplified
wild-type genome (Fig. 2B and 3B). In contrast to the replication
level, expression and secretion of HBs- Ag and HBeAg were
much less frequently affected. Most of the Taq
polymerase-amplified genomes and all of the Taq-Pwo
polymerase-amplified genomes produced HBsAg at about the wild-type
level (Fig. 3). Similarly, 87% of the Taq polymerase-amplified genomes and 65% of the Taq-Pwo
polymerase-amplified genomes efficiently produced HBeAg (Fig. 3). All
genomes which showed the authentic replication phenotype also expressed
HBsAg and HBeAg at preamplification levels, whereas genomes with
defects in replication frequently also had defects in antigen
production (Table 1).

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FIG. 2.
Southern blot analysis of intracellular replicative HBV
DNA intermediates produced by amplified genomes after transfection into
HuH7 cells. (A) Analysis of cloned genomes amplified from 900 template
molecules of wild-type HBV DNA (10) (plasmid pSM2) with
Taq polymerase. (B) Analysis of cloned genomes amplified
from 90 template molecules of wild-type HBV DNA with Taq-Pwo
polymerase mixture. WT, nonamplified wild-type genome (10)
(plasmid pHBV-SapI); , mock transfection; M, marker lane with 3.2-kb
double-stranded (ds) and single-stranded (ss) HBV DNA. Note that the
bands at the 3.2-kb position seen in all lanes of the amplified genomes
represent input rather than progeny HBV DNA.
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FIG. 3.
Levels of HBsAg, HBeAg, and intracellular replicative
HBV DNA produced by HBV genomes amplified with Taq
polymerase (A) or Taq-Pwo polymerase mixture (B). HBsAg and
HBeAg were measured in the cell culture supernatant by enzyme
immunoassays (Abbott), and the HBV DNA signals shown in Fig. 2 were
quantified with TINA software (Raytest). The designation of the clones
is the same as in Fig. 2. The values are given relative to that of the
nonamplified wild-type genome (WT; open bar). Genomes which replicate
at about wild-type genome level (range, WT/1.5 to WT × 1.5) are
grouped (shaded bars), and those which were partially or completely
sequenced are marked with an asterisk. Solid bars represent defective
genomes.
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TABLE 1.
Correlation of the replication competence of the
amplified HBV genomes with HBsAg and HBeAg levels and the number of
PCR-introduced mutations
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Since many genomes in clinical samples may be naturally defective in
replication, we wondered whether a fraction of replication-competent genomes similar to that in the PCR test system is obtained with HBV DNA
from patients. Therefore, 102 to 104 HBV
genomes (as estimated by PCR) from sera of eight patients with
fulminant hepatitis (32) were amplified with
Taq-Pwo polymerases, cloned, and analyzed by transfection.
Of 35 genomes tested, 24 (68%) were replication competent. This
fraction is even larger than that obtained after the amplification of
cloned wild-type genomes, indicating that the predominant virus
population in the sera of these patients was replication competent.
Taken together, after extensive amplification, as required for sera
from patients with very low levels of viremia, the fraction of HBV
genomes that exhibit the original phenotype of replication and antigen
expression is about 40% if the PCR is performed with
Taq-Pwo polymerase mixture. Taq polymerase alone
produces a much larger fraction of defective genomes. The replication
competence of a genome correlates with intact HBsAg and HBeAg
expression.
Number and type of mutations introduced during PCR.
To
elucidate which and how many mutations accumulate during PCR and
whether the number differs between genomes which showed the authentic
phenotype and those which were rendered defective during PCR, a total
of 30 kb of the amplified genomes was sequenced (Table
2). Taking the data of all analyzed
genomes together, those with the authentic phenotype had an average of
0.9 mutations whereas the defective ones had an average of 5.4 mutations (Table 1). Nearly all of the mutations (27 of 32) were
transitions, usually T
C or A
G (Table 2), which are specific for
Taq polymerase (37). They frequently led to amino
acid changes in at least one HBV reading frame and created a
translational stop codon in the polymerase (P) and nucleocapsid (C)
genes of genomes Taq-2 and Taq/Pwo-16, respectively. The latter
mutations explain the replication defects of these genomes as well as
the lack of HBeAg expression of genome Taq/Pwo-16 (Fig. 3B). Because
the defective genomes Taq-1, Taq/Pwo-14, and Taq/Pwo-15 lack amino acid
changes in the nucleocapsid protein, those in the polymerase protein
are most likely responsible for the replication defect (Table 2). Taken
together, the data indicate a correlation between the number of
PCR-introduced mutations and the phenotypes of the amplified genomes.
