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

作者：Luongo Monica; Critelli Rosina; Grottola Antonella; Gitto Stefano; Bernabucci Veronica; Bevini Mirco; Vecchi Chiara; Montagnani Giuliano; Villa Erica^*

来源：Journal of Clinical Virology, 2015, 62: 89-91.

DOI：10.1016/j.jcv.2014.11.029

• Hepatitis B virus
• Escape mutant
• Vaccine
• Acute hepatitis
• Telbivudine

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.

• 出版日期2015-1