1
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Shaver ZM, Anderson M, Bhebhe L, Baruti K, Chogaa WT, Ngidi J, Mbangiwa T, Taua M, Setlhare DR, Melamu P, Phinius BB, Musonda R, Mine M, Moyo S, Gaseitsiwe S. Decreased hepatitis B virus vaccine response among HIV-positive infants compared with HIV-negative infants in Botswana. AIDS 2022; 36:755-762. [PMID: 35113045 PMCID: PMC7614825 DOI: 10.1097/qad.0000000000003183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We sought to determine vaccine antibody titres and the prevalence of hepatitis B surface antigen (HBsAg) in both HIV-positive and HIV-negative infants born to HIV-positive mothers in Botswana. DESIGN This was a retrospective cross-sectional study using 449 archived dried blood spot samples from both HIV-positive and HIV-negative infants collected between 2016 and 2018. METHODS We screened dried blood spot samples for HBsAg and determined hepatitis B surface antibody titres. We determined hepatitis B virus (HBV) genotypes by amplifying 415 base-pairs of the surface region. RESULTS HIV-positive infants mounted a significantly lower immune response to the HBV vaccine (P < 0.001). Furthermore, a lower proportion of HIV-positive infants had protective hepatitis B surface antibody titres (74.5%) than HIV-negative infants (89.2%) (P < 0.001). HIV-positive infants were older and 50.9% of them had completed vaccination (P = 0.018). Of the 449 infant samples tested, three (0.67%) were positive for HBsAg. Of the three HBsAg-positive infants, two had protective titres (>10 mIU/ml). Two of the three HBV-positive infants were infected with genotype D3 and had no drug-resistance or escape mutations. CONCLUSION Vaccine response was lower among HIV-positive infants compared with HIV-negative infants. HBV infections were observed in both HIV-positive and HIV-negative infants in Botswana. Studies to investigate additional preventive strategies to reduce HBV mother-to-child transmission are recommended.
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Affiliation(s)
| | | | | | - Kabo Baruti
- Botswana Harvard AIDS Institute Partnership, Gaborone
- University of Botswana, Department of Biological Sciences, Gabarone, Botswana
| | - Wonderful T. Chogaa
- Botswana Harvard AIDS Institute Partnership, Gaborone
- Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Julia Ngidi
- Botswana Harvard AIDS Institute Partnership, Gaborone
- National Health Laboratory, Ministry of Health and Wellness, Gaborone, Botswana
| | | | - Modiri Taua
- Botswana Harvard AIDS Institute Partnership, Gaborone
- National Health Laboratory, Ministry of Health and Wellness, Gaborone, Botswana
| | - Ditiro R. Setlhare
- Botswana Harvard AIDS Institute Partnership, Gaborone
- National Health Laboratory, Ministry of Health and Wellness, Gaborone, Botswana
| | - Pinkie Melamu
- Botswana Harvard AIDS Institute Partnership, Gaborone
| | | | | | - Madisa Mine
- Botswana Harvard AIDS Institute Partnership, Gaborone
- National Health Laboratory, Ministry of Health and Wellness, Gaborone, Botswana
| | - Sikhulile Moyo
- Botswana Harvard AIDS Institute Partnership, Gaborone
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Simani Gaseitsiwe
- Botswana Harvard AIDS Institute Partnership, Gaborone
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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2
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Research Progress on the Mechanism of Persistent Low-Level HBsAg Expression in the Serum of Patients with Chronic HBV Infection. J Immunol Res 2022; 2022:1372705. [PMID: 35465353 PMCID: PMC9020929 DOI: 10.1155/2022/1372705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/28/2022] [Indexed: 12/17/2022] Open
Abstract
Among HBV-infected persons, there is a group of people with hepatitis B surface antigen (HBsAg) showing persistently low levels of expression. The production of low-level HBsAg does not mean a good outcome of chronic HBV infection. Patients still have virus replication and sustained liver damage, and they have the potential to transmit the infection. This risk poses a challenge to clinical diagnosis and blood transfusion safety and is a major concern of experts. However, the mechanism behind persistent low-level HBsAg expression in serum is not completely clear, and complete virus clearance by the host is vital. In this review, we summarize the research progress on the mechanism behind low-level expression of HBsAg in patients with chronic HBV infection in recent years.
