title: A serological and molecular survey of hepatitis B in children 15 years after inception of the national hepatitis B vaccination program in eastern China.
abstract: The emergence of mutations in the hepatitis B virus (HBV) S gene has threatened the long-term success of vaccination programs since the worldwide introduction of effective vaccines against hepatitis B. This study was conducted on 5,407 children (0-8 years old) in eastern China in 2007. We analyzed the prevalence of HBsAg, anti-HBs, and "a"-determinant mutations in the HBV S gene by microparticle enzyme immunoassays, PCR, and DNASTAR software. The total HBsAg prevalence was 1.52% (82/5,407) in the children and increased with age. In contrast, the positive rate (65.42%, 2,374/3,629) and the titers of anti-HBs decreased with age. The predominant infection was HBV of genotype C and serotype adr (45/51; 88% of cases). Mutations of I126T, amino acid 137 (nt553T deletion mutation), G145A, G145R, and F158S were found in the children; the mutations of amino acid 137 and F158S have not been reported previously. The total prevalence of mutant strains was 14% (7/51). To investigate whether the infection resulted from maternal transmission, we compared the S gene sequences in 16 mother-child pairs. Fourteen mother-child pairs exhibited the same HBV genotype, with 99.5-100% sequence homology in the S gene, while two pairs exhibited different genotypes. This study suggested that the hepatitis B vaccination strategies in eastern China have been successful. Although the emergence of "a"-determinant mutations in the HBV S gene have resulted in HBV infection in immunized children, this does not pose a threat to the vaccination strategies. The HBV-infected children had contracted the infection via vertical transmission.
authors.affiliation: Department of Oncology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, [corrected] China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Dong
authors.forename: She-Lan
authors.initials: SL
authors.lastname: Liu
authors.forename: Xiang-Jun
authors.initials: XJ
authors.lastname: Zhai
authors.forename: Feng-Cai
authors.initials: FC
authors.lastname: Zhu
authors.forename: Hao
authors.initials: H
authors.lastname: Pan
authors.forename: Jia-Xi
authors.initials: JX
authors.lastname: Yu
authors.forename: Yin-Zhong
authors.initials: YZ
authors.lastname: Chen
authors.forename: Yi-Rui
authors.initials: YR
authors.lastname: Xie
authors.forename: Xiao-Yu
authors.initials: XY
authors.lastname: Zhang
authors.forename: Hong-Mei
authors.initials: HM
authors.lastname: Zhang
authors.forename: Lan-Juan
authors.initials: LJ
authors.lastname: Li
authors.forename: Hua
authors.initials: H
authors.lastname: Wang
authors.forename: Bing
authors.initials: B
authors.lastname: Ruan
mesh_terms: D000328:Adult; D000595:Amino Acid Sequence; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D016000:Cluster Analysis; D004279:DNA, Viral / Q000737:chemistry / Q000235:genetics; D005260:Female; D005838:Genotype; D006509:Hepatitis B / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D006510:Hepatitis B Antibodies / Q000097:blood*; D006514:Hepatitis B Surface Antigens / Q000097:blood* / Q000235:genetics; D017325:Hepatitis B Vaccines / Q000276:immunology*; D006515:Hepatitis B virus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D008969:Molecular Sequence Data; D009035:Mothers; D020125:Mutation, Missense; D010802:Phylogeny; D016036:Seroepidemiologic Studies
chemical_list: D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines