In a heterozygous state for HbS, what other hemoglobin appears alongside HbS in sickle cell trait?

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In individuals with sickle cell trait, who are heterogeneous for the HbS gene, both hemoglobin S (HbS) and hemoglobin A (HbA) are present in their blood. Sickle cell trait occurs when one allele for the beta-globin gene is mutated to produce HbS, while the other allele produces the normal beta-globin, which leads to the synthesis of HbA. This results in a mixture of both types of hemoglobin, with the majority typically being HbA. The presence of HbA alongside HbS helps to mitigate some of the symptoms associated with sickle cell disease, as HbA does not sickle under low-oxygen conditions as HbS does.

In contrast, while HbF (fetal hemoglobin) and HbC can be present in individuals with various hemoglobinopathies, they are not the predominant hemoglobins found in sickle cell trait. HbE is also a different variant of hemoglobin, but it does not typically co-exist with HbS in sickle cell trait. The key point is that in sickle cell trait, HbA is the major hemoglobin alongside HbS.

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