Sub-optimal protection against past hepatitis B virus infection where subtype mismatch exists between vaccine and circulating viral genotype in northern Australia

Cheah, Benjamin C.; Davies, Jane; Singh, Gurmeet; Wood, Nicholas; Jackson, Kathy Merlock; Davison, Belinda; McIntyre, Peter; Locarnini, Stephen; Davis, Joshua S.; Tong, Steven Y. C.

doi:10.1016/j.vaccine.2018.01.062

Cited by 12 publications

(13 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, in a recent study carried out in Australia, a suboptimal protection against infections caused by subgenotypes other than the antigen present in the vaccine (HBV‐A2) was observed . However, in our study, the lower frequencies of VEMs were observed in subgenotypes F1b, F4 and A1, while D1 and A2 showed intermediate prevalence and D2, D3 and D4 presented very high prevalence of VEMs.…”

Section: Discussionmentioning

confidence: 81%

See 1 more Smart Citation

Molecular epidemiology of hepatitis B virus mutants associated with vaccine escape, drug resistance and diagnosis failure

Lello

Ridruejo

Martínez

et al. 2019

Journal of Viral Hepatitis

View full text Add to dashboard Cite

Summary The massive implementation of the vaccine and antiviral agents against hepatitis B virus (HBV), targeting the envelope and viral polymerase genes, induces a selection pressure that might lead to the emergence of variants that impair the effectiveness of the vaccine, diagnostic methods and antiviral therapy. The aim of this study was to evaluate the prevalence of HBV vaccine escape mutants (VEMs), diagnostic failure mutants (DFMs) and treatment resistance mutants (ARMs) among individuals from Buenos Aires, Argentina. HBV surface antigen and polymerase sequences obtained from serum samples of 530 HBV‐infected individuals were analysed. Samples belonged to genotypes A (28.1%), D (13.6%) and F (58.3%). VEMs, DMFs and ARMs were present in 40 (7.5%), 57 (10.7%) and 27 (5.1%) samples within the studied population. Additionally, eight nonpreviously reported VEMs and nine DFMs were identified. VEMs and DFMs were biased by genotype, being higher in genotype D (33.3% and 33.3%) compared to genotype A (6% and 17.4%) and genotype F (2.3% and 2.3%) (P > 0.001). On the contrary, there was no association between the presence of ARMs and HBV genotype (P = 0.324). VEMs, DFMs and ARMs create public health concerns. The current study provided valuable information about mutants in surface antigen and polymerase in HBV‐infected patients from Argentina where HBV‐F is the most prevalent genotype. Consequently, it constitutes an important reference for Latin American clinicians in order to optimize the management of HBV‐infected patients.

show abstract

Section: Discussionmentioning

confidence: 81%

“…1.5%; HBV-F1b: 39.8%; and HBV-F4: 18.5%. The patient's age was evenly distributed among the different genotypes: HBV-A 45 (37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56), HBV-D 44 and HBV-F 44 , P = 0.900.…”

Section: Characteristics Of the Study Populationmentioning

confidence: 99%

Molecular epidemiology of hepatitis B virus mutants associated with vaccine escape, drug resistance and diagnosis failure

Lello

Ridruejo

Martínez

et al. 2019

Journal of Viral Hepatitis

View full text Add to dashboard Cite

show abstract

“…This may be particularly important in the NT setting where HBV sub-genotype C4, the only sub-genotype documented in Aboriginal people, has a serotype mismatch with the HBV vaccine [12]. Emerging evidence suggests that despite the existing subtype mismatch, the vaccine is largely effective in preventing against chronic infection but it is sub-optimal at protecting against Anti-HBc positivity [42] It is still unclear if this is clinically important [42].…”

Section: Limitations Of the Studymentioning

confidence: 99%

Data linkage and computerised algorithmic coding to enhance individual clinical care for Aboriginal people living with chronic hepatitis B in the Northern Territory of Australia – Is it feasible?

