Vaccine-induced escape mutant of hepatitis B virus

W. F. Carman, P. Karayiannis, J. Waters, H. C. Thomas, A. R. Zanetti, G. Manzillo, A. J. Zuckerman

Research output: Contribution to journalArticlepeer-review

900 Citations (Scopus)


In southern Italy, 44 contacts of hepatitis B virus carriers, including infants of carrier mothers, became HBsAg positive despite passive and active immunisation according to standard protocols. In 32 of these vaccinees infection was confirmed by the presence of additional markers of viral replication. In 1 infant, serious disease occurred. The virus from this patient is an escape mutant with a different sequence from that of the isolate from the mother. A point mutation from guanosine to adenosine at nucleotide position 587 resulted in an aminoacid substitution from glycine to arginine in the highly antigenic a determinant of HBsAg. This mutation is stable: it is present in an isolate from the child 5 years later. In some of these patients, including this child, the a determinant, to which a large part of the vaccine-induced immunity is directed, has been partly lost. Binding to HBsAg of a monoclonal antibody, previously mapped to the region of the mutation, was reduced in the child relative to that of the mother.

Original languageEnglish
Pages (from-to)325-329
Number of pages5
JournalThe Lancet
Issue number8711
Publication statusPublished - 11 Aug 1990


Dive into the research topics of 'Vaccine-induced escape mutant of hepatitis B virus'. Together they form a unique fingerprint.

Cite this