Emily
Editor, Senior Moderator
https://academic.oup.com/jid/article-abstract/220/12/1935/5550108
Romina Salpini, Andrea Pietrobattista, Lorenzo Piermatteo, Maria Sole Basso, Maria C Bellocchi, Daniela Liccardo, Luca Carioti, Paola Francalanci, Marianna Aragri, Mohammed Alkhatib, Rossana Scutari, Manila Candusso, Marco Ciotti, Valentina Svicher, Establishment of a Seronegative Occult Infection With an Active Hepatitis B Virus Reservoir Enriched of Vaccine Escape Mutations in a Vaccinated Infant After Liver Transplantation, The Journal of Infectious Diseases, Volume 220, Issue 12, 15 December 2019, Pages 1935?1939, https://doi.org/10.1093/infdis/jiz411
Abstract
We describe the establishment of a seronegative occult hepatitis B virus (HBV) infection (OBI) in a successfully vaccinated infant who underwent liver transplantation from an donor positive for antibody to hepatitis B core antigen (anti-HBc). The use of highly sensitive droplet digital polymerase chain reaction assays revealed a not negligible and transcriptionally active intrahepatic HBV reservoir (circular covalently closed DNA, relaxed circular DNA, and pregenomic RNA: 5.6, 2.4, and 1.1 copies/1000 cells, respectively), capable to sustain ongoing viral production and initial liver damage. Next-generation sequencing revealed a peculiar enrichment of hepatitis B surface antigen vaccine-escape mutations that could have played a crucial role in OBI transmission. This clinical case highlights the pathobiological complexity and the diagnostic challenges underlying OBI.
Topic:
Viruses
Romina Salpini, Andrea Pietrobattista, Lorenzo Piermatteo, Maria Sole Basso, Maria C Bellocchi, Daniela Liccardo, Luca Carioti, Paola Francalanci, Marianna Aragri, Mohammed Alkhatib, Rossana Scutari, Manila Candusso, Marco Ciotti, Valentina Svicher, Establishment of a Seronegative Occult Infection With an Active Hepatitis B Virus Reservoir Enriched of Vaccine Escape Mutations in a Vaccinated Infant After Liver Transplantation, The Journal of Infectious Diseases, Volume 220, Issue 12, 15 December 2019, Pages 1935?1939, https://doi.org/10.1093/infdis/jiz411
Abstract
We describe the establishment of a seronegative occult hepatitis B virus (HBV) infection (OBI) in a successfully vaccinated infant who underwent liver transplantation from an donor positive for antibody to hepatitis B core antigen (anti-HBc). The use of highly sensitive droplet digital polymerase chain reaction assays revealed a not negligible and transcriptionally active intrahepatic HBV reservoir (circular covalently closed DNA, relaxed circular DNA, and pregenomic RNA: 5.6, 2.4, and 1.1 copies/1000 cells, respectively), capable to sustain ongoing viral production and initial liver damage. Next-generation sequencing revealed a peculiar enrichment of hepatitis B surface antigen vaccine-escape mutations that could have played a crucial role in OBI transmission. This clinical case highlights the pathobiological complexity and the diagnostic challenges underlying OBI.
Topic:
- polymerase chain reaction
- mutation
- hepatitis b surface antigens
- infant
- liver transplantation
- vaccination
- vaccines
- infections
- hepatitis b virus
- hepatitis b core antibody
Viruses