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A renal transplant recipient became persistently positive for hepatitis B virus (HBV) despite preexisting anti-hepatitis B surface (HBs) antibodies. The antigenicity and immunogenicity of wild-type (wt) and mutant HBs antigens (Ags) were compared. In contrast to wt HBsAg, genetic vaccination with mutant HBsAgs did not induce anti-HBs. Thus, mutations within HBsAg may enable HBV to escape immunological control.

the journal of infectious diseases (online. university of chicago press)/the journal of infectious diseases

De Novo Infection in a Renal Transplant Recipient Caused by Novel Mutants of Hepatitis B Virus Despite the Presence of Protective Anti–Hepatitis B Surface Antibody