Hepatitis B viremia in completely immunized individuals negative for anti-hepatitis B core antibody

Ming Wei Lai, Tzou Yien Lin, Kung Hao Liang, Wey Ran Lin, Chau Ting Yeh

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

The presence of anti-hepatitis B virus (HBV) core antibody (anti-HBc) is considered a sensitive lifetime marker of HBV infection. Here, we examined this dogma by investigating the prevalence of hepatitis B viremia in anti-HBc negative complete vaccines in Taiwan. A total of 795 participants (1.7-20.0 years old) had completed HBV vaccination in infancy and were anti-HBc negative. Serum samples were available for 460 individuals with isolated anti-HBV surface antibodies (anti-HBs) (HBsAg-negative and anti-HBc negative) and for 245 individuals who tested negative for all 3 markers (triple seronegative). All samples were submitted for polymerase chain reaction (PCR) targeting both the preS/S and X/pre-C gene regions. Of the 460 participants with isolated anti-HBs, 26 (5.65%) were positive for HBV by 2-target PCR. Of the 245 triple seronegative samples, 12 (4.90%) were positive for HBV DNA. In the former group, the prevalence of viremia was significantly higher in individuals aged 6 to 10 years than in all other ages combined (11.82% vs 3.7%, P=0.001). The anti-HBs titers were significantly lower in participants 6 to 10 years old than in all other ages combined (72.06 vs 99.64mIU/mL, P=0.038). In total, 7 (0.99%) subjects had quantifiable HBV DNA levels (280-18,820IU/mL). Sequence analysis of the S gene revealed vaccine escape like mutations. Hepatitis B viremia can occur in completely vaccinated individuals who are negative for anti-HBc.

Original languageEnglish
Pages (from-to)e5625
JournalMedicine (United States)
Volume95
Issue number49
DOIs
Publication statusPublished - 2016
Externally publishedYes

Fingerprint

Hepatitis B Antibodies
Viremia
Hepatitis B
Hepatitis B virus
Vaccines
Polymerase Chain Reaction
DNA
Virus Diseases
Hepatitis B Surface Antigens
Taiwan
Genes
Sequence Analysis
Vaccination
Mutation
Serum

Keywords

  • Escape mutant
  • HBsAg-negative
  • Hepatitis B vaccination
  • Nucleic acid testing
  • Occult HBV infection
  • Seronegative

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Hepatitis B viremia in completely immunized individuals negative for anti-hepatitis B core antibody. / Lai, Ming Wei; Lin, Tzou Yien; Liang, Kung Hao; Lin, Wey Ran; Yeh, Chau Ting.

In: Medicine (United States), Vol. 95, No. 49, 2016, p. e5625.

Research output: Contribution to journalArticle

Lai, Ming Wei ; Lin, Tzou Yien ; Liang, Kung Hao ; Lin, Wey Ran ; Yeh, Chau Ting. / Hepatitis B viremia in completely immunized individuals negative for anti-hepatitis B core antibody. In: Medicine (United States). 2016 ; Vol. 95, No. 49. pp. e5625.
@article{bb361d45f91f4dddbb234548ff20edba,
title = "Hepatitis B viremia in completely immunized individuals negative for anti-hepatitis B core antibody",
abstract = "The presence of anti-hepatitis B virus (HBV) core antibody (anti-HBc) is considered a sensitive lifetime marker of HBV infection. Here, we examined this dogma by investigating the prevalence of hepatitis B viremia in anti-HBc negative complete vaccines in Taiwan. A total of 795 participants (1.7-20.0 years old) had completed HBV vaccination in infancy and were anti-HBc negative. Serum samples were available for 460 individuals with isolated anti-HBV surface antibodies (anti-HBs) (HBsAg-negative and anti-HBc negative) and for 245 individuals who tested negative for all 3 markers (triple seronegative). All samples were submitted for polymerase chain reaction (PCR) targeting both the preS/S and X/pre-C gene regions. Of the 460 participants with isolated anti-HBs, 26 (5.65{\%}) were positive for HBV by 2-target PCR. Of the 245 triple seronegative samples, 12 (4.90{\%}) were positive for HBV DNA. In the former group, the prevalence of viremia was significantly higher in individuals aged 6 to 10 years than in all other ages combined (11.82{\%} vs 3.7{\%}, P=0.001). The anti-HBs titers were significantly lower in participants 6 to 10 years old than in all other ages combined (72.06 vs 99.64mIU/mL, P=0.038). In total, 7 (0.99{\%}) subjects had quantifiable HBV DNA levels (280-18,820IU/mL). Sequence analysis of the S gene revealed vaccine escape like mutations. Hepatitis B viremia can occur in completely vaccinated individuals who are negative for anti-HBc.",
keywords = "Escape mutant, HBsAg-negative, Hepatitis B vaccination, Nucleic acid testing, Occult HBV infection, Seronegative",
author = "Lai, {Ming Wei} and Lin, {Tzou Yien} and Liang, {Kung Hao} and Lin, {Wey Ran} and Yeh, {Chau Ting}",
year = "2016",
doi = "10.1097/MD.0000000000005625",
language = "English",
volume = "95",
pages = "e5625",
journal = "Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries",
issn = "0025-7974",
publisher = "Lippincott Williams and Wilkins",
number = "49",

