Hepatitis B virus infection in post-vaccination South Africa: occult HBV infection and circulating surface gene variants.
Hepatitis B virus infection in post-vaccination South Africa: occult HBV infection and circulating surface gene variants.
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DOI：
10.1016/j.jcv.2014.11.032
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发表时间：
2015-02
期刊：
影响因子：
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通讯作者：
Mphahlele MJ
中科院分区：
文献类型：
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作者：
Amponsah-Dacosta E;Lebelo RL;Rakgole JN;Selabe SG;Gededzha MP;Mayaphi SH;Powell EA;Blackard JT;Mphahlele MJ
本研究的目的是调查南非人群中隐性B型肝炎病毒（HBV）感染的患病率和在普及B型肝炎疫苗接种近20年后传播的HBV表面（S）基因变异。从先前的血清学调查中，确定了201份具有暴露于HBV的血清学证据的血清样本，并将其分层为疫苗引入后和引入前人群。对于所有样本，使用实时PCR检测筛选和定量HBV DNA，并与HBV血清学标志物一起分析结果。如果HIV结果可用，则进行子集分析。对37株HBV S基因进行PCR扩增和序列分析。隐匿性HBV感染的患病率从疫苗引入前的70.4%降至疫苗引入后的66.0%。在疫苗引入后的人群中，HIV感染与隐匿性HBV感染的患病率增加之间存在相关性，尽管这在统计学上并不显著。此外，序列分析显示以下HBV亚型; A1（n = 34），A2（n = 2）和罕见的D4分离株。分离出HBV S基因变异体，包括诊断性逃逸突变体。南非疫苗接种后隐匿性HBV感染的患病率有所下降，尽管在HIV合并感染人群中疾病负担仍然很大。经过近20年的普及B型肝炎疫苗接种计划，没有观察到疫苗逃逸突变体的阳性选择。
The aim of this study was to investigate the prevalence of occult hepatitis B virus (HBV) infection and the HBV surface (S) gene variants circulating in the South African population after nearly two decades of universal hepatitis B vaccination. From a previous serosurvey, 201 serum samples with serological evidence of exposure to HBV were identified and these were stratified into post- and pre-vaccine introduction populations. For all samples, HBV DNA was screened and quantified using a real-time PCR assay and results analysed together with HBV serological markers. Where HIV results were available, subset analysis was performed. The HBV S gene was PCR-amplified and sequences analysed for a total of 37 isolates. The prevalence of occult HBV infection reduced from 70.4% in the pre-vaccine introduction era to 66.0% post-vaccine introduction. There was an association between HIV infection and an increase in prevalence of occult HBV infection within the post-vaccine introduction population, although this was not statistically significant. Furthermore, sequence analysis revealed the following HBV subgenotypes; A1 (n = 34), A2 (n = 2) and a rare D4 isolate. HBV S gene variants, including diagnostic escape mutants were isolated. There was a decline in the prevalence of occult HBV infection in post-vaccination South Africa, although the disease burden remains significant in the HIV co-infected population. After nearly two decades of a universal hepatitis B vaccination programme, no positive selection of vaccine escape mutants were observed.