et al. 2020

Self Cite

View full text Add to dashboard Cite

BackgroundChronic hepatitis B (CHB) is endemic in the Aboriginal population of Australia's Northern Territory (NT). However, many people's hepatitis B virus (HBV) status remains unknown. Objective 1. To maximise the utility of existing HBV test and vaccination data in the NT by creating a linked dataset and computerised algorithmic coding. 2. To undertake rigorous quality assurance processes to establish feasibility of using the linked dataset and computerised algorithmic coding for individual care for people living with CHB. MethodsStep 1: We used deterministic data linkage to merge information from three separate patient databases. HBV testing and vaccination data from 2008-2016 was linked and extracted for 19,314 people from 21 remote Aboriginal communities in the Top End of the NT. Step 2: A computerised algorithm was developed to allocate one of ten HBV codes to each individual.Step 3: A quality assurance process was undertaken by a clinician, using standardised processes, manually reviewing all three databases, for a subset of 5,293 Aboriginal people from five communities to check the accuracy of each allocated code.

show abstract

“…Potential issues with the early implementation of these programmes have been identified, including the use of plasma‐derived vaccines until 1991, which may have a decreased immunogenic response in infants, 12 and breaches of the cold chain, including freezing of vaccines during transport, 13,14 making it possible that fully vaccinated infants in the NT have decreased HBV immunity. Indeed, a handful of studies have suggested decreased HBV vaccine efficacy in fully vaccinated Indigenous children in the NT 15–17 …”

Section: Introductionmentioning

confidence: 99%

Hepatitis B in the Northern Territory: insights into the changing epidemiology of an ancient condition

Qama

Allard

Cowie

et al. 2021

Internal Medicine Journal

Self Cite

View full text Add to dashboard Cite

Background Aboriginal and Torres Strait Islander people are disproportionately affected by hepatitis B virus (HBV) infection. A proposed mismatch between standard vaccines and the HBV/C4 sub‐genotype prevalent in Aboriginal people in the Northern Territory (NT) may reduce vaccine effectiveness. Aims To determine HBV prevalence in the NT by Indigenous status and to explore patterns of immunity following implementation of universal vaccination, using a large longitudinal diagnostic dataset. Methods A retrospective analysis of all available HBV serology results in the NT from 1991 to 2011 was conducted, with HBV prevalence and vaccination status analysed according to adigenous status, age and sex using individuals' patterns of HBsAg, anti‐HBs and anti‐HBc serology over repeated tests. Results 100 790 individuals were tested (33.4% Indigenous) between 1991 and 2011 (26.1% of the 2011 NT population), with a total of 211 802 tests performed. In 2011, the proportion of HBV positive individuals in the NT was 3.17% (5.22% in Indigenous populations) compared to previous 2011 estimates of 1.70% (3.70% in Indigenous populations). The vaccine failure rate was lower than expected with only one presumed vaccinated person subsequently developing HBsAg positivity (0.02%). Evidence of suboptimal vaccine efficacy by breakthrough anti‐HBc positivity in vaccinated individuals was demonstrated in 3.1% of the vaccinated cohort, of which 86.4% identified as Indigenous (HR 1.17). No difference in HBeAg positivity or seroconversion was observed between Indigenous and non‐Indigenous individuals living with CHB. Conclusions The burden of CHB in Indigenous people in the NT has previously been underestimated. A higher HBV prevalence in the NT than described in previous cross‐sectional studies was found, including a higher prevalence in Indigenous people. Evidence of suboptimal vaccine efficacy was demonstrated predominantly in Indigenous individuals.

show abstract

Sub-optimal protection against past hepatitis B virus infection where subtype mismatch exists between vaccine and circulating viral genotype in northern Australia

Cited by 12 publications

References 31 publications

Molecular epidemiology of hepatitis B virus mutants associated with vaccine escape, drug resistance and diagnosis failure

Molecular epidemiology of hepatitis B virus mutants associated with vaccine escape, drug resistance and diagnosis failure

Data linkage and computerised algorithmic coding to enhance individual clinical care for Aboriginal people living with chronic hepatitis B in the Northern Territory of Australia – Is it feasible?

Hepatitis B in the Northern Territory: insights into the changing epidemiology of an ancient condition

Contact Info

Product

Resources

About