In defective genomes six times more mutations accumulated than in those
which retained the authentic phenotype. The results also show that the
random introduction of only a few mutations into a HBV genome can
render it replication defective.
Determination of the polymerase error rate.
The fidelity of
polymerases is usually determined in assays which are based on one
polymerization reaction or a few PCR cycles (7). However,
the fidelity of Taq polymerase may be different if the
reaction runs for a large number of cycles. This may be due, for
example, to a change in the reaction conditions on which the fidelity
of Taq polymerase strongly depends (7).
Therefore, we calculated the error rate of Taq polymerase
and Taq-Pwo polymerase mixture in the 40-cycle full-length
PCR. Based on the number of initial template molecules, the number of
final reaction products, and the number of mutations found per number
of bases sequenced, the error rate of Taq polymerase was
determined to be 12.1 × 10
5 misincorporations per
polymerized nucleotide and that of the Taq-Pwo polymerase
mixture was determined to be 6.0 × 10
5 (Table
3). The calculated error rate of
Taq polymerase agrees well with several published values
ranging from 8.9 × 10
5 to 13.4 × 10
5 (2, 3, 37), which indicates no decrease in
fidelity during full-length PCR. The combination of Pwo
polymerase with Taq polymerase improved the fidelity of
polymerization twofold, which is close to the threefold increase
previously determined with a lacI-based assay
(9).
Functional analysis of amplified HBV genomes without cloning:
optimization and influence of PCR on the HBV phenotype.
The HBV
full-length PCR also allows functional analysis of the amplified
genomes by transfection without prior cloning (13). This
technique had not been tested with HBV DNA from samples from patients
with low levels of viremia because a single PCR did not yield
sufficient DNA for transfection. However, when the 3.2-kb PCR products
were gel purified with the Qiagen kit and reamplified with the
Taq-Pwo polymerase mixture, between 5 and 7 µg of DNA per
50-µl PCR assay mixture was obtained. The 3.2-kb HBV DNA represented about 50% of the total DNA: the rest was nonspecific background. HBV
genome populations amplified by two rounds of PCR from a small number
of molecules of cloned wild-type HBV DNA as well as from HBV DNA from
the serum of a patient worked well in transfection experiments. They
expressed HBsAg as well as HBeAg (not shown) and produced replicative
HBV DNA intermediates (Fig. 4A, lanes WT-PCR and Patient-PCR). The potential of this system for the analysis
of the sensitivity of clinical HBV isolates to antiviral drugs was
evaluated by testing the IFN-
responsiveness of the amplified HBV
genomes. Replication of an amplified wild-type genome population was
inhibited by IFN-
(Fig. 4A, compare lanes IFN-
+ and
), as is
known for nonamplified wild-type HBV in stable transfection systems
(16). Thus, a two-step PCR method was established for
amplification of HBV genomes from material from patients with low
levels of viremia which yields sufficient product for transfection without prior cloning. The amplified genome populations replicate, express viral antigens, and are susceptible to IFN-
when transfected into cells.

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FIG. 4.
(A) Southern blot analysis of intracellular replicative
HBV DNA intermediates produced after transfection of cloned genomes
(WT) or PCR products (WT-PCR and Patient-PCR). WT, nonamplified cloned
wild-type genome pHBV-SapI; WT-PCR, HBV genomes produced during 60 cycles with 0.3 pg of wild-type genomes integrated in plasmid pSM2
(105 template molecules); Patient-PCR, HBV genomes
synthesized during 60 cycles with approximately 104 to
105 HBV virion DNA template molecules isolated from the
serum of a patient; M, length marker as described in the legend to Fig.
2; ds, double stranded; ss, single stranded. (B) Comparison of the
levels of secreted HBsAg and HBeAg as well as that of intracellular
replicative HBV DNA produced by WT and WT-PCR. The WT levels were
defined as 1.0. The means and standard deviations of two experiments
are shown.