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3
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Jiang X, Chang L, Yan Y, Wang L. Paradoxical HBsAg and anti-HBs coexistence among Chronic HBV Infections: Causes and Consequences. Int J Biol Sci 2021; 17:1125-1137. [PMID: 33867835 PMCID: PMC8040313 DOI: 10.7150/ijbs.55724] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/11/2021] [Indexed: 12/11/2022] Open
Abstract
Hepatitis B surface antigen (HBsAg) and Hepatitis B surface antibody (anti-HBs) were reported simultaneously among Hepatitis B virus (HBV) infections. HBsAg is a specific indicator of acute or chronic HBV infections, while anti-HBs is a protective antibody reflecting the recovery and immunity of hosts. HBsAg and anti-HBs coexist during seroconversion and then form immune complex, which is rare detected in clinical cases. However, with the promotion of vaccination and the application of various antiviral drugs, along with the rapid development of medical technology, the coexistence of HBsAg and anti-HBs has become more prevalent. Mutations in the viral genomes, immune status and genetic factors of hosts may contribute to the coexistence. Novel HBsAg assays, with higher sensitivity and ability to detect mutations or immune complexes, can also yield HBsAg/anti-HBs coexistence. The discovery of coexistence has shattered the idea of traditional serological patterns and raised questions about the effectiveness of vaccines. Worth noting is that HBsAg/anti-HBs double positivity is strongly associated with progressive liver diseases, especially hepatocellular carcinoma. In conclusion, viral mutations, host factors, and methodology impacts can all lead to the coexistence of HBsAg and anti-HBs. This coexistence is not an indicator of improvement, as an increased risk of adverse clinical outcomes still exists.
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Affiliation(s)
- Xinyi Jiang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, P.R. China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Le Chang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, P.R. China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Ying Yan
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, P.R. China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Lunan Wang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, P.R. China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China
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4
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Nishiya AS, Levi JE, de Almeida-Neto C, Witkin SS, Ferreira SC, Bassit L, Sabino EC, Di-Lorenzo-Oliveira C, Salles NA, Coutinho AS, Bellesa MA, Rocha V, Mendrone-Jr A. Occult and active hepatitis B virus detection in donated blood in São Paulo, Brazil. Transfusion 2021; 61:1495-1504. [PMID: 33687074 DOI: 10.1111/trf.16344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND The present study determined the HBV antigen, antibody, and DNA status in blood donations deemed to be HBV positive. Individuals with an occult HBV infection (OBI), defined as being positive for HBV DNA but negative for HBV surface antigen (HBsAg), as well as those with active infection (HBsAg-positive), were identified and characterized. STUDY DESIGN AND METHODS From a total pool if 198,363 blood donations, we evaluated in a cross-sectional study, 1106 samples that were positive in screening tests for antibody to HBV core antigen (HBcAb), HBsAg, and/or HBV DNA by nucleic acid testing (NAT-HBV). The presence of genetic variants in the HBV pol/S gene in individuals with an active HBV infection was also determined. RESULTS OBIs were detected in six of 976 samples (0.6%) that were positive only for HBcAb. The rate of HBV active infection was 0.024% (48/198,363) and there was a predominance of HBV sub-genotype A1 (62.2%, 28/45), followed by D3 (17.8%, 8/45). Mutations in the S gene were found in 57.8% (26/45) and immune escape mutations in 37.8% (17/45) of active HBV-infected donors. Among them, T123N, G145A, and D144G high-impact immune escape mutations were identified. CONCLUSION Highly sensitive molecular tests improve the capacity to detect OBIs. When NAT is performed in pooled samples, HBcAb test has value in the detection of donors with OBI and improves transfusion safety. Mutations in the S gene are frequent in HBsAg-positive blood, including those associated with diagnostic failure and vaccine escape mutations.
