Hepatitis B Virus Immunization and Neonatal Acquisition of Persistent Infection in England and Wales.
J Infect Dis
; 218(5): 726-733, 2018 07 24.
Article
em En
| MEDLINE
| ID: mdl-29688415
ABSTRACT
Background:
It is believed that between 2% and 5% of infants born to hepatitis B virus (HBV)-infected mothers at a high risk of perinatal transmission will become persistently infected despite immunization starting at birth. We investigated factors associated with breakthrough infections.Methods:
Sixty-nine samples from HBV-infected infants born between 2003 and 2015 were tested for HBV serological and molecular markers. Sequencing and epitope phenotyping were used to investigate alterations in hepatitis B surface antigen (HBsAg) sequence and antigenicity in infants and in mothers known to have transmitted and not to have transmitted virus to their infants.Results:
Vaccine/hepatitis B immune globulin uptake was complete in the majority of HBV-infected infants. A minority (8 [12%]) had detectable plasma antibody to HBsAg at 12 months. Twenty-five of 68 (37%) infants harbored a virus with amino acid changes in the HBsAg "a" determinant, of which 13 displayed altered HBsAg antigenicity. Viral load was 30-fold higher in maternal samples from those who transmitted.Conclusions:
Our data provide evidence to suggest that immune selection drives change at mother-infant transmission, resulting in the alteration of HBsAg antigenicity. These changes may play a role in immunization failure, but other factors including viral load may be more important. Continued monitoring of vaccine efficacy is essential.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Vacinas contra Hepatite B
/
Transmissão Vertical de Doenças Infecciosas
/
Hepatite B
Limite:
Child
/
Child, preschool
/
Female
/
Humans
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Infant
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Male
/
Newborn
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Pregnancy
País/Região como assunto:
Europa
Idioma:
En
Revista:
J Infect Dis
Ano de publicação:
2018
Tipo de documento:
Article