}

TY - JOUR

T1 - Hepatitis B viremia in completely immunized individuals negative for anti-hepatitis B core antibody

AU - Lai, Ming Wei

AU - Lin, Tzou Yien

AU - Liang, Kung Hao

AU - Lin, Wey Ran

AU - Yeh, Chau Ting

PY - 2016

Y1 - 2016

N2 - The presence of anti-hepatitis B virus (HBV) core antibody (anti-HBc) is considered a sensitive lifetime marker of HBV infection. Here, we examined this dogma by investigating the prevalence of hepatitis B viremia in anti-HBc negative complete vaccines in Taiwan. A total of 795 participants (1.7-20.0 years old) had completed HBV vaccination in infancy and were anti-HBc negative. Serum samples were available for 460 individuals with isolated anti-HBV surface antibodies (anti-HBs) (HBsAg-negative and anti-HBc negative) and for 245 individuals who tested negative for all 3 markers (triple seronegative). All samples were submitted for polymerase chain reaction (PCR) targeting both the preS/S and X/pre-C gene regions. Of the 460 participants with isolated anti-HBs, 26 (5.65%) were positive for HBV by 2-target PCR. Of the 245 triple seronegative samples, 12 (4.90%) were positive for HBV DNA. In the former group, the prevalence of viremia was significantly higher in individuals aged 6 to 10 years than in all other ages combined (11.82% vs 3.7%, P=0.001). The anti-HBs titers were significantly lower in participants 6 to 10 years old than in all other ages combined (72.06 vs 99.64mIU/mL, P=0.038). In total, 7 (0.99%) subjects had quantifiable HBV DNA levels (280-18,820IU/mL). Sequence analysis of the S gene revealed vaccine escape like mutations. Hepatitis B viremia can occur in completely vaccinated individuals who are negative for anti-HBc.

AB - The presence of anti-hepatitis B virus (HBV) core antibody (anti-HBc) is considered a sensitive lifetime marker of HBV infection. Here, we examined this dogma by investigating the prevalence of hepatitis B viremia in anti-HBc negative complete vaccines in Taiwan. A total of 795 participants (1.7-20.0 years old) had completed HBV vaccination in infancy and were anti-HBc negative. Serum samples were available for 460 individuals with isolated anti-HBV surface antibodies (anti-HBs) (HBsAg-negative and anti-HBc negative) and for 245 individuals who tested negative for all 3 markers (triple seronegative). All samples were submitted for polymerase chain reaction (PCR) targeting both the preS/S and X/pre-C gene regions. Of the 460 participants with isolated anti-HBs, 26 (5.65%) were positive for HBV by 2-target PCR. Of the 245 triple seronegative samples, 12 (4.90%) were positive for HBV DNA. In the former group, the prevalence of viremia was significantly higher in individuals aged 6 to 10 years than in all other ages combined (11.82% vs 3.7%, P=0.001). The anti-HBs titers were significantly lower in participants 6 to 10 years old than in all other ages combined (72.06 vs 99.64mIU/mL, P=0.038). In total, 7 (0.99%) subjects had quantifiable HBV DNA levels (280-18,820IU/mL). Sequence analysis of the S gene revealed vaccine escape like mutations. Hepatitis B viremia can occur in completely vaccinated individuals who are negative for anti-HBc.

KW - Escape mutant

KW - HBsAg-negative

KW - Hepatitis B vaccination

KW - Nucleic acid testing

KW - Occult HBV infection

KW - Seronegative

UR - http://www.scopus.com/inward/record.url?scp=85007505725&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85007505725&partnerID=8YFLogxK

U2 - 10.1097/MD.0000000000005625

DO - 10.1097/MD.0000000000005625

M3 - Article

C2 - 27930595

AN - SCOPUS:85007505725

VL - 95

SP - e5625

JO - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

JF - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

SN - 0025-7974

IS - 49

ER -