Acute hepatitis B caused by a vaccine-escape HBV strain in vaccinated subject: sequence analysis and therapeutic strategy

J Clin Virol. 2015 Jan:62:89-91. doi: 10.1016/j.jcv.2014.11.029. Epub 2014 Nov 29.

Abstract

HBV vaccine contains the 'a' determinant region, the major immune-target of antibodies (anti-HBs). Failure of immunization may be caused by vaccine-induced or spontaneous 'a' determinant surface gene mutants. Here, we evaluate the possible lack of protection by HBV vaccine, describing the case of an acute hepatitis B diagnosed in a 55-year-old Caucasian male unpaid blood donor, vaccinated against HBV. Sequencing data for preS-S region revealed multiple point mutations. Of all the substitutions found, Q129H, located in the "a" determinant region of HBsAg, can alter antigenicity, leading to mutants. This mutant may cause vaccine failure especially when associated with high viremia of infecting source.

Keywords: Acute hepatitis; Escape mutant; Hepatitis B virus; Telbivudine; Vaccine.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Amino Acid Sequence
  • Genotype
  • Hepatitis B / drug therapy
  • Hepatitis B / immunology
  • Hepatitis B / prevention & control
  • Hepatitis B / virology*
  • Hepatitis B Surface Antigens / chemistry
  • Hepatitis B Surface Antigens / genetics
  • Hepatitis B Surface Antigens / immunology
  • Hepatitis B Vaccines / adverse effects*
  • Hepatitis B Vaccines / genetics
  • Hepatitis B Vaccines / immunology
  • Hepatitis B virus* / genetics
  • Hepatitis B virus* / immunology
  • Humans
  • Male
  • Middle Aged
  • Molecular Sequence Data
  • Mutation
  • Sequence Alignment
  • Vaccination / adverse effects

Substances

  • Hepatitis B Surface Antigens
  • Hepatitis B Vaccines