title: Surface protein mutations in chronic hepatitis B patients who received hepatitis B vaccine therapy.
abstract: The aim of this study was to determine the correlation between vaccine therapy and appearance of mutations in hepatitis B surface antigen (HBsAg)-positive chronic hepatitis B virus (HBV) patients.
  
  
  METHODS
  16 patients received the HBV vaccine and another 16 individuals from the control group did not. The surface gene was amplified and directly sequenced from samples prior to vaccination and six months after the third dose.
  
  
  RESULTS
  Only one patient lost HBsAg. 48 and 44 amino acid mutations were found before and after vaccine therapy in the vaccine group respectively, 51 of which (55.4%) occurred in immune epitopes: 5 were in B cell, 21 in T helper (Th), and 25 in cytotoxic T-lymphocyte (CTL) epitopes. In the control group, 35 and 41 amino acid substitutions were found before and after therapy, respectively. 32 (42%) of 76 amino acid changes occurred within immune epitopes. There were no differences in age, gender, and duration of chronicity in both patient and control groups in terms of the frequency and the patterns of mutations.
  
  
  CONCLUSIONS
  In chronic carriers who already had HBsAg variants selected by the host-immune response, any immune stimulation by the vaccine had no effect on the chronic state of these patients or selected any remarkable escape mutants. Newer strategies should be considered based on third generation or the use of DNA vaccines or new adjuvants.
authors.affiliation: Hepatitis B Molecular Laboratory, Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Daram
authors.affiliation: Digestive Disease Research Center, Shariati Hospital, Tehran, Iran.
authors.forename: Ghodratollah
authors.initials: G
authors.lastname: Montazeri
authors.affiliation: Hepatitis B Molecular Laboratory, Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Hadi
authors.initials: H
authors.lastname: Karimzadeh
authors.affiliation: Digestive Disease Research Center, Shariati Hospital, Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Malekzadeh
authors.affiliation: Department of Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mahmood
authors.initials: M
authors.lastname: Mahmoodi
authors.affiliation: Hepatitis B Molecular Laboratory, Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Goodarzi
authors.affiliation: Keyvan Virology Laboratory, Tehran, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Keyvani
authors.affiliation: Imam Khomeini Hospital, Tehran, Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Mirmomen
authors.affiliation: Baqiyatallah Research Center for Gastroenterology and Liver Disease, Tehran, Iran.
authors.forename: Seyed Moayed
authors.initials: SM
authors.lastname: Alavian
authors.affiliation: Robert-Koch-Haus Virchowstr.179.45147, Essen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Roggendorf
authors.affiliation: Hepatitis B Molecular Laboratory, Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Mohammad
authors.initials: SM
authors.lastname: Jazayeri
keywords: HBsAg mutants; Hepatitis B immune epitopes; Hepatitis B vaccine