Bertolini Dennis Armando, Ribeiro Patrícia Cristiane, Lemos Marcílio Figueiredo, Saraceni Cláudia Patara, Pinho João Renato Rebello
Department of Clinical Analyses, Universidade Estadual de Maringá, PR, Brazil.
Rev Inst Med Trop Sao Paulo. 2010 Jan-Feb;52(1):25-30. doi: 10.1590/s0036-46652010000100004.
The present study investigated if hepatitis B virus (HBV) mutants circulate in the southwestern region of the State of Paraná, Brazil, by analyzing samples from children who received immunoprophylaxis but were born to HBV carrier mothers. Samples from 25 children were screened for HBV serum markers and for HBV DNA by PCR. Only one sample was positive for HBsAg, anti-HBs and HBV DNA, although the child had been vaccinated. Analysis of the S gene sequence of this sample showed the presence of a proline at position 105, a serine at position 114, three threonines at positions 115, 116 and 140, and a glutamine at position 129. The presence of these amino acids, except for serine at position 114, has been related to monoclonal or polyclonal therapy with anti-HBs after liver transplantation, whereas the presence of threonine at position 116 has been described in immunized children from Singapore. This finding demonstrates the possible circulation of HBV strains resistant to hepatitis B immunoprophylaxis in southwestern Paraná, Brazil. The genotype of the sample was identified as genotype D, which is frequently found in the region studied. Since 36% of the children had received incomplete or no immunoprophylaxis, more extensive follow-up of children born to HBsAg-positive mothers is needed.
本研究通过分析接受免疫预防但母亲为乙肝病毒携带者的儿童样本,调查巴西巴拉那州西南部地区是否存在乙肝病毒(HBV)突变株。对25名儿童的样本进行了乙肝病毒血清标志物筛查和PCR检测HBV DNA。尽管该儿童已接种疫苗,但仅一份样本的乙肝表面抗原、乙肝表面抗体和HBV DNA呈阳性。对该样本的S基因序列分析显示,第105位为脯氨酸,第114位为丝氨酸,第115、116和140位为三个苏氨酸,第129位为谷氨酰胺。除第114位的丝氨酸外,这些氨基酸的存在与肝移植后使用乙肝表面抗体的单克隆或多克隆治疗有关,而第116位苏氨酸的存在在新加坡的免疫儿童中也有描述。这一发现表明,巴西巴拉那州西南部可能存在对乙肝免疫预防耐药的HBV毒株。该样本的基因型被鉴定为D型,这在研究区域中经常发现。由于36%的儿童接受的免疫预防不完全或未接受免疫预防,因此需要对乙肝表面抗原阳性母亲所生儿童进行更广泛的随访。