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Unusual hepatitis B surface antigen variation in a child immunised against hepatitis B
L Roznovsky1, T J Harrison, Z L Fang
1Department of Infectious Diseases, University Hospital, Ostrava, Czech Republic. ludek.roznovsky@fnspo.cz
Insights
Hepatitis B (HBV) vaccination after birth effectively prevents perinatal transmission from HBsAg-positive mothers. A study found only one infant carrier, infected with HBV variants, highlighting the vaccine
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Perinatal transmission of Hepatitis B Virus (HBV) from HBsAg-positive mothers can occur despite timely infant vaccination.
- HBV variants with mutations in the HBsAg
Purpose of the Study:
- To evaluate the effectiveness of combined active and passive immunisation against HBV in infants born to HBsAg-positive mothers.
- To identify HBV variants involved in breakthrough infections.
Main Methods:
- Combined active and passive immunisation administered to 446 newborn infants.
- Sequencing of HBV DNA from the plasma of a carrier infant and his mother to analyze HBsAg gene variants.
Main Results:
- Only one out of 446 infants became an HBsAg carrier, experiencing a mild HBV infection in early childhood.
- The carrier infant was infected with HBV variants featuring substitutions at residues 137 and 139.
- The mother's virus showed substitutions at residues 120 and 121, with both mother and child harboring an unusual substitution at residue 118.
Conclusions:
- Combined active and passive immunisation is highly effective in preventing HBV carriage in infants of HBsAg-positive mothers.
- HBV variants, including those with substitutions in the HBsAg
Abstract:
Perinatal transmission of and infection with hepatitis B (HBV) in early childhood are observed in a small proportion of the offspring of hepatitis B surface antigen (HBsAg)-positive mothers who are vaccinated against HBV immediately after giving birth. The children may be infected by wild-type HBV or by variants with amino acid substitutions in the "a" determinant of HBsAg, particularly at position 145 and, rarely, at positions 120, 126, 129, 131, 141, and 144. Four hundred and forty-six newborn infants of HBsAg-positive mothers in the northeastern part of the Czech Republic received combined active and passive immunisation against HBV. Only one child became an HBsAg carrier. This followed a mild, acute HBV illness in the beginning of the second year of his life. HBV DNA encoding the "a" determinant and surrounding region of HBsAg was sequenced after amplification from the plasma of the child and his mother. The child was infected with variants of HBsAg with substitutions at residues 137 and 139. The virus of the mother had changes at residues 120 and 121. HBV from both child and mother had an unusual substitution at residue 118 and seemed to be of the ayw subdeterminant.