Amino acid substitutions in the S region of hepatitis B virus in sera from patients with acute hepatitis.

BACKGROUND: An increase in the number of acute hepatitis patients with hepatitis B virus (HBV) of non-indigenous genotypes may reduce the efficacy of vaccination against HBV. METHODS: We have determined the amino acid (aa) sequences in the major hydrophilic region (MHR) in the S region of HBV in patients with acute hepatitis B and compared those with the ones from HBV strains used for the production of HBV vaccines commercially available in Japan. RESULTS: Of 48 patients studied, 11 were infected with genotype A, 11 with genotype B and 26 with genotype C HBV. The aa sequences of the nine genotype A isolates were the same as the aa sequence of J02205 which is used for the production of one of the commercially available recombinant vaccines. The aa sequences of the 11 genotype B isolates differed from the aa sequence of J02205 in two or three amino acids. Of the26 genotype C isolates, 22 had the same aa sequence as X01587 which is used for the production of another recombinant vaccine. The remaining genotype C isolates had aa substitutions at aa131, which have a potential to alter the hydropathy and the three-dimensional structure of the MHR. The differences among the three current HBV vaccines in aa sequences in the MHR theoretically alter the hydropathy and three-dimensional structure. CONCLUSION: Our results suggest that the transmission of HBV isolates with different genotypes or with aa substitutions in the MHR might reduce the efficacy of currently available HBV vaccines in the protection of HBV infections.