Open AccessHepatitis B surface antigen escape mutations: Indications for initiation of antiviral therapy revisited
Author(s) -
Jennifer Leong,
Derek Lin,
Mindie H. Nguyen
Publication year - 2016
Publication title -
world journal of clinical cases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.368
H-Index - 10
ISSN - 2307-8960
DOI - 10.12998/wjcc.v4.i3.71
Subject(s) - medicine , transmission (telecommunications) , antiviral therapy , hepatitis b , virology , vaccination , immunology , antibody , antigen , disease , immune escape , mutation , chronic hepatitis , immune system , virus , gene , genetics , biology , electrical engineering , engineering
Approximately 240 million people are chronically infected with hepatitis B. The implementation of rigorous vaccination programs has led to an overall decrease in the prevalence of this disease worldwide but this may also have led to emergence of viral mutations that can escape the protection of hepatitis B surface antibody. As this phenomenon is increasingly recognized, concern for transmission to vaccinated individuals has also been raised. Herein, we describe two cases where the suspected presence of a hepatitis B surface antigen escape mutation impacted the decision to initiate early antiviral therapy, as well as provide a brief review of these mutations. Our findings described here suggest that a lower threshold for initiating therapy in these individuals should be considered in order to reduce the risk of transmission, as vaccination does not provide protection.