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Affiliation(s)
- Anna S Nishiya
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.,Laboratory of Medical Investigation in Pathogenesis and Targeted Therapy in Oncoimmunohematology (LIM-31), Department of Hematology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - José E Levi
- Instituto de Medicina Tropical da Universidade de São Paulo, São Paulo, Brazil
| | - Cesar de Almeida-Neto
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.,Disciplina de Ciências Médicas, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | - Steven S Witkin
- Instituto de Medicina Tropical da Universidade de São Paulo, São Paulo, Brazil.,Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, New York, USA
| | - Suzete C Ferreira
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.,Laboratory of Medical Investigation in Pathogenesis and Targeted Therapy in Oncoimmunohematology (LIM-31), Department of Hematology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Leda Bassit
- Center for AIDS Research, Laboratory of Biochemical Pharmacology, Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Ester C Sabino
- Instituto de Medicina Tropical da Universidade de São Paulo, São Paulo, Brazil.,Disciplina de Ciências Médicas, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | | | - Nanci A Salles
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil
| | | | - Maria A Bellesa
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil
| | - Vanderson Rocha
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.,Laboratory of Medical Investigation in Pathogenesis and Targeted Therapy in Oncoimmunohematology (LIM-31), Department of Hematology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.,Disciplina de Ciências Médicas, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.,Churchill Hospital, Oxford University, Oxford, UK
| | - Alfredo Mendrone-Jr
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.,Laboratory of Medical Investigation in Pathogenesis and Targeted Therapy in Oncoimmunohematology (LIM-31), Department of Hematology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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5
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Hou W, Huo Z, Du Y, Wang C, Syn WK. Characteristics of amino acid substitutions within the "a" determinant region of hepatitis B virus in chronically infected patients with coexisting HBsAg and anti-HBs. Clin Res Hepatol Gastroenterol 2020; 44:923-931. [PMID: 31624004 DOI: 10.1016/j.clinre.2019.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 08/06/2019] [Accepted: 08/09/2019] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Simultaneous positivity for both hepatitis B surface antigen (HBsAg) and antibodies to HBsAg (anti-HBs) is an atypical serological profile in chronic hepatitis B (CHB) patients. The exact mechanisms underlying the uncommon profile remains unclear. The aim of this study was to analyze the characteristics of amino acid substitutions within the "a" determinant region in a large cohort of CHB patients with coexistence of HBsAg and anti-HBs. METHODS In total 8687 CHB patients, of which 505 had coexisting HBsAg and anti-HBs, were enrolled in this study. Mutations within the "a" determinant region in 131 HBsAg+/anti-HBs+ patients and 150 age and gender matched HBsAg+/anti-HBs- patients were determined by direct sequencing and the characteristics of amino acid substitutions were analyzed. RESULTS The prevalence of coexistence of HBsAg and anti-HBs in the CHB patients was 5.81%. Compared to the control subjects, there were more amino acid substitutions in HBsAg+/anti-HBs+ patients (30.5% vs. 12.7%, P<0.001), especially within the first loop of the "a" determinant region. The most frequent amino acid substitution was located at position s126 and the predominant substitution was sI126T in HBsAg+/anti-HBs+ patients with genotype C. The frequency of additional N-glycosylation sites in HBsAg+/anti-HBs+ patients and the control subjects was 3.8% and 0.6%, respectively. CONCLUSIONS The accumulation and diversity of amino acid variations within "a" determinant region might contribute to the coexistence of HBsAg and anti-HBs. These findings extend understanding of the genetic mechanism of this atypical serological profile in CHB patients.
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Affiliation(s)
- Wei Hou
- Tianjin Second People's Hospital and Tianjin Institute of Hepatology, Tianjin, China; Division of Gastroenterology and Hepatology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Zhixiao Huo
- Tianjin Second People's Hospital and Tianjin Institute of Hepatology, Tianjin, China
| | - Yanan Du
- Department of Biomedical Engineering, School of Medicine, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Tsinghua University, Beijing, China
| | - Cindy Wang
- Division of Gastroenterology and Hepatology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Wing-Kin Syn
- Division of Gastroenterology and Hepatology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA; Section of Gastroenterology, Ralph H Johnson Veterans Affairs Medical Center, Charleston, SC, USA; Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain.
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6
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Lampe E, Mello FCA, do Espírito-Santo MP, Oliveira CMC, Bertolini DA, Gonçales NSL, Moreira RC, Fernandes CAS, Nascimento HCL, Grotto RMT, Pardini MIMC, On Behalf Of The Brazilian Hepatitis B Research Group. Nationwide overview of the distribution of hepatitis B virus genotypes in Brazil: a 1000-sample multicentre study. J Gen Virol 2017. [PMID: 28631602 DOI: 10.1099/jgv.0.000789] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The influence of hepatitis B virus (HBV) genotypes in the natural history of the disease and its response to antiviral treatment have been addressed in many studies. In Brazil, studies on HBV genotype circulation have been restricted to specific population groups and states. Here, we have conducted a nationwide multicentre study with an unprecedented sample size representing all Brazilian regions in an effort to better understand the viral variants of HBV circulating among chronic carriers. Seven HBV genotypes were found circulating in Brazil. Overall, HBV/A was the most prevalent, identified in 589 (58.7 %) samples, followed by HBV/D (23.4 %) and HBV/F (11.3 %). Genotypes E, G, C and B were found in a minor proportion. The distribution of the genotypes differed markedly from the north to the south of the country. While HBV/A was the most prevalent in the North (71.6 %) and Northeast (65.0 %) regions, HBV/D was found in 78.9 % of the specimens analysed in the South region. HBV/F was the second most prevalent genotype in the Northeast region (23.5 %). It was detected in low proportions (7 to 10 %) in the North, Central-West and Southeast regions, and in only one sample in the South region. HBV/E was detected in all regions except in the South, while monoinfection with HBV/G was found countrywide, with the exception of Central-West states. Our sampling covered 24 of the 26 Brazilian states and the Federal District and is the first report of genotype distribution in seven states. This nationwide study provides the most complete overview of HBV genotype distribution in Brazil to date and reflects the origin and plurality of the Brazilian population.
