Vaccination campaign doubles HBV mutations

Contact: Garth Hogan ghogan@asmusa.org 202-942-9389 American Society for Microbiology

WASHINGTON, DC – October 7, 2013 – A universal infant vaccination campaign in China has led the Hepatitis B virus (HBV) to more than double its rate of “breakout” mutations. These mutations may enable the virus to elude the vaccine, necessitating new vaccination strategies. Researchers at the Chinese Centers for Disease Control and Prevention and University of North Carolina, Chapel Hill, report their findings in an article published ahead of print in the Journal of Virology.

Until a universal vaccination program for infants was implemented in 1992, nearly ten percent of Chinese—children included—were infected with HBV. The vaccination campaign has protected an estimated 80 million children, dramatically reducing the percentage of children under 5 who are infected, from nearly 10 percent in 1992 to less than one percent in 2005. But these gains are in danger of being eroded as the virus develops surface mutations.

Taking advantage of 1992 and 2005 survey, investigators found that the prevalence of HBV escape mutants in children rose from 6.5 percent in 1992, before the start of the universal vaccination program, to nearly 15 percent in 2005. Among the control group of adults unaffected by the universal vaccination campaign, the rate of break-out mutants was virtually unchanged.

Hepatitis B is an infectious illness of the liver which can cause vomiting, inflammation, jaundice, and, rarely, death. About a third of the world’s population has been infected at some point in their lives. Transmission of hepatitis B virus results from exposure to infectious blood or bodily fluids containing blood. The infection is preventable by vaccination, which has been routinely used since the 1980s.

Researcher Tao Bian of Chapel Hill says that the vaccine remains quite effective, but that because escape mutants are likely to increase, public health officials need to track the rise of escape mutants, in order to know when it becomes time to consider new vaccination strategies. Measures that might be taken include boosting doses, adjusting the timing of vaccinations, or improving the vaccine. A next generation HBV vaccine has been invented, containing a second antigen in addition to the virus’ surface antigen. That means that both antigens would have to develop breakout mutations in order to elude the vaccine.

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A copy of the manuscript can be found online at http://bit.ly/asmtip0913e.  Formal publication is scheduled for the November 2013 issue of the Journal of Virology.

The Journal of Virology is a publication of the American Society for Microbiology (ASM). The ASM is the largest single life science society, composed of over 39,000 scientists and health professionals. ASM’s mission is to advance the microbiological sciences as a vehicle for understanding life processes and to apply and communicate this knowledge for the improvement of health and environmental and economic well-being worldwide.

Vitamin D deficiency may help spread of hepatitis B throughout liver

Contact: Dawn Peters sciencenewsroom@wiley.com 781-388-8408 Wiley

Researchers from Germany have found that low levels of vitamin D are associated with high levels of hepatitis B virus (HBV) replication. Findings published online in Hepatology, a journal of the American Association for the Study of Liver Diseases, suggest seasonal fluctuations in vitamin D and HBV levels point to a link in these variables among patients with chronic HBV.

While highly effective vaccines are available, HBV still remains one of the most significant infectious diseases worldwide. In fact, the World Health Organization (WHO) states that HBV is 50 to 100 times more infectious than human immunodeficiency virus (HIV). Furthermore WHO reports that two billion individuals have been infected with HBV, which is responsible for nearly 600,000 deaths each year. In the U.S. the Centers for Disease Control and Prevention (CDC) estimates that up to 1.4 million Americans are living with chronic HBV.

“Vitamin D helps maintain a healthy immune system and there is evidence of its role in inflammatory and metabolic liver disease, including infection with hepatitis C virus (HCV),” explains lead investigator Dr. Christian Lange from Johann Wolfgang Goethe University Hospital in Frankfurt. “However, the relationship between vitamin D metabolism and chronic HBV infection remains unknown and is the focus of our present study.”

Between January 2009 and December 2010, the team recruited 203 patients with chronic HBV who had not previously received treatment for their infection. Levels of 25-hydroxyvitamin D were measured from each participant. Patients co-infected with HCV, HIV, or hepatitis D; those with excessive alcohol use; and those with liver cancer or other malignancies were excluded.

Results show that 34% of participants had severe vitamin D deficiency (less than 10 ng/mL), 47% with vitamin D insufficiency (between 10-20 ng/mL) and 19% had normal levels of vitamin D (greater than 20 ng/mL). Further analyses indicate that the concentration of HBV in the blood, known as viral load, was a strong indicator of low vitamin D levels. In patients with HBV DNA less than 2000 IU/mL versus 2000 IU/mL or more, the levels of vitamin D were 17 and 11 ng/mL, respectively.

Researchers also determined that patients with the hepatitis B antigen (HBeAg) had lower levels of vitamin D than HBeAg negative participants. Inverse seasonal fluctuations between vitamin D and HBV levels were noted, which further suggests a relationship between the two variables.

“Our data confirm an association between low levels of vitamin D and high concentrations of HBV in the blood,” concludes Dr. Lange. “These findings differ from previous research of patients with chronic hepatitis C, which found no connection between vitamin D levels and concentration of HCV in the blood.” The authors propose further investigation of vitamin D as a therapeutic intervention for controlling HBV.

