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Establishment of a seronegative occult infection with an active HBV reservoir enriched of vaccine escape mutations in a vaccinated infant after liver transplant

Establishment of a seronegative occult infection with an active HBV reservoir enriched of vaccine... Abstract We describe the establishment of a seronegative occult HBV infection (OBI) in a successfully vaccinated infant who underwent liver transplantation from an antiHBc-positive donor. The use of highly sensitive droplet digital PCR (ddPCR) assays revealed a not negligible and transcriptionally active intrahepatic HBV reservoir (cccDNA, relaxed-circular DNA and pre-genomic RNA: 5.6, 2.4 and 1.1 copies/1000 cells, respectively), capable to sustain ongoing viral production and initial liver damage. Next-generation sequencing revealed a peculiar enrichment of HBsAg vaccine-escape mutations that can have played a crucial role in OBI transmission. This clinical case highlights the pathobiological complexity and the diagnostic challenges underlying OBI. Hepatitis B Occult Infection, HBV Reservoir, Liver Transplantation, Vaccine escape mutations, digital droplet PCR, Liver Transplantation This content is only available as a PDF. Author notes equally contributed to the study © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png The Journal of Infectious Diseases Oxford University Press

Establishment of a seronegative occult infection with an active HBV reservoir enriched of vaccine escape mutations in a vaccinated infant after liver transplant

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References (15)

Publisher
Oxford University Press
Copyright
© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
ISSN
0022-1899
eISSN
1537-6613
DOI
10.1093/infdis/jiz411
Publisher site
See Article on Publisher Site

Abstract

Abstract We describe the establishment of a seronegative occult HBV infection (OBI) in a successfully vaccinated infant who underwent liver transplantation from an antiHBc-positive donor. The use of highly sensitive droplet digital PCR (ddPCR) assays revealed a not negligible and transcriptionally active intrahepatic HBV reservoir (cccDNA, relaxed-circular DNA and pre-genomic RNA: 5.6, 2.4 and 1.1 copies/1000 cells, respectively), capable to sustain ongoing viral production and initial liver damage. Next-generation sequencing revealed a peculiar enrichment of HBsAg vaccine-escape mutations that can have played a crucial role in OBI transmission. This clinical case highlights the pathobiological complexity and the diagnostic challenges underlying OBI. Hepatitis B Occult Infection, HBV Reservoir, Liver Transplantation, Vaccine escape mutations, digital droplet PCR, Liver Transplantation This content is only available as a PDF. Author notes equally contributed to the study © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Journal

The Journal of Infectious Diseases – Oxford University Press

Published: Nov 6, 2019

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