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F9 p.Ala279Thr

c.835G>A · rs137852247 · VCV216926

Pathogenic Expert panel
Classification
Pathogenic
ClinVar
Review
Expert panel ★★★☆
ClinVar · 13 submitters
AlphaMissense
likely benign
0.26 · ACMG-weighted
gnomAD v4.1
Rare
very rare (popmax 0.000235%, nfe)
Missense predictors
2/3 damaging
AlphaMissense, REVEL, SaProt
Conditions
3
hemophilia B

ClinGen expert panel — Coagulation Factor Deficiency VCEP

Pathogenic for hemophilia B. Applied ACMG criteria (verbatim):

PP4_Moderate PS4_VeryStrong PM2_Supporting PP3

Curation rationale (ClinGen, verbatim)

The NM_000133.3:c.835G>A variant that results in the Ala279Thr missense change is absent from gnomAD v2.1.1 and v3, meeting PM2_Supporting. More than 59 male patients with mild hemophilia B are reported hemizygous for this variant in the literature, meeting PS4_Very strong and PP4_Moderate criteria (PMID: 29296726, 29656491). It is noted as a founder variant but may also have arisen de novo as a recurrent variant and is found in multiple ethnicities. The variant has a REVEL score of 0.765 (>0.6) which meets the thresholds recommended for PP3. In summary, the variant meets criteria to be classified as pathogenic. ACMG/AMP criteria applied, as specified by the Coagulation Factor Deficiency Variant Curation Expert Panel for F9: PS4_Very Strong, PP3, PP4_Moderate, PM2_Supporting.

ClinGen Evidence Repository → · reported verbatim, not re-tallied by Sugi Variant.

Computational evidence

Protein change
AlphaMissense0.26likely benign ⚠ discordant with ClinVar
REVEL0.765pathogenic-leaning
SaProtLLR -11.09damaging
⇒ REVEL and SaProt call this damaging; AlphaMissense does not.
Splicing
SpliceAI—not assessed · no allele here is in the release
Constraint at this position
ConservationphyloP 12GERP 5.2, phastCons 1
Regional constrainto/e 0.57unconstrained · MANE · 25 kb · p 2.3e-14 · regional, not allelic
Overall
CADD24.4PHRED · no single calibrated threshold — expert panels disagree

AlphaMissense carries the ACMG weight for missense; REVEL and SaProt are independent agreement signals.

Population frequency

gnomAD v4.1 · exomes + genomes
Grpmax group 0.000235% European (non-Finnish) · 2/852,306 alleles
Filtering AF 3.9e-05% ClinGen BA1/BS1 input FAF95, joint · FAF99 1.5e-05%
Overall 0.00019% 2/1,050,721 alleles · very rare

Rarity supports pathogenicity (ACMG PM2); frequency above a disease-specific BA1/BS1 threshold argues against it. A variant frequent in one ancestry group can be near-absent in others, so a single global figure can mislead.

Variant & gene context

Gene
F9
Protein
p.Ala279Thr
Coding
c.835G>A
MANE Select
NM_000133
dbSNP
rs137852247
Type
single nucleotide variant
Location
chrX:139560852 (GRCh38)
Structure
AlphaFold pLDDT 80.45 · 57 PDB
Residue 279
a UniProt-annotated variant site (in hemb; mild); a β-strand; a disulfide bond; the peptidase s1 domain
Full F9 gene report on Sugi Atlas → Gene function, pathways, protein structure, interactions & more

Disease context

hemophilia B — disease report on Sugi Atlas → Associated genes, phenotypes, clinical trials & treatments

Also linked: thrombophilia, X-linked, due to factor 9 defecthemophilia A

For Hemophilia B (Orphanet):

Inheritance
X-linked recessive
Onset
Childhood, Infancy, Neonatal
Prevalence
1-9 / 100 000 (Europe)

Similar variants

Built on 18 open, versioned datasets — ClinVar, gnomAD, AlphaMissense, REVEL, ClinGen & more — plus Sugi Variant's own cross-source analysis. Source data 2026-01–2026-10, ClinVar 2026-10. Full sources & versions →

Cite Sugi Variant

Gür T. Sugi Variant: A Deterministic Per-Variant Germline Reference from a Knowledge Graph for Humans and AI Agents. 2026. doi:10.5281/zenodo.21509445. This variant: https://sugi.bio/variant/f9-p-ala279thr (accessed [today's date]).

Preprint & method: sugi.bio/variant/method Machine-readable: this page as Markdown