Proteomic Signatures of Hepatitis B Virus Mutations Reveal Genotype-Specific Host Responses and Biomarker Candidates

Hepatitis B virus (HBV) remains a global health challenge, with viral genetic heterogeneity and mutation-driven resistance complicating treatment outcomes. While previous genomic and transcriptomic studies have characterized HBV mutations, the proteomic consequences of these variants remain underexplored. In this study, we applied liquid chromatography– mass spectrometry (LC–MS)–based proteomics and systems biology approaches to serum samples from 60 HBV-infected patients, stratified by mutation-defined genotype signatures. Four genotype groups were generated, including those harboring mutation related to liver disease progression (rt269/s184) and basal core promoter/precore mutations (A1762T/G1896A). Comparative analyses of 406 high-abundance plasma proteins revealed distinct proteomic signatures, particularly in the ##AG group lacking mutation related to liver disease progression motifs. This group exhibited elevated CRISPLD2 and HSPD1 expression, implicating a dual axis of anti-inflammatory buffering and chaperone-mediated viral processes. Network and co-expression analyses identified modules enriched in focal adhesion, extracellular matrix remodeling, angiogenesis, and PI3K/Akt signaling—pathways tightly linked to hepatocarcinogenesis. Protein–protein interaction enrichment further highlighted disruption of chaperone networks, cytoskeletal regulation, and unfolded protein response. These findings provide molecular evidence for genotype-specific host–virus interactions, nominate CRISPLD2 and HSPD1 as biomarker candidates, and suggest therapeutic strategies targeting PI3K/Akt and microenvironmental pathways. Our results underscore the value of proteomics in refining genotype-informed risk stratification and personalized management in chronic HBV.