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Salpini R, Pietrobattista A, Piermatteo L, Basso MS, Bellocchi MC, Liccardo D, Carioti L, Francalanci P, Aragri M, Alkhatib M, Scutari R, Candusso M, Ciotti M, Svicher V. Establishment of a Seronegative Occult Infection With an Active Hepatitis B Virus Reservoir Enriched of Vaccine Escape Mutations in a Vaccinated Infant After Liver Transplantation. J Infect Dis 2020; 220:1935-1939. [PMID: 31412121 DOI: 10.1093/infdis/jiz411] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 08/08/2019] [Indexed: 02/07/2023] Open
Abstract
We describe the establishment of a seronegative occult hepatitis B virus (HBV) infection (OBI) in a successfully vaccinated infant who underwent liver transplantation from an donor positive for antibody to hepatitis B core antigen (anti-HBc). The use of highly sensitive droplet digital polymerase chain reaction assays revealed a not negligible and transcriptionally active intrahepatic HBV reservoir (circular covalently closed DNA, relaxed circular DNA, and pregenomic RNA: 5.6, 2.4, and 1.1 copies/1000 cells, respectively), capable to sustain ongoing viral production and initial liver damage. Next-generation sequencing revealed a peculiar enrichment of hepatitis B surface antigen vaccine-escape mutations that could have played a crucial role in OBI transmission. This clinical case highlights the pathobiological complexity and the diagnostic challenges underlying OBI.
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Affiliation(s)
- Romina Salpini
- Department of Experimental Medicine, University of Rome "Tor Vergata,", Rome, Italy
| | - Andrea Pietrobattista
- Department of Hepatology and Gastroenterology, Polyclinic Tor Vergata Foundation, Rome, Italy
| | - Lorenzo Piermatteo
- Department of Experimental Medicine, University of Rome "Tor Vergata,", Rome, Italy
| | - Maria Sole Basso
- Department of Hepatology and Gastroenterology, Polyclinic Tor Vergata Foundation, Rome, Italy
| | - Maria C Bellocchi
- Department of Experimental Medicine, University of Rome "Tor Vergata,", Rome, Italy
| | - Daniela Liccardo
- Department of Hepatology and Gastroenterology, Polyclinic Tor Vergata Foundation, Rome, Italy
| | - Luca Carioti
- Department of Experimental Medicine, University of Rome "Tor Vergata,", Rome, Italy
| | - Paola Francalanci
- Department of Pathology, Bambino Gesù Children Hospital, Polyclinic Tor Vergata Foundation, Rome, Italy
| | - Marianna Aragri
- Department of Experimental Medicine, University of Rome "Tor Vergata,", Rome, Italy
| | - Mohammed Alkhatib
- Department of Experimental Medicine, University of Rome "Tor Vergata,", Rome, Italy
| | - Rossana Scutari
- Department of Experimental Medicine, University of Rome "Tor Vergata,", Rome, Italy
| | - Manila Candusso
- Department of Hepatology and Gastroenterology, Polyclinic Tor Vergata Foundation, Rome, Italy
| | - Marco Ciotti
- Department of Clinical Microbiology and Virology, Polyclinic Tor Vergata Foundation, Rome, Italy
| | - Valentina Svicher
- Department of Experimental Medicine, University of Rome "Tor Vergata,", Rome, Italy
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Salpini R, Piermatteo L, Gill U, Battisti A, Stazi F, Guenci T, Giannella S, Serafini V, Kennedy PTF, Perno CF, Svicher V, Ciotti M. Quantification of intrahepatic total HBV DNA in liver biopsies of HBV-infected patients by a modified version of COBAS ® Ampliprep/COBAS ®TaqMan HBV test v2.0. Med Microbiol Immunol 2017; 206:295-299. [PMID: 28401351 DOI: 10.1007/s00430-017-0504-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 04/05/2017] [Indexed: 10/19/2022]
Abstract
Intrahepatic total HBV DNA (it-HBV DNA) level might reflect the size of virus reservoir and correlate with the histological status of the liver. To quantitate it-HBV DNA in a series of 70 liver biopsies obtained from hepatitis B chronic patients, a modified version of the COBAS®Ampliprep/COBAS®TaqMan HBV test v2.0 was used for this purpose. The linearity and reproducibility of the modified protocol was tested by quantifying serial dilutions of a full-length HBV containing plasmid and it-HBV DNA from a reference patient. A good linear trend between the expected values and those generated by the assay was observed at different concentrations of both plasmid and reference patient (R 2 = 0.994 and 0.962, respectively). Differences between the values obtained in two independent runs were ≤0.3 log IU for the plasmid and ≤0.6 log IU/mg for the reference patient, showing a high inter-run reproducibility. In the 70 liver biopsies, it-HBV DNA level ranged from 1.4 to 5.4 log IU/mg, with a good linearity and reproducibility between the values obtained in two runs [R 2 = 0.981; median (IQR) difference of it-HBV DNA 0.05 (0.02-0.09) IU/mg]. The modified COBAS®Ampliprep/COBAS®TaqMan HBV test v2.0 allows an accurate quantitation of it-HBV DNA. Its determination may have prognostic value and may be a useful tool for the new therapeutic strategies aimed at eradicating the HBV infection.
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Affiliation(s)
- Romina Salpini
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Lorenzo Piermatteo
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Upkar Gill
- Hepatology, Centre for Immunobiology, Blizard Institute, Barts and The London SMD, QMUL, London, UK
| | - Arianna Battisti
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Francesca Stazi
- Laboratory of Molecular Virology, Polyclinic Tor Vergata Foundation, Viale Oxford 81, 00133, Rome, Italy
| | - Tania Guenci
- Laboratory of Molecular Virology, Polyclinic Tor Vergata Foundation, Viale Oxford 81, 00133, Rome, Italy
| | - Sara Giannella
- Laboratory of Molecular Virology, Polyclinic Tor Vergata Foundation, Viale Oxford 81, 00133, Rome, Italy
| | - Valentina Serafini
- Laboratory of Molecular Virology, Polyclinic Tor Vergata Foundation, Viale Oxford 81, 00133, Rome, Italy
| | - Patrick T F Kennedy
- Hepatology, Centre for Immunobiology, Blizard Institute, Barts and The London SMD, QMUL, London, UK
| | - Carlo Federico Perno
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.,Laboratory of Molecular Virology, Polyclinic Tor Vergata Foundation, Viale Oxford 81, 00133, Rome, Italy
| | - Valentina Svicher
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Marco Ciotti
- Laboratory of Molecular Virology, Polyclinic Tor Vergata Foundation, Viale Oxford 81, 00133, Rome, Italy.
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