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

Ming Wei Lai, Tzou Yien Lin, Kuo Chien Tsao, Chung Guei Huang, Mei Jen Hsiao, Kung Hao Liang, Chau Ting Yeh

Research output: Contribution to journalArticle

49 Citations (Scopus)

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. 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. 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. 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.

Original languageEnglish
Pages (from-to)400-407
Number of pages8
JournalGastroenterology
Volume143
Issue number2
DOIs
Publication statusPublished - Aug 2012
Externally publishedYes

Fingerprint

Seroepidemiologic Studies
Hepatitis B virus
Hepatitis B Core Antigens
Vaccination
Mutation
Hepatitis B Surface Antigens
DNA
Genes
Hepatitis B Antibodies
Taiwan
Antibodies
Vaccines
Virus Diseases
Sequence Analysis
Anti-Idiotypic Antibodies
Viruses
Polymerase Chain Reaction
Serum

Keywords

  • Immune Escape
  • Immunization
  • Resistance Mechanisms
  • Viremia

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Increased seroprevalence of HBV DNA with mutations in the S gene among individuals greater than 18 years old after complete vaccination. / Lai, Ming Wei; Lin, Tzou Yien; Tsao, Kuo Chien; Huang, Chung Guei; Hsiao, Mei Jen; Liang, Kung Hao; Yeh, Chau Ting.

In: Gastroenterology, Vol. 143, No. 2, 08.2012, p. 400-407.

Research output: Contribution to journalArticle

Lai, Ming Wei ; Lin, Tzou Yien ; Tsao, Kuo Chien ; Huang, Chung Guei ; Hsiao, Mei Jen ; Liang, Kung Hao ; Yeh, Chau Ting. / Increased seroprevalence of HBV DNA with mutations in the S gene among individuals greater than 18 years old after complete vaccination. In: Gastroenterology. 2012 ; Vol. 143, No. 2. pp. 400-407.
@article{7e3c0eb1ede44988971d4d7d49c29387,
title = "Increased seroprevalence of HBV DNA with mutations in the S gene among individuals greater than 18 years old after complete vaccination",
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. 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. 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. 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.",
keywords = "Immune Escape, Immunization, Resistance Mechanisms, Viremia",
author = "Lai, {Ming Wei} and Lin, {Tzou Yien} and Tsao, {Kuo Chien} and Huang, {Chung Guei} and Hsiao, {Mei Jen} and Liang, {Kung Hao} and Yeh, {Chau Ting}",
year = "2012",
month = "8",
doi = "10.1053/j.gastro.2012.05.002",
language = "English",
volume = "143",
pages = "400--407",
journal = "Gastroenterology",
issn = "0016-5085",
publisher = "W.B. Saunders Ltd",
number = "2",

}

TY - JOUR

T1 - Increased seroprevalence of HBV DNA with mutations in the S gene among individuals greater than 18 years old after complete vaccination

AU - Lai, Ming Wei

AU - Lin, Tzou Yien

AU - Tsao, Kuo Chien

AU - Huang, Chung Guei

AU - Hsiao, Mei Jen

AU - Liang, Kung Hao

AU - Yeh, Chau Ting

PY - 2012/8

Y1 - 2012/8

N2 - 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. 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. 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. 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.

AB - 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. 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. 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. 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.

KW - Immune Escape

KW - Immunization

KW - Resistance Mechanisms

KW - Viremia

UR - http://www.scopus.com/inward/record.url?scp=84864278758&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84864278758&partnerID=8YFLogxK

U2 - 10.1053/j.gastro.2012.05.002

DO - 10.1053/j.gastro.2012.05.002

M3 - Article

C2 - 22580098

AN - SCOPUS:84864278758

VL - 143

SP - 400

EP - 407

JO - Gastroenterology

JF - Gastroenterology

SN - 0016-5085

IS - 2

ER -