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Increased seroprevalence of HBV DNA with mutations in the s gene among individuals greater than 18 years old after complete vaccination.

Authors :
Lai MW
Lin TY
Tsao KC
Huang CG
Hsiao MJ
Liang KH
Yeh CT
Source :
Gastroenterology [Gastroenterology] 2012 Aug; Vol. 143 (2), pp. 400-7. Date of Electronic Publication: 2012 May 10.
Publication Year :
2012

Abstract

Background & Aims: Despite the success of a universal vaccination program against hepatitis B virus (HBV) in Taiwan, a small but substantial proportion of individuals remain infected by mutant viruses that escape the vaccine. We investigated the seroepidemiology and genotypic characteristic of HBV for long periods after neonatal vaccination.<br />Methods: We measured hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen (anti-HBc), and antibody to hepatitis B surface antigen (anti-HBs) in 1214 serum samples collected throughout Taiwan from individuals 0.6-87.8 years old in 2007. HBV DNA was detected using polymerase chain reaction and sequence analysis in vaccine recipients who tested positive for anti-HBc and/or HBsAg.<br />Results: The overall seroprevalence of HBsAg and anti-HBc was significantly lower among individuals born after the initiation of the nationwide vaccination program (P < .001). However, we observed increasing seroprevalence of anti-HBc and isolated anti-HBs when subjects were grouped by age: at 10-14, 14-18, to 18-21 years of age, values were 0.4%, 1.9%, and 8.1% (P = .0135) and 43.7%, 55.4%, and 59.6% (P = .0093), respectively (χ(2) test for trend). A large increase was observed in the percentage of patients who tested positive for HBV DNA at 18-21 years of age (3.0% vs 0.2% [P = .002] for all eligible subjects and 5.7% vs 0.3% [P < .001] for subjects vaccinated with ≥3 doses). Five of 8 completely vaccinated individuals who were seropositive for HBV DNA carried variants with mutations in the S gene.<br />Conclusions: Universal vaccination effectively controls HBV infection in children and adolescents. However, after adolescence, there is a significant increase in the seroprevalence of anti-HBs, anti-HBc, and HBV DNA, indicating that new preventative strategies are needed for adults.<br /> (Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1528-0012
Volume :
143
Issue :
2
Database :
MEDLINE
Journal :
Gastroenterology
Publication Type :
Academic Journal
Accession number :
22580098
Full Text :
https://doi.org/10.1053/j.gastro.2012.05.002