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Low prevalence of hepatitis B vaccine escape mutants among individuals born after the initiation of a nationwide vaccination program in Iran

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Abstract

A nationwide hepatitis B virus (HBV) vaccination program for neonates was launched in Iran in 1993. Despite the success of this program, concern about its long-term success still remains, because breakthrough infections due to emergence of surface mutants have been reported in immunized children. We aimed to evaluate the seroprevalence of HBV and vaccine escape mutants among individuals born after the initiation of the nationwide vaccination program in Iran. This study included 1115 participants younger than 23 years old, with 223 in each age cohort. The presence of HBsAg, anti-HBs and anti-HBc was evaluated using an ELISA kit. HBV-DNA levels were measured in anti-HBc and/or HBsAg-positive subjects. PCR products were sequenced and mutations were identified. The overall HBsAg prevalence was 0.27 %. Anti-HBs and anti-HBc positive rates were 48 % and 0.18 %, respectively. Two individuals were positive for anti-HBc, one of whom was also positive for HBsAg, and the other was positive for anti-HBc only. HBV DNA was detected in three out of four anti-HBc-and /or HBsAg-positive subjects. An I195M mutation within the S gene was detected in two of the three HBV-DNA-positive cases. A very low prevalence of HBsAg and isolated anti-HBc were found in this study. The I195M mutation found in the surface gene could have been induced by immune pressure. Although the number of ‘‘vaccine escape’’ mutants found in this cohort was low, ongoing surveillance of breakthrough infections and escape mutants is still needed.

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Acknowledgements

The authors are grateful to Pasteur Institute of Iran for financial support of this study.

Author information

Authors and Affiliations

  1. Hepatitis and AIDS Deptartment, Pasteur Institute of Iran, Tehran, Iran

    Mohammad Reza Aghasadeghi, Fatemeh Motevalli & Sepehr Soleymani

  2. Pediatric Respiratory Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Ali Akbar Velayati

  3. Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Setareh Mamishi

  4. Center for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran

    Mahmood Nabavi

  5. Clinical Research Deptartment, Pasteur Institute of Iran, 13164, Pasteur Ave., Tehran, Iran

    Arezoo Aghakhani & Amitis Ramezani

  6. Pathology Ward, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Farahnaz Bidari-Zerehpoosh & Shahram Sabeti

  7. Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran

    Mohammad-Taghi Haghi Ashtiani

  8. Iranian Society for Support of Patients with Infectious Disease, Tehran, Iran

    Mohammad Banifazl

  9. Hepatitis Deptartment, Center for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran

    Fatemeh Azimian-Zavareh

Authors
  1. Mohammad Reza Aghasadeghi
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  2. Ali Akbar Velayati
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  9. Mohammad Banifazl
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  10. Fatemeh Azimian-Zavareh
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  11. Fatemeh Motevalli
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  12. Sepehr Soleymani
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  13. Amitis Ramezani
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Corresponding author

Correspondence to Amitis Ramezani.

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Funding

This study was funded by Pasteur Institute of Iran (grant number: 767).

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Pasteur Institute of Iran ethics committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Aghasadeghi, M.R., Velayati, A.A., Mamishi, S. et al. Low prevalence of hepatitis B vaccine escape mutants among individuals born after the initiation of a nationwide vaccination program in Iran. Arch Virol 161, 3405–3411 (2016). https://doi.org/10.1007/s00705-016-3050-1

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  • DOI: https://doi.org/10.1007/s00705-016-3050-1

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