title: Hepatitis B viremia in completely immunized individuals negative for anti-hepatitis B core antibody.
abstract: The presence of anti-hepatitis B virus (HBV) core antibody (anti-HBc) is considered a sensitive lifetime marker of HBV infection. Here, we examined this dogma by investigating the prevalence of hepatitis B viremia in anti-HBc negative complete vaccines in Taiwan.A total of 795 participants (1.7-20.0 years old) had completed HBV vaccination in infancy and were anti-HBc negative. Serum samples were available for 460 individuals with isolated anti-HBV surface antibodies (anti-HBs) (HBsAg-negative and anti-HBc negative) and for 245 individuals who tested negative for all 3 markers (triple seronegative). All samples were submitted for polymerase chain reaction (PCR) targeting both the preS/S and X/pre-C gene regions.Of the 460 participants with isolated anti-HBs, 26 (5.65%) were positive for HBV by 2-target PCR. Of the 245 triple seronegative samples, 12 (4.90%) were positive for HBV DNA. In the former group, the prevalence of viremia was significantly higher in individuals aged 6 to 10 years than in all other ages combined (11.82% vs 3.7%, P = 0.001). The anti-HBs titers were significantly lower in participants 6 to 10 years old than in all other ages combined (72.06 vs 99.64 mIU/mL, P = 0.038). In total, 7 (0.99%) subjects had quantifiable HBV DNA levels (280-18,820 IU/mL). Sequence analysis of the S gene revealed vaccine escape like mutations.Hepatitis B viremia can occur in completely vaccinated individuals who are negative for anti-HBc.
authors.affiliation: Division of Pediatric Gastroenterology Division of Pediatric Infectious Diseases, Department of Pediatrics Department of Gastroenterology and Hepatology Liver Research Center, Chang Gung Memorial Hospital, Linkou Branch Molecular Medicine Research Center, Chang Gung University Chang Gung University, College of Medicine, Taoyuan, Taiwan.
authors.forename: Ming-Wei
authors.initials: MW
authors.lastname: Lai
authors.forename: Tzou-Yien
authors.initials: TY
authors.lastname: Lin
authors.forename: Kung-Hao
authors.initials: KH
authors.lastname: Liang
authors.forename: Wey-Ran
authors.initials: WR
authors.lastname: Lin
authors.forename: Chau-Ting
authors.initials: CT
authors.lastname: Yeh
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology*; D006512:Hepatitis B Core Antigens / Q000032:analysis / Q000276:immunology*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000276:immunology; D006801:Humans; D015994:Incidence; D008297:Male; D016133:Polymerase Chain Reaction / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012698:Serologic Tests / Q000379:methods; D017678:Sex Distribution; D013624:Taiwan; D014611:Vaccination / Q000379:methods; D014766:Viremia / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology*; D055815:Young Adult
chemical_list: D006512:Hepatitis B Core Antigens; D017325:Hepatitis B Vaccines