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Báo cáo y học: " Infection with hepatitis B virus carrying novel pre-S/S gene mutations in female siblings vaccinated at birth: two case reports"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Infection with hepatitis B virus carrying novel pre-S/S gene mutations in female siblings vaccinated at birth: two case reports. | Lai et al. Journal of Medical Case Reports 2010 4 190 http www.jmedicalcasereports.eom content 4 1 190 jA JOURNALOF.MEDICAL CASE REPORTS CASE REPORT Open Access Inflection with hepatitis B virus carrying novel pre-S S gene mutations in female siblings vaccinated at birth two case reports Ming-Wei Lai1 2 Christopher S-H Yeh3 and Chau-Ting Yeh 2 3 Abstract Introduction After the initiation of a mass hepatitis B vaccination program in Taiwan the prevalence of hepatitis B virus infection has declined progressively. However about 1 percent of the young generation who received hepatitis B vaccination at birth remain carriers. Infection with vaccine-escape hepatitis B virus mutants always occurs shortly after birth. Here we report two female siblings in whom the infection occurred in their adolescence. This report raises the question of whether a booster for hepatitis B vaccination is needed. Case presentation Two 19 and 14-year-old Taiwanese female siblings were born to a mother infected with hepatitis B virus and received a complete course of hepatitis B vaccination at birth. They remained negative for serum hepatitis B surface antigen and positive for serum anti-hepatitis B surface antibody throughout their childhood. However both were infected with the hepatitis B virus in their adolescence. Hepatitis B virus DNA was extracted from serum samples from the mother and two siblings. Hepatitis B virus pre-S S sequence was amplified by polymerase chain reaction followed by nucleotide sequencing. When compared with the sequence obtained from the mother multiple amino acid substitutions located near or in the major hydrophilic region of the surface antigen were identified in the elder sister. Four of these mutations sL97S sL98S sG102R and sA159P were novel. A novel in-frame deletion 14 amino acids deleted pre-S 127-140 was found in the hepatitis B virus pre-S2 region in the younger sister. Conclusions Despite having received hepatitis B vaccination at birth hepatitis B virus