Comprehensive analysis of the prevalence of hepatitis B virus escape mutations in the major hydrophilic region of surface antigen

Ma, Qiang; Wang, Yefu

doi:10.1002/jmv.23183

Cited by 92 publications

(131 citation statements)

References 36 publications

(60 reference statements)

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“…On the contrary, there remains a concern that the antibodies generated by vaccination may enhance dengue, particularly when antibody levels wane in the years following vaccination. Furthermore, vaccination may not prevent infection against all strains [142] or may drive the emergence of vaccine-escape mutants [143], as encountered with other infections, such as hepatitis B [144]. A comprehensive surveillance of dengue among cases of febrile illness would thus be needed to determine the true efficacy of vaccination and to monitor for vaccine failure.…”

Section: Diagnosis Of Dengue In a Vaccinated Populationmentioning

confidence: 99%

Diagnosis of dengue: an update

Tang

Ooi

2012

Expert Review of Anti-infective Therapy

113

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Section: Diagnosis Of Dengue In a Vaccinated Populationmentioning

confidence: 99%

Diagnosis of dengue: an update

Tang

Ooi

2012

Expert Review of Anti-infective Therapy

113

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“…Mutations at multiple positions of the S gene, including position 120, have been associated with evasion of vaccine or immunoglobulin therapy. 9 Our patient developed chronic hepatitis B infection despite receiving adequate immunoprophylaxis. This scenario suggests that her virus, with its P120T surface antigen mutation, may have been a vaccine escape mutant.…”

Section: Discussionmentioning

confidence: 95%

New-Onset Scleral Icterus in a School-Aged Female

Thompson

Bilhartz

Abramowsky

et al. 2016

Clin Pediatr (Phila)

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A 9-year-old, previously healthy, African American female was admitted with 2 weeks of mild, diffuse abdominal pain and 2 days of pronounced scleral icterus. She initially presented to an outside institution where she was noted to have marked hepatomegaly. Further examination at our institution was notable for an illappearing child with a pulse of 144 beats per minute and respiratory rate of 48 breaths per minute. She had a nontender, but distended, abdomen with a firm liver edge palpable 5 cm below the right costal margin. She had nonpitting edema in both lower extremities and palmar erythema.Laboratory studies revealed a microcytic anemia (hemoglobin 9.1 g/dL [range 11.5-15.5g/dL], mean corpuscular volume 76 fL [range 77-95 fL]), elevated transaminases (AST 419 U/L [range 22-55 U/L), ALT 78 U/L [range 11-30 U/L]), and hyperbilirubinemia (total bilirubin 5.5 mg/dL [range 0.2-1.0 mg/dL]). Serum α-fetoprotein was markedly elevated at 100 000 ng/mL. Abdominal ultrasound demonstrated a large, right-sided hepatic mass. Contrast-enhanced computed tomography (CT) scan was notable for a nodular liver, a large mixed density mass measuring 15 cm × 12 cm × 18 cm within the right hepatic lobe ( Figure 1A), multiple smaller hepatic lesions, splenomegaly, and diffuse pulmonary nodules concerning for metastatic disease. Hospital CourseThe patient underwent open wedge liver biopsy, which revealed a well-differentiated hepatocellular carcinoma (HCC) with active micronodular cirrhosis ( Figure 1B) that was HBsAg positive ( Figure 1C). α-Fetoprotein immunostaining was positive in the tumor cells ( Figure 1D). Investigation for an underlying etiology revealed positive serum HBsAg without any detectable hepatitis B surface antibody (anti-HBs). Hepatitis B virus (HBV) DNA was detected in the blood at 100 000 IU/mL and she was hepatitis B envelope antigen (HBeAg) positive. Her HBV genotype was type A with a P120T surface antigen mutation. Testing was negative for HIV-1, hepatitis C virus, and inherited cholestatic diseases that could predispose her to HCC.Evaluation of her mother's prenatal records revealed that the mother was HBsAg positive during her pregnancy. She was unaware of her diagnosis and denied receiving any further testing or treatment. At the birth hospital, the patient was born full term via Caesarean section due to failure to progress, and was given hepatitis B vaccine and hepatitis B immune globulin (HBIg) on day 1 of life. She received 3 additional doses of the hepatitis B vaccine at 3, 5, and 18 months of age. There were no records of an evaluation for hepatitis B infection, including HBsAg and anti-HBs testing after she completed her vaccination series. She was never breastfed. She did not have any other identified risk, either via blood-borne or sexual exposure, for hepatitis B virus infection by history.The patient rapidly deteriorated postbiopsy progressing to multisystem organ failure. She developed respiratory failure requiring endotracheal intubation and had echocardiogram findings consistent with hepatopulmo...

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“…Single or multiple mutations occurring within the Major Hydrophilic Region (MHR) could lead to a conformational change of this epitope which can affect the antigenicity (Ma and Wang, 2012). Several notable mutations: T/I126S, Q129H, G130N, S143L, D144A, G145A, and G145R (Figure 2), are involved in diagnostic failure, and escape from being neutralised by antibodies induced by available vaccines as well as resulting in a failure of HBIg therapy (Jolivet-Reynaud et al, 2001).…”

Section: Hepatitis B Surface Mutationmentioning

confidence: 99%

An Overview of Hepatitis B Virus Surface Antigen Mutant in the Asia Pacific

Hudu

Malik²,

Taib³

et al. 2014

Current Issues in Molecular Biology

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Hepatitis B virus infection is a serious health problem worldwide, and more than 350 million people are chronic carriers, constituting a major global threat. Southeast Asia and the Western Pacific have the highest levels of endemicity in the world, with an estimated seroprevalence ranging between 2% and 31%. Mutations in the hepatitis B surface antigen (HBsAg) have been reported in many parts of the world but are most common in Asian infants; such mutants have several clinical effects, such as the development of hepatocellular carcinoma. Diagnostic failures by commercial assays have reduced the diagnostic effectiveness of HBsAg detection. For example the substitution of an amino acid in the major hydrophilic region of the S gene reduces the binding of hepatitis B surface antibodies leading to immune escape. The safety of blood transfusion may be compromised by current screening tests due to escape from being neutralised by antibodies induced by HBsAg mutants, and undetectable levels of viral surface protein. Data on the epidemiology of HBsAg mutation in Asia Pacific are scant; however, this manuscript has reviewed the available information on the epidemiology of HBsAg mutation in Asia Pacific.

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Comprehensive analysis of the prevalence of hepatitis B virus escape mutations in the major hydrophilic region of surface antigen

Cited by 92 publications

References 36 publications

Diagnosis of dengue: an update

Diagnosis of dengue: an update

New-Onset Scleral Icterus in a School-Aged Female

An Overview of Hepatitis B Virus Surface Antigen Mutant in the Asia Pacific

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