Breakthrough HBV infection in a vaccinated child due to vaccine escape mutant

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  • Ohta Takanori
    Department of Pediatrics and Neonatology, Graduate School of Medical Sciences, Nagoya City University
  • Ito Koichi
    Department of Pediatrics and Neonatology, Graduate School of Medical Sciences, Nagoya City University
  • Sugiura Tokio
    Department of Pediatrics and Neonatology, Graduate School of Medical Sciences, Nagoya City University Sugiura Kids Clinic, Hekinan
  • Koyama Norihisa
    Department of Pediatrics, Toyohashi Municipal Hospital
  • Saitoh Shinji
    Department of Pediatrics and Neonatology, Graduate School of Medical Sciences, Nagoya City University
  • Murakami Shuko
    Department of Virology and Liver Unit, Graduate School of Medical Sciences, Nagoya City University
  • Tanaka Yasuhito
    Department of Virology and Liver Unit, Graduate School of Medical Sciences, Nagoya City University Department of Gastroenterology and Hepatology, Kumamoto University

Bibliographic Information

Other Title
  • HBVワクチンエスケープ変異株によりブレイクスルー感染した小児例
  • HBV ワクチンエスケープ ヘンイカブ ニ ヨリ ブレイクスルー カンセン シタ ショウニレイ

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Abstract

<p>We present a case of hepatitis B virus (HBV) infection in a boy who had appropriate immunoprophylaxis starting at birth and an apparent protective immune response post-vaccination. His mother and elder sister were HBeAg-positive carriers with a high viral load. He received HB immunoglobulin at birth and HB vaccines at birth, 1, and 6 months. His HBs antigen was negative and anti-HBs was 333.8 mIU/ml at 1 year old. Then, at 2 years old, his HBs antigen became positive at 0.25 IU/ml, but anti-HBs was 115.6 mIU/ml. By direct sequencing gene analysis, G145R mutation and P120Q mutation, which are known as vaccine escape mutations, were found in HBV derived from him, his mother, and his sister. It was considered that the HBV had been transmitted horizontally from his mother or sister to him due to immune escape after 1 year of age. For children born to HBV carrier mothers with a high viral load, continuous follow-up after 2 years of age and aggressive booster vaccinations should be considered.</p>

Journal

  • Kanzo

    Kanzo 62 (7), 403-412, 2021-07-01

    The Japan Society of Hepatology

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