Yeast-recombinant hepatitis B vaccine. Efficacy with hepatitis B immune globulin in prevention of perinatal hepatitis B virus transmission

Stevens, Cladd E.

doi:10.1001/jama.257.19.2612

Cited by 132 publications

(43 citation statements)

References 31 publications

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“…This study did not attempt to demonstrate postexposure immunoprophylaxis against mutant HBV infection, but because successful postexposure prophylaxis against field strains of HBV by HB vaccines is well documented in chimpanzees 52,53 and in infants born to carrier mothers, [54][55][56] the results suggest that perinatal transmission of the Gly-145-Arg mutant of HBV would also be prevented by immunization programs that were properly administered as currently recommended. 48,49,[57][58][59] Several reasons for reported vaccination failures may exist. In cases of perinatal vaccine failure, high maternal virus loads [60][61][62] and/or intrauterine infections, possibly inducing tolerance of neonates to HBsAg, 63-67 may play a role.…”

Section: Discussionmentioning

confidence: 99%

Licensed recombinant hepatitis B vaccines protect chimpanzees against infection with the prototype surface gene mutant of hepatitis B virus

et al. 1999

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The emergence in vaccinated individuals of hepatitis B virus (HBV) mutants with amino acid substitutions within the a determinant of the surface protein has raised the possibility that such variants represent neutralization escape mutants. We previously demonstrated that one such mutant HBV, strain AS, with an arginine substituted for glycine at surface gene codon 145, was infectious and pathogenic in seronegative chimpanzees. In the present study, the protective efficacy of licensed hepatitis B vaccines was evaluated against challenge with this mutant virus.

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Section: Discussionmentioning

confidence: 99%

Licensed recombinant hepatitis B vaccines protect chimpanzees against infection with the prototype surface gene mutant of hepatitis B virus

et al. 1999

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“…The efficacy of immunization against HBV of infants was evaluated by analysis using PCR to detect HBV-DNA, because PCR can detect HBV-DNA in amounts as low as 10 −5 pg of HBV-DNA [Kaneko et al, 1989;Sumazaki et al, 1989] and because HBV genomes are often detected in patients with chronic liver disease who are negative for HBsAg or positive for anti-HBs [Kuhns et al, 1992;Zhang et al, 1993;Hou et al, 1995;Kamito et al, 1996]. Based on the fact that infection by HBeAg-positive carrier mothers is most likely to result in a chronic carrier state in infected infants [Beasley et al, 1983;Wong et al, 1984;Stevens et al, 1987], possibly by induction of immunological tolerance to HBeAg in utero [Milich et al, 1990], 29 infants who were born to both HBsAg-and HBeAg-positive mothers and received immunization with HBIG and vaccine were studied. All the 29 infants were negative for HBsAg, and 27 infants were positive for anti-HBs at 1 year following immunization.…”

Section: Discussionmentioning

confidence: 99%

“…Immunization of infants against HBV is of particular importance because perinatal transmission of HBV is the most common mode of infection in some regions of the world [Beasley et al, 1983;Wong et al, 1984;Stevens et al, 1987]. In addition, since therapy for hepatitis B is effective only in a proportion of patients, prevention of infection by immunization is a key strategy to eradicate the HBV-associated liver disease.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of immunization of high-risk infants against hepatitis B virus evaluated by polymerase chain reaction

et al. 1997

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The polymerase chain reaction (PCR) is a rapid and very sensitive method to detect viral genomes. In the present study, the efficacy of immunization against hepatitis B virus (HBV) of high-risk infants was evaluated by PCR. Twenty-nine infants born to 24 HBeAg-positive carrier mothers were given hepatitis B immune globulin (HBIG) at birth and thereafter received repeated inoculations of plasma-derived vaccine or HBIG, or both, within 1 year. Serum samples at 1 year following immunization were stored at -40 degrees C for later analysis using PCR to detect HBV-DNA. When HBV genomes were detected in infants, the DNA sequences in the S gene of HBV were determined. Of 29 infants, 2 were positive for HBV-DNA at the 1 year following immunization; one had the HBV containing only the wild-type sequence in the S gene and became negative for HBV-DNA during the follow-up period. In contrast, another had the HBV, which contained nucleotide substitutions that altered the expression of the common group-specific determinant "a" of the S gene and resulted in clinical hepatitis with viral persistence. PCR analysis suggests that immunization against HBV prevents effectively high-risk infants from mother-to-child transmission. Even then, however, it is possible that amino acid substitutions in the "a" determinant of the S gene are associated with failure of conventional immunization against HBV.

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“…In addition, the antibody responses against the surface antigen protein elicited by the recombinant yeastderived vaccine now in use are weaker and more specific than those achieved with the previous plasma-derived surface antigen vaccine. [22][23][24] In Province of Taiwan, China, up to 28% of children with chronic hepatitis B infection also harbour hepatitis B surface antigen mutants. So VEMs capable of causing infection in fully immunized individuals are not uncommon in countries with high rates of endemic HBV infection and universal hepatitis B infant immunization programmes.…”

Section: Features Of the Virusmentioning

confidence: 99%

Global control of hepatitis B virus: does treatment-induced antigenic change affect immunization?

Clements¹,

Coghlan²,

Creati³

et al. 2010

Bull World Health Org

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Since its widespread introduction, the hepatitis B vaccine has become an essential part of infant immunization programmes globally. The vaccine has been particularly important for countries where the incidence of hepatitis B virus-related hepatocellular carcinoma is high. Effective treatment options for individuals with chronic hepatitis B infection were limited until 1998 when lamivudine, the first nucleoside analogue drug, was introduced. As a single treatment agent, however, lamivudine has a significant drawback: it induces lamivudine-resistant hepatitis B virus strains that may pose a risk to the global hepatitis B immunization programme. Mutations associated with drug treatment can cause changes to the surface antigen protein, the precise part of the virus that the hepatitis B vaccine mimics. However, the emergence of antiviral drug-associated potential vaccine escape mutants (ADAP-VEMs) in treated patients does not necessarily pose a significant, imminent threat to the global hepatitis B immunization programme. Nonetheless, there is already evidence that current treatment regimens have resulted in the selection of stable ADAPVEMs. Treatment is currently intended to prevent the long-term complications of hepatitis B virus infection, with little consideration given to potential adverse public health impacts. To address individual and public health concerns, trials are urgently needed to find the optimal combination of existing drugs that are effective but do not induce the emergence of ADAP-VEMs. This paper examines the mechanism of antiviral drug-selected changes in the portion of the viral genome that also affects the surface antigen, and explores their potential impact on current hepatitis B immunization programmes.Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español. ‫املقالة.‬ ‫لهذه‬ ‫الكامل‬ ‫النص‬ ‫نهاية‬ ‫يف‬ ‫الخالصة‬ ‫لهذه‬ ‫العربية‬ ‫الرتجمة‬

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Yeast-recombinant hepatitis B vaccine. Efficacy with hepatitis B immune globulin in prevention of perinatal hepatitis B virus transmission

Cited by 132 publications

References 31 publications

Licensed recombinant hepatitis B vaccines protect chimpanzees against infection with the prototype surface gene mutant of hepatitis B virus

Licensed recombinant hepatitis B vaccines protect chimpanzees against infection with the prototype surface gene mutant of hepatitis B virus

Efficacy of immunization of high-risk infants against hepatitis B virus evaluated by polymerase chain reaction

Global control of hepatitis B virus: does treatment-induced antigenic change affect immunization?

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