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This study is published in Hepatology. Media wishing to receive a PDF of this article may contact sciencenewsroom@wiley.com.

Full citation: “Low Vitamin D Serum Concentration is Associated with High Levels of Hepatitis B Virus (HBV) Replication in Chronically Infected Patients.” Harald Farnik, Jorg Bojunga, Annemarie Berger, Regina Allwinn, Oliver Waidmann, Bernd Kronenberger, Oliver T. Keppler, Stefan Zeuzem, Christoph Sarrazin and Christian M. Lange. Hepatology; (DOI: 10.1002/hep.26488) Published Online: May 22, 2013.

URL: http://doi.wiley.com/10.1002/hep.26488

About the Journal

Hepatology is the premier publication in the field of liver disease, publishing original, peer-reviewed articles concerning all aspects of liver structure, function and disease. Each month, the distinguished Editorial Board monitors and selects only the best articles on subjects such as immunology, chronic hepatitis, viral hepatitis, cirrhosis, genetic and metabolic liver diseases and their complications, liver cancer, and drug metabolism. Hepatology is published on is published by Wiley on behalf of the American Association for the Study of Liver Diseases (AASLD). For more information, please visit http://wileyonlinelibrary.com/journal/hep.

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Children with MS were 1.74 times more likely to have received a certain type of hepatitis B vaccine, called Engerix B®. Those children with MS developed symptoms three or more years after the vaccine.

Public release date: 25-Sep-2008 Re-Posted for Filing

Contact: Rachel Seroka
rseroka@aan.com
651-695-2738
American Academy of Neurology

Majority of children vaccinated against hepatitis B not at increased risk of MS

ST. PAUL, Minn. – The majority of children vaccinated against hepatitis B are not at an increased risk of developing multiple sclerosis (MS), according to a study to be published in the October 8, 2008, online issue of Neurology®, the medical journal of the American Academy of Neurology.

The study based in France involved 349 children with MS and 2,941 children without the disease. The children were all under the age of 16. A total of 24.4 percent of the children with MS were vaccinated for hepatitis B in the three years before the study, compared to 27.3 percent for the children without MS.

Although the study found that hepatitis B vaccination does not generally increase the risk of multiple sclerosis, the children with MS were 1.74 times more likely to have received a certain type of hepatitis B vaccine, called Engerix B®. Those children with MS developed symptoms three or more years after the vaccine. The risk was only found for this specific type of hepatitis B vaccine and not found for all vaccines against hepatitis B.

This association cannot be taken as confirmation that the vaccine caused MS. Further studies are needed to determine whether this is a causal relationship.

 

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The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer’s disease, epilepsy, Parkinson’s disease, and multiple sclerosis.

For more information about the American Academy of Neurology, visit www.aan.com.

Hepatitis A and or B Gives greater chance to recover from Hep C..Plus Morphine increases HCV Replication

Contact: Lixin Zhu wjg@wjgnet.com 86-108-538-1892 World Journal of Gastroenterology

Who will recover spontaneously from hepatitis C virus infection

More than 3% of world population is infected with hepatitis C virus (HCV). The outcome of HCV infections is either self recovery or chronic hepatitis, and many of the chronic infections will develop into liver cirrhosis or liver cancer. Since there is no cure for chronic hepatitis C, nor is there any approved vaccine for this virus, hepatitis C is currently a major health problem worldwide.

Twenty to fifty percent of HCV infected patients recovers spontaneously. The hepatitis C patients and their relatives like to know if his/her infection would fall into the category for self recovery.

A research article to be published on August 21 in the World Journal of Gastroenterology addresses this question. The research team led by Dr. Mihm from Georg-August-Universität spent more than 8 years working with a cohort of 67 patients who spontaneously recovered from HCV infection. In addition to these, the researchers included a similar number of patients with chronic HCV infection. Large sample size allowed these investigators to obtain results with great statistical significance, and to draw very reliable conclusions.

One conclusion reported by the investigators is, patients who self recovered usually have lower levels of HCV antibody. Thus patients with lower HCV antibody titer may have a brighter clinical outcome. However, for a practical standard to be established to define a low HCV antibody titer, more effort is needed by investigators in the future.

Another interesting conclusion reached by these investigators is, co-infection by hepatitis B virus (HBV) is associated with a higher possibility of self recovery. The investigators suggested that the infection of HBV interferes with the HCV replication, which would finally lead to virus eradiacation.. HCV patients co-infected by hepatitis A virus also have a better chance of self recovery, possibly by a similar mechanism.

Active iv drug users are less likely to self recover, for a couple of reasons: 1, they have a higher incidence of re-infection; 2, drugs have been shown to inhibit the expression of antiviral cytokines such as IFN- and IFN-; 3, HCV replication has been shown to be enhanced both by morphine use and morphine withdrawal.

Several different genotypes of HCV were discovered. The HCV genotype studied by Dr. Milm¡¯s group is type 1b, which is the prevalent genotype in Germany, and in China.

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* Reposted on Request