Effectiveness of Hepatitis B Vaccination in Babies Born to Hepatitis B Surface Antigen–Positive Mothers in Italy

Mele, Alfonso; Tancredi, Francesco; Romanò, Luisa; Giuseppone, Anna; Colucci, Mario; Sangiuolo, A; Lecce, R.; Adamo, B; Tosti, Maria Elena; Taliani, Gloria; Zanetti, Alessandro

doi:10.1086/323396

Cited by 100 publications

(47 citation statements)

References 14 publications

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“…6,7 Additional mutations have also been described after therapeutic interventions such as antiviral therapy and vaccination. 8,9 Thus, the ability to detect these mutants is essential to further our understanding of the natural history of HBV and its response to antiviral therapy and immunoprophylaxis.Presently, the detection of HBV mutants is largely performed by restriction fragment length polymorphism analysis, 10,11 gap ligase chain reaction assay and/or direct sequencing. 12,13 These methods are time consuming, labor intensive, and require the optimization of polymerase chain reactions (PCRs).…”

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Rapid detection of hepatitis B virus mutations using real-time PCR and melting curve analysis

2002

Hepatology

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Current methods of detecting hepatitis B virus (HBV) mutations are time consuming, labor intensive, and not suitable for screening large numbers of samples. In the present study, we documented the advantages of a system that exploits differences in thermal stability between perfect match and mismatch hybrids, and thereby distinguishes between wild-type and mutants. Hybridization probes were designed complementary to specific wild-type HBV sequences in surface (S), precore, and basal core promoter (BCP) regions of the HBV genome (nt 587, 1896, and 1762/1764, respectively). Two probes were designed for each mutation: anchor probes were 3 labeled with fluorescein and sensor probes, 5 labeled with LC-Red 640, and 3 phosphorylated. Temperatures for each probe melted from amplification products were then determined in a melting program. Sera from 12 patients, each containing identified HBV mutants (6 S-escape, 1 precore, 1 BCP, and 4 mixed precore and BCP), and 5 control sera from patients with wild-type virus were analyzed. Genomic sequences of mutant and wild-type viruses were confirmed by direct sequencing. Real-time polymerase chain reaction (PCR) with fluorescent hybridization probes accurately identified each mutant and wild-type genome. Melting temperatures obtained from probe-product duplexes for the 3 mutants were distinguished from wild-type (>4.0°C, minimal) within 45 minutes. The sensitivity of the system was 100 copies/mL and as few as 5% of mutant among wild-type virus were detected. In conclusion, real-time PCR with fluorescent hybridization probes is a specific, sensitive, quantitative, and rapid means of detecting clinically relevant HBV mutants. (HEPATOLOGY 2002;36:723-728.) T he hepatitis B virus (HBV) is one of the most common infectious agents in humans and a major cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma. [1][2][3] It is a partially double-stranded DNA molecule virus that replicates through an RNA intermediate by reverse transcription. 4,5 The reverse transcriptase enzyme responsible for this aspect of the replication cycle lacks proofreading function and, therefore, mutations to the genome are common. Indeed, it is now recognized that the majority of chronic HBV infections are associated with emergence of mutations throughout the viral genome. Some of these mutations result in the generation of diverse viral populations and different clinical outcomes. Those in the surface, core, precore, and basal core promoter (BCP) regions appear to have the greatest clinical relevance. 6,7 Additional mutations have also been described after therapeutic interventions such as antiviral therapy and vaccination. 8,9 Thus, the ability to detect these mutants is essential to further our understanding of the natural history of HBV and its response to antiviral therapy and immunoprophylaxis.Presently, the detection of HBV mutants is largely performed by restriction fragment length polymorphism analysis, 10,11 gap ligase chain reaction assay and/or direct sequencing. 12,13 These methods ...

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Rapid detection of hepatitis B virus mutations using real-time PCR and melting curve analysis

2002

Hepatology

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“…A decline in the prevalence of chronic HBV infection among vaccinated people has been documented throughout the world, including Hong Kong, Taiwan, Italy, the Gambia, Alaska, and Senegal. 19,[38][39][40][41][42][43][44] In the United States, which implemented routine HepB vaccination in 1991, the incidence of acute hepatitis B among children and adolescents has decreased by 89%. 45 In Taiwan, where routine infant HepB vaccination commenced in 1984, there has been a 75% decrease in the incidence of HCC among children.…”

