Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Feb:63:12-7.
doi: 10.1016/j.jcv.2014.11.032. Epub 2014 Dec 3.

Hepatitis B virus infection in post-vaccination South Africa: occult HBV infection and circulating surface gene variants

Edina Amponsah-Dacosta  1 , Ramokone L Lebelo  1 , J Nare Rakgole  1 , Selokela G Selabe  1 , Maemu P Gededzha  1 , Simnikiwe H Mayaphi  2 , Eleanor A Powell  3 , Jason T Blackard  3 , M Jeffrey Mphahlele  4
Affiliations

Hepatitis B virus infection in post-vaccination South Africa: occult HBV infection and circulating surface gene variants

Edina Amponsah-Dacosta et al. J Clin Virol. 2015 Feb.

Abstract

Background and objective: 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.

Study design: 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.

Results: 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.

Conclusion: 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.

Keywords: Diagnostic escape mutants; HIV infection; Hepatitis B vaccine; Occult HBV infection; Subgenotype D4.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Bayesian inference tree showing the phylogenetic analysis of HBV genotypes A and D sequences. Study sequences are shown within rectangles, with the subgenotype D4 isolate indicated by an arrow. HBV reference sequences can be identified by their accession numbers as they appear in GenBank.
See this image and copyright information in PMC

References

    1. Alavian SM, Carman WF, Jazayeri SM. HBsAg variants: diagnostic escape and diagnostic dilemma. J Clin Virol. 2012;57:201–8. - PubMed
    1. Amponsah-Dacosta E, Lebelo RL, Rakgole JN, Burnett RJ, Selabe SG, Mphahlele MJ. Evidence for a change in the epidemiology of hepatitis B virus infection after nearly two decades of universal hepatitis B vaccination in South Africa. J Med Virol. 2014;86:918–24. - PubMed
    1. Ayuk J, Mphahlele J, Bessong P. Hepatitis B virus in HIV-infected patients in north-eastern South Africa: prevalence, exposure, protection and response to HAART. S Afr Med J. 2013;103:330–3. - PubMed
    1. Barth RE, Huijgen Q, Templeman HA, Mudrikova T, Wensing AMJ, Hoepelman AIM. Presence of occult HBV, but near absence of active HBV and HCV infections in people with HIV infection in rural South Africa. J Med Virol. 2011;83:929–34. - PubMed
    1. Bell TG, Makondo E, Martinson NA, Kramvis A. Hepatitis B virus infection in human immunodeficiency virus infected Southern African Adults: occult or overt – that is the question. PLoS ONE. 2012;7:e45750. http://dx.doi.org/10.1371/journal.pone.0045750. - DOI - PMC - PubMed

Publication types

MeSH terms