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Affiliation(s)
- Elisabeth Lampe
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Francisco C A Mello
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | | | - Cintia M C Oliveira
- Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, AM, Brazil
| | - Dennis A Bertolini
- Laboratório de Imunologia Clínica, Departamento de Análise Clínicas e Biomedicina, Universidade Estadual de Maringá, Maringá, PR, Brazil
| | - Neiva S L Gonçales
- Laboratório do Grupo de Estudo das Hepatites, UNICAMP, Campinas, SP, Brazil
| | - Regina C Moreira
- Laboratório de Hepatites, Instituto Adolfo Lutz, São Paulo, SP, Brazil
| | | | | | - Rejane M T Grotto
- Universidade Estadual Paulista (Unesp), Faculdade de Ciências Agronômicas (FCA), Campus de Botucatu, Botucatu, SP, Brazil.,Universidade Estadual Paulista (Unesp), Faculdade de Medicina (FMB), Divisão Hemocentro, Laboratório de Biologia Molecular, Campus de Botucatu, Botucatu, SP, Brazil
| | - Maria Inês M C Pardini
- Universidade Estadual Paulista (Unesp), Faculdade de Medicina (FMB), Divisão Hemocentro, Laboratório de Biologia Molecular, Campus de Botucatu, Botucatu, SP, Brazil
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7
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Fu X, Chen J, Chen H, Lin J, Xun Z, Li S, Liu C, Zeng Y, Chen T, Yang B, Ou Q. Mutation in the S gene of hepatitis B virus and anti-HBs subtype-nonspecificity contributed to the co-existence of HBsAg and anti-HBs in patients with chronic hepatitis B virus infection. J Med Virol 2017; 89:1419-1426. [PMID: 28198078 DOI: 10.1002/jmv.24782] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 12/25/2016] [Accepted: 01/17/2017] [Indexed: 02/03/2023]
Affiliation(s)
- Xiaochun Fu
- Department of Laboratory Medicine; The First Affiliated Hospital of Fujian Medical University; Fuzhou China
- First Clinical College; Fujian Medical University; Fuzhou China
- The Genetic Diagonstic Laboratory; The First Affiliated Hospital of Fujian Medical University; China
| | - Jing Chen
- Department of Laboratory Medicine; The First Affiliated Hospital of Fujian Medical University; Fuzhou China
- The Genetic Diagonstic Laboratory; The First Affiliated Hospital of Fujian Medical University; China
| | - Huijuan Chen
- Department of Laboratory Medicine; The First Affiliated Hospital of Fujian Medical University; Fuzhou China
- The Genetic Diagonstic Laboratory; The First Affiliated Hospital of Fujian Medical University; China
| | - Jinpiao Lin
- Department of Laboratory Medicine; The First Affiliated Hospital of Fujian Medical University; Fuzhou China
- The Genetic Diagonstic Laboratory; The First Affiliated Hospital of Fujian Medical University; China
| | - Zhen Xun
- Department of Laboratory Medicine; The First Affiliated Hospital of Fujian Medical University; Fuzhou China
- First Clinical College; Fujian Medical University; Fuzhou China
- The Genetic Diagonstic Laboratory; The First Affiliated Hospital of Fujian Medical University; China
| | - Shiqi Li
- Department of Laboratory Medicine; The First Affiliated Hospital of Fujian Medical University; Fuzhou China
- First Clinical College; Fujian Medical University; Fuzhou China
- The Genetic Diagonstic Laboratory; The First Affiliated Hospital of Fujian Medical University; China
| | - Can Liu
- Department of Laboratory Medicine; The First Affiliated Hospital of Fujian Medical University; Fuzhou China
- The Genetic Diagonstic Laboratory; The First Affiliated Hospital of Fujian Medical University; China
| | - Yongbin Zeng
- Department of Laboratory Medicine; The First Affiliated Hospital of Fujian Medical University; Fuzhou China
- The Genetic Diagonstic Laboratory; The First Affiliated Hospital of Fujian Medical University; China
| | - Tianbin Chen
- Department of Laboratory Medicine; The First Affiliated Hospital of Fujian Medical University; Fuzhou China
- The Genetic Diagonstic Laboratory; The First Affiliated Hospital of Fujian Medical University; China
| | - Bin Yang
- Department of Laboratory Medicine; The First Affiliated Hospital of Fujian Medical University; Fuzhou China
- The Genetic Diagonstic Laboratory; The First Affiliated Hospital of Fujian Medical University; China
| | - Qishui Ou
- Department of Laboratory Medicine; The First Affiliated Hospital of Fujian Medical University; Fuzhou China
- The Genetic Diagonstic Laboratory; The First Affiliated Hospital of Fujian Medical University; China
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