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confidence: 99%

24 year outcomes of hepatitis B vaccination in Hangzhou, China

Xu²,

Wang³

et al. 2015

Human Vaccines & Immunotherapeutics

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To evaluate the impact of the universal infant HepB vaccination program on hepatitis B virus infection in Hangzhou, China. Hepatitis B incidences and HepB vaccination rates of Hangzhou from 1990 to 2003 were acquired from the historical paper-documents, while which were derived from China Information System for Diseases Control and , P < 0.001). Significant association was found between incidence of hepatitis B and HepB vaccination rate (r D 0 .946, x 2 D 11.813, P for trend D 0.001). A total of 5605 participants aged 0-59 y included in this serological survey. The prevalence of HBsAg, anti-HBs, anti-HBc, HBeAg and anti-HBe were 6.19%, 45.83%, 57.25%, 0.62%, and 4.37%, respectively. Hangzhou has successfully integrated the HepB into routine immunization programs and this has had a significant impact on decreasing the incidence of hepatitis B infection.

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“…However no evidence exist that s-gene immunization escape mutants posing a risk to currently existing programmes using hepatitis B vaccine. 55 Further studies including surveillance are needed to track any possible emergence of these variants in future.…”

Section: Nigerian Hbv Vaccination Schedulementioning

confidence: 99%

Prevention of mother to child transmission of hepatitis B virus infection in Nigeria: A call to action

Eke¹,

Onyire²,

Amadi³

2016

Nig. J. Paed.

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Abstract:Background: Sub-Sahara Africa including Nigeria has the second largest global burden of chronic carriers of hepatitis B virus (HBV) infection after Asia. Mother-to-child transmission (MTCT) of HBV is the most commonroute of transmission in high endemic areas .MTCT of hepatitis B virus infection continues to occur despite the interventions of hepatitis B vaccinations and immunoglobulins in settings where it is practiced. Infants most at risk are those whose mothers have high HBV DNA viral loads and produce the protein HBeAg. Various Nigerian studies have reported high HBV infection rates as well as HBeAg positivity among pregnant women. These HBV infections usually occur intrapartum and rarely inutero. Mothers with HBeAg positivity known to be associated with higher HBV DNA viral loads have been linked with higher chances of MTCT as HBeAg is the only structural HBV protein that can cross into the placental circulation. In the absence of post exposure prophylaxis about 40 percent of infants delivered by HBV infected mothers could develop HBV infections, and about 25% of them may come down with chronic hepatitis and resulting possible complications including liver cirrhosis and hepatocellular cancer later in life. The prevention of transmission of retroviral infection from motherto-child has been a success story of the 21 st century and such feat could be replicated for HBV infection. The standard PMTCT of HBV currently will comprise: timely prenatal screening, starting anti-viral therapy for pregnant women with HBeAg positivity and high viral load, infant postexposure prophylaxis and followup of infants of HBsAg positive mothers. There is no co-ordinated PMTCT of HBV programme in place in our setting despite the huge burden of the disease in Nigeria. Hence the need therefore to develop a home grown PMTCT programme of HBV to help tackle the burden of the disease in our country. An evidence based review of current best practice guidelines for the prevention of mother-to-child transmission of HBV for use in low and medium resource income settings with hepatitis B hyperendemicity will be quiet apt in this circumstance. This document therefore will be useful as a quick guide to Paediatricians, Obstetricians, Family Physicians, General Practice Doctors and other allied health workers charged with the care of pregnant mothers and their young children. Methods: Relevant literatures published in English language or translated into English were searched manually and electronically in PUBMED and SCOPUS for the period between 1990 and 2016 on the subject. Keywords searched included: epidemiology of HBV infection, MTCT of HBV, and its preventive strategies including prenatal screening, antiviral agents in pregnancy, infant post exposure prophylaxis and follow-up of infected children. Results: Over 35 scholarly articles on HBV epidemiology, MTCT, and preventive measures as well as follow -up models were retrieved and analyzed. Conclusion: Universal screening of all pregnant women for HBV infection is the most effective...

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Effectiveness of Hepatitis B Vaccination in Babies Born to Hepatitis B Surface Antigen–Positive Mothers in Italy

Cited by 100 publications

References 14 publications

Rapid detection of hepatitis B virus mutations using real-time PCR and melting curve analysis

Rapid detection of hepatitis B virus mutations using real-time PCR and melting curve analysis

24 year outcomes of hepatitis B vaccination in Hangzhou, China

Prevention of mother to child transmission of hepatitis B virus infection in Nigeria: A call to action

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