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As shown above, individual amplified DNA molecules are rather
frequently rendered completely defective by PCR-introduced mutations. Such drastic effects are not necessarily expected when the whole population of amplified molecules is functionally analyzed. However, amplification may quantitatively change phenotypic features of the
amplified DNA population according to the number of mutations (and
thus, of defective genomes) that accumulate during PCR. To estimate
this effect, a nonamplified, cloned wild-type genome as well as
extensively amplified wild-type genomes was transfected and its
replication and antigen expression levels were compared. In general,
the PCR products produced lower levels of replicative HBV DNA, HBsAg,
and HBeAg than the nonamplified genome (Fig. 4A and B, compare lanes
WT-PCR and WT). Interestingly, the levels of replicative HBV DNA were
reduced two to three times more than the antigen levels, which is
probably a consequence of PCR-introduced mutations.
 |
DISCUSSION |
The efficiency of HBV full-length genome PCR as well as the
frequency and functional relevance of PCR-introduced mutations in
different polymerase assays was evaluated in this study. The Taq-Pwo polymerase mixture was found to be the most
sensitive, and it introduced fewer mutations when amplifying low copy
numbers. With this assay, about 40% of the replication-competent HBV
genomes from a clinical specimen from a patient with a low level of
viremia can be expected to retain their replication and antigen
expression phenotypes after amplification. Because replication
competence was found to be highly sensitive to random mutations, it is
a useful marker to identify HBV genomes with few or no PCR-introduced mutations.
Previous studies demonstrated an increase in PCR sensitivity and
fidelity if a polymerase that exhibits proofreading activity is
combined with an enzyme lacking this activity (2, 9). Here,
we confirmed this by testing Taq and Pwo
polymerases alone and combined in the HBV full-length PCR. However,
additional enzyme combinations are currently available, and further
experiments are needed to test whether they perform similarly to or
even better than the Taq-Pwo polymerase system.
Two observations have important implications for the functional
analysis of genomes amplified from clinical samples. First, nearly all
amplified wild-type genomes either replicated at the authentic
preamplification level or were completely defective, and second, the
replication competence of an amplified genome correlated with intact
HBsAg and HBeAg expression and a low number of artificial mutations.
Therefore, it can be expected that the majority of genomes which remain
replication competent after amplification show the authentic
replication and antigen expression phenotypes and contain no or very
few PCR-introduced mutations. Replication-competent genomes in which
mutations have accumulated during amplification will most likely be
defective and can easily be excluded from a detailed analysis when one
screens first for replication competence.
The identification of replication-defective genomes in sera is not
easy. An indication whether a genome is naturally or artificially defective may be provided by determining the type and prevalence of the
mutation(s) by sequencing. All artificial mutations found in the
amplified genomes in our study were nucleotide changes, and the same
one was never found in more than one genome. Therefore, a mutation(s)
shared by a substantial virus subpopulation or deletions and insertions
is not likely to be PCR derived. Furthermore, the data provided by this
study allow a rough estimate of the fraction of naturally defective
genomes in clinical specimens. If far more genomes are replication
defective than would be expected from artificial mutations after
amplification (Fig. 5 shows an estimation of this fraction according to the template number), this indicates a
large fraction of naturally defective genomes in the analyzed sample. A
first analysis revealed that this is obviously not the case for HBV
populations in sera of patients with fulminant hepatitis, as the
fraction of genomes which were replication competent after amplification corresponded to the expected level.

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FIG. 5.
Calculated fraction of genomes with 2 artificial
mutations within the final population of amplified genomes when initial
template molecule amounts (Ni), as indicated on
the x axis, were amplified to 2 µg of PCR product
(approximately Nf = 6 × 1011
final molecules) with Taq or Taq-Pwo polymerases.
The fraction of genomes with 2 artificial mutations may roughly
correspond to the fraction of genomes which remain replication
competent after PCR, since most replication-competent genomes will
contain either no, one, or two mutations after PCR, according to our
experiments (an average of one mutation per genome). Consistent with
this assumption, the calculated fractions of genomes with 2 mutations
(5 and 40% after PCR with Taq polymerase [900 templates]
and Taq-Pwo polymerases [90 templates], respectively) are
in good agreement with the fractions of replication-competent genomes
determined experimentally (12 and 41%). Based on a simplified PCR
model the fractions were calculated by using the distribution function
of the binomial distribution B(2;n;Pgen/2)
(see Materials and Methods). n was calculated with
Ni and Nf, and
Pgen = Ppos × 3,200. The
error rate, Ppos, was experimentally determined
for Taq polymerase and the Taq-Pwo polymerase
mixture (Table 3).
