BACKGROUND: Blood and plasma donor screening for hepatitis B virus (HBV) DNA, HBV surface antigen (HBsAg), and antibodies to surface (anti-HBs) and core (anti-HBc) antigens allows identification of individuals who acquired HBV despite previous HBV vaccination. METHODS: Of 14 HBV acute infection donor panels (HBV-DNA-positive/anti-HBc-negative), 6 donors were previously vaccinated (anti-HBs+). We investigated the differences in viral kinetics and immune responses in vaccinated and nonvaccinated individuals. Serial specimens were characterized for HBV DNA and serological markers and 39 cytokines. RESULTS: The rate of viral load increase was blunted, and virus was cleared more rapidly in vaccinated individuals (P = .004). In unvaccinated individuals, induced protein 10 (IP-10), interleukin 10 (IL-10), macrophage inflammatory protein 1β (MIP-1β), and soluble interleukin 2Rα (sIL-2Rα) levels were commonly elevated at the time of peak viremia. In contrast, vaccinated individuals had earlier peaks in IL-10 and IP-10 responses that occurred at much lower viral loads and coincided with anamnestic anti-hepatitis B surface (HBs) responses and clearance of viremia. CONCLUSION: There is earlier engagement of innate and adaptive immunity in infected subjects with previous vaccination, possibly explaining suppressed viremia in vaccine breakthrough infections. Although breakthrough infections occur in partially protected vaccine recipients, vaccination likely contributes to early control of replication, limiting immune activation and preventing development of clinically significant acute and chronic HBV infection.
BACKGROUND: Blood and plasma donor screening for hepatitis B virus (HBV) DNA, HBV surface antigen (HBsAg), and antibodies to surface (anti-HBs) and core (anti-HBc) antigens allows identification of individuals who acquired HBV despite previous HBV vaccination. METHODS: Of 14 HBV acute infectiondonor panels (HBV-DNA-positive/anti-HBc-negative), 6 donors were previously vaccinated (anti-HBs+). We investigated the differences in viral kinetics and immune responses in vaccinated and nonvaccinated individuals. Serial specimens were characterized for HBV DNA and serological markers and 39 cytokines. RESULTS: The rate of viral load increase was blunted, and virus was cleared more rapidly in vaccinated individuals (P = .004). In unvaccinated individuals, induced protein 10 (IP-10), interleukin 10 (IL-10), macrophage inflammatory protein 1β (MIP-1β), and soluble interleukin 2Rα (sIL-2Rα) levels were commonly elevated at the time of peak viremia. In contrast, vaccinated individuals had earlier peaks in IL-10 and IP-10 responses that occurred at much lower viral loads and coincided with anamnestic anti-hepatitis B surface (HBs) responses and clearance of viremia. CONCLUSION: There is earlier engagement of innate and adaptive immunity in infected subjects with previous vaccination, possibly explaining suppressed viremia in vaccine breakthrough infections. Although breakthrough infections occur in partially protected vaccine recipients, vaccination likely contributes to early control of replication, limiting immune activation and preventing development of clinically significant acute and chronic HBV infection.
Entities:
Keywords:
acute infection; chemokine; cytokine; hepatitis B virus; immunity; vaccination
Authors: Eric E Mast; Harold S Margolis; Anthony E Fiore; Edward W Brink; Susan T Goldstein; Susan A Wang; Linda A Moyer; Beth P Bell; Miriam J Alter Journal: MMWR Recomm Rep Date: 2005-12-23
Authors: G J Webster; S Reignat; M K Maini; S A Whalley; G S Ogg; A King; D Brown; P L Amlot; R Williams; D Vergani; G M Dusheiko; A Bertoletti Journal: Hepatology Date: 2000-11 Impact factor: 17.425
Authors: Andrea R Stacey; Philip J Norris; Li Qin; Elizabeth A Haygreen; Elizabeth Taylor; John Heitman; Mila Lebedeva; Allan DeCamp; Dongfeng Li; Douglas Grove; Steven G Self; Persephone Borrow Journal: J Virol Date: 2009-01-28 Impact factor: 5.103
Authors: David G Bowen; Monica Zen; Lauren Holz; Thomas Davis; Geoffrey W McCaughan; Patrick Bertolino Journal: J Clin Invest Date: 2004-09 Impact factor: 14.808
Authors: Stefan F Wieland; Hans Christian Spangenberg; Robert Thimme; Robert H Purcell; Francis V Chisari Journal: Proc Natl Acad Sci U S A Date: 2004-02-05 Impact factor: 11.205
Authors: S A Whalley; J M Murray; D Brown; G J Webster; V C Emery; G M Dusheiko; A S Perelson Journal: J Exp Med Date: 2001-04-02 Impact factor: 14.307
Authors: Brenna C Simons; Philip R Spradling; Dana J T Bruden; Carolyn Zanis; Samantha Case; Tammy L Choromanski; Minjun Apodaca; Hazel D Brogdon; Gaelen Dwyer; Mary Snowball; Susan Negus; Michael G Bruce; Chihiro Morishima; Cindy Knall; Brian J McMahon Journal: J Infect Dis Date: 2016-04-07 Impact factor: 5.226
Authors: S K Sarin; M Kumar; G K Lau; Z Abbas; H L Y Chan; C J Chen; D S Chen; H L Chen; P J Chen; R N Chien; A K Dokmeci; Ed Gane; J L Hou; W Jafri; J Jia; J H Kim; C L Lai; H C Lee; S G Lim; C J Liu; S Locarnini; M Al Mahtab; R Mohamed; M Omata; J Park; T Piratvisuth; B C Sharma; J Sollano; F S Wang; L Wei; M F Yuen; S S Zheng; J H Kao Journal: Hepatol Int Date: 2015-11-13 Impact factor: 6.047
Authors: Andrew E Armitage; Andrea R Stacey; Eleni Giannoulatou; Elizabeth Marshall; Pamela Sturges; Kamaljit Chatha; Nicola M G Smith; XiaoJie Huang; XiaoNing Xu; Sant-Rayn Pasricha; Ning Li; Hao Wu; Craig Webster; Andrew M Prentice; Pierre Pellegrino; Ian Williams; Phillip J Norris; Hal Drakesmith; Persephone Borrow Journal: Proc Natl Acad Sci U S A Date: 2014-08-04 Impact factor: 11.205