title: Cytokine and chemokine responses in the acute phase of hepatitis B virus replication in naive and previously vaccinated blood and plasma donors.
abstract: BACKGROUND
  Blood and plasma donor screening for hepatitis B virus (HBV) DNA, HBV surface antigen (HBsAg), and antibodies to surface (anti-HBs) and core (anti-HBc) antigens allows identification of individuals who acquired HBV despite previous HBV vaccination.
  
  
  METHODS
  Of 14 HBV acute infection donor panels (HBV-DNA-positive/anti-HBc-negative), 6 donors were previously vaccinated (anti-HBs+). We investigated the differences in viral kinetics and immune responses in vaccinated and nonvaccinated individuals. Serial specimens were characterized for HBV DNA and serological markers and 39 cytokines.
  
  
  RESULTS
  The rate of viral load increase was blunted, and virus was cleared more rapidly in vaccinated individuals (P = .004). In unvaccinated individuals, induced protein 10 (IP-10), interleukin 10 (IL-10), macrophage inflammatory protein 1β (MIP-1β), and soluble interleukin 2Rα (sIL-2Rα) levels were commonly elevated at the time of peak viremia. In contrast, vaccinated individuals had earlier peaks in IL-10 and IP-10 responses that occurred at much lower viral loads and coincided with anamnestic anti-hepatitis B surface (HBs) responses and clearance of viremia.
  
  
  CONCLUSIONS
  There is earlier engagement of innate and adaptive immunity in infected subjects with previous vaccination, possibly explaining suppressed viremia in vaccine breakthrough infections. Although breakthrough infections occur in partially protected vaccine recipients, vaccination likely contributes to early control of replication, limiting immune activation and preventing development of clinically significant acute and chronic HBV infection.
authors.affiliation: Blood Systems Research Institute, San Francisco, California.
authors.forename: Sheila M
authors.initials: SM
authors.lastname: Keating
authors.forename: John D
authors.initials: JD
authors.lastname: Heitman
authors.forename: Shiquan
authors.initials: S
authors.lastname: Wu
authors.forename: Xutao
authors.initials: X
authors.lastname: Deng
authors.forename: Susan L
authors.initials: SL
authors.lastname: Stramer
authors.forename: Mary C
authors.initials: MC
authors.lastname: Kuhns
authors.forename: Carolyn
authors.initials: C
authors.lastname: Mullen
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Norris
authors.forename: Michael P
authors.initials: MP
authors.lastname: Busch
mesh_terms: D000208:Acute Disease; D001782:Blood Donors; D016000:Cluster Analysis; D016207:Cytokines / Q000097:blood / Q000276:immunology*; D006509:Hepatitis B / Q000097:blood / Q000276:immunology* / Q000821:virology*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000276:immunology; D006515:Hepatitis B virus / Q000276:immunology / Q000502:physiology*; D006801:Humans; D008137:Longitudinal Studies; D014611:Vaccination; D019562:Viral Load; D014779:Virus Replication / Q000276:immunology
chemical_list: D016207:Cytokines; D017325:Hepatitis B Vaccines
keywords: acute infection; chemokine; cytokine; hepatitis B virus; immunity; vaccination