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The need for analysis of individual genomes can be circumvented if the
amplified genomes are directly transfected without prior cloning, as
was previously shown for genomes amplified from high-titer sera
(13). As an extension of these previous results we present
evidence that this method works even after extensive amplification of a
small number of template molecules. However, for correct interpretation
of data obtained by the described method one has to take into account
that amplification selectively reduces the level of replication
compared to that of antigen expression. This is probably the result of
PCR-introduced mutations, which affect replication more frequently than
antigen expression, as is evident from the analysis of the cloned
genomes. This effect need not be considered if data are compared that
were obtained with the same HBV DNA preparation analyzed under
different conditions, as exemplified here by testing HBV replication
with and without the addition of IFN-
to the transfected cells.
Thus, the PCR product transfection assay may prove particularly useful
for monitoring the possible resistance of clinical HBV isolates to
antiviral drugs before and during therapy (1, 19, 38).
From a biological point of view, it is surprising that the
replication-competent genomes contained only an average of one artificial mutation. This suggests that the random introduction of very
few mutations can severely interfere with HBV replication. This would
not be expected, considering the high sequence heterogeneity of HBV,
with several genotypes which differ by more than 10% on the nucleotide
level (23). Replication can be affected by mutations which
inactivate RNA or DNA elements involved in transcription, pregenome
encapsidation, and replication or by mutations which alter the function
of the nucleocapsid or HBV polymerase proteins. In two of the defective
genomes one of the latter proteins is predictably truncated due to
premature stop codons, which explains the replication defect. In most
other defective genomes inactivation of the HBV polymerase function is
most likely responsible for the replication defect, for two reasons.
First, the coding sequence of the HBV polymerase covers about
two-thirds of the HBV genome, which leads to a high probability that a
random mutation will change the amino acid sequence of the HBV
polymerase. Consistent with this speculation, most of the amino acid
changes in the amplified genomes were found in the polymerase. Second,
the HBV polymerase is a multifunctional protein with a function in
assembly
encapsidation of RNA
and three enzymatic functions: DNA
synthesis priming and DNA polymerase and RNase H activity (22,
26). All these functions are probably highly susceptible to
changes in the protein structure. This speculation is supported by our
observation that in three amplified genomes the defect in replication
can be attributed to only a few amino acid changes in the polymerase
(Fig. 6). This interpretation is
consistent with a study showing that most of a variety of single amino
acid changes rendered the HBV polymerase inactive (27). In
conclusion, our data point to a rather limited sequence flexibility of
the HBV genome, probably because of the highly mutation-sensitive
polymerase protein encoded by a large part of the genome.

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|
FIG. 6.
Schematic map of the positions of amino acid changes in
the polymerase protein of replication-defective genomes Taq/Pwo-15 (A),
Taq/Pwo-14 (B), and Taq-1 (C). The nucleocapsid protein, as well as
known sequence elements essential for replication, is not affected in
these genomes (Table 2). The functional domains (TP, terminal protein
for DNA synthesis priming; RT, reverse transcriptase) (26),
as well as functionally important amino acid residues involved in HBV
DNA synthesis (Y, priming tyrosine; YMDD, RT catalytic site), are
indicated.
|
|
 |
ACKNOWLEDGMENTS |
We thank S. Polywka and R. Laufs for measuring HBsAg and HBeAg
and A. Röhl of the Mathematisches Seminar der Universität Hamburg for advice. We appreciate the critical reading of the manuscript by V. Radwitz-Will.
This work was supported by grants from the Bundesministerium für
Bildung, Wissenschaft, Forschung und Technologie (Verbundvorhaben, project 01KI9560) and the Wilhelm-Sander-Stiftung. The
Heinrich-Pette-Institut für Experimentelle Virologie und
Immunologie is supported by the Freie und Hansestadt Hamburg and the
Bundesministerium für Gesundheit.
 |
FOOTNOTES |
*
Corresponding author. Mailing address:
Heinrich-Pette-Institut für Experimentelle Virologie und
Immunologie an der Universität Hamburg, Martinistr. 52, D-20251
Hamburg, Federal Republic of Germany. Phone and fax: (49) 40 48051 222. E-mail: will{at}hpi.uni-hamburg.de.
 |
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