Human Leukocyte Antigens Influence the Antibody Response to Hepatitis B Vaccine
Abstract
Hepatitis B virus (HBV) infection and its sequelae such as cirrhosis and hepatocellular carcinoma has remained a serious public health problem throughout the world. The WHO strategy for effective control of HBV infection and its complications is mass vaccination of neonates and children within the framework of Expanded Programme on Immunization (EPI). Vaccination with hepatitis B surface antigen (HBsAg) induces protective antibody response (anti-HBs ≥ 10 IU/L) in 90-99% of vaccinees.The lack of response to HBsAg has been attributed to a variety of immunological mechanisms, including defect in antigen presentation, defect in HBsAg-specific T and/or B cell repertoires, T-cell suppression, increase in the regulatory T cell count, lack of necessary help of T-cells for production of anti-HBs by B cells, defect in Th1 and/or Th2 cytokine production and selective killing of HBsAg-specific B-cells by human leukocyte antigen (HLA)-restricted cytotoxic T lymphocytes. The HLA complex plays an important role in many of these immunological processes.A variety of HLA class I, II, and III alleles and antigens have been reported to beassociated with antibody response to HBsAg vaccination in different ethnic populations. Moreover, some HLA haplotypes were also associated with responsiveness to HBsAg.In this review the association of the HLA specificities with antibody response to hepatitis B (HB) vaccine is discussed.
1 Specialist Panel on Chronic Hepatitis B in the Middle East. A review of chronic hepatitis B epidemiology and management issues in selected countries in the Middle East. J Viral Hepat 2012; 19(1):9-22.
2 Franco E, Bagnato B, Marino MG, Meleleo C, Serino L, Zaratti L. Hepatitis B: Epidemiology and prevention in developing countries. World J Hepatol 2012; 4(3):74-80.
3 Ott JJ, Stevens GA, Groeger J, Wiersma ST. Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity. Vaccine 2012; 30(12):2212-9.
4 Bonanni P, Pesavento G, Boccalini S, Bechini A.Perspectives of public health: present and foreseen impact of vaccination on the epidemiology of hepatitis B. J Hepatol 2003; 39(Suppl 1):224-9.
5 Alavian SM, Fallahian F, Lankarani KB. Implementing strategies for hepatitis B vaccination. Saudi J Kidney Dis Transpl 2010; 21(1):10-22.
6 Goldstein ST, Zhou F, Hadler SC, Bell BP, Mast EE, Margolis HS. A mathematical model to estimate global hepatitis B disease burden and vaccination impact. Int J Epidemiol 2005; 34(6):1329-39.
7 Alavian SM, Fallahian F, Lankarani KB. The changing epidemiology of viral hepatitis B in Iran. J Gastrointestin Liver Dis 2007; 16(4):403-6.
8 Shokri F, Jafarzadeh A. High seroprotection rate induced by low doses of a recombinant hepatitis B vaccine in healthy Iranian neonates. Vaccine 2001; 19(31):4544-8.
9 Kwon SY, Lee CH. Epidemiology and prevention of hepatitis B virus infection. Korean J Hepatol 2011;17(2):87-95.
10 Zeeshan M, Jabeen K, Ali AN, Ali AW, Farooqui SZ, Mehraj V, et al. Evaluation of immune response to Hepatitis B vaccine in health care workers at a tertiary care hospital in Pakistan: an observational prospective study. BMC Infect Dis 2007; 7:120.
11 Hagedorn HJ, Rettmann NA, Dieperink EW, Durfee J, Aqel B. Antibody response to hepatitis B vaccine in substance use disorder patients. Drug Alcohol Depend 2010; 107(1):39-43.
12 Prather AA, Hall M, Fury JM, Ross DC, Muldoon MF, Cohen S, et al. Sleep and antibody response to hepatitis B vaccination. Sleep 2012; 35(8):1063-9.
13 Nahar K, Jahan M, Nessa A, Tabassum S. Antibody responses after hepatitis B vaccination among maintenance haemodialysis patients. Bangladesh Med Res Counc Bull 2011; 37(3):88-91.
14 Schillie SF, Spradling PR, Murphy TV. Immune response of hepatitis B vaccine among persons with diabetes: a systematic review of the literature. Diabetes Care 2012;35(12):2690-7.
15 Pullukcu H, Ertem E, Karaca Y, Yamazhan T, Sertoz RY, Altuglu I. Efficacy of accelerated hepatitis B vaccination program in patients being actively treated for hematologic malignancies. Int J Infect Dis 2008; 12(2):166-70.
16 Schillie SF, Murphy TV. Seroprotection after recombinant hepatitis B vaccination among newborn infants: a review. Vaccine 2013; 31(21):2506-16.
17 Moorman JP, Zhang CL, Ni L, Ma CJ, Zhang Y, Wu XY, et al. Impaired hepatitis B vaccine responses during chronic hepatitis C infection: involvement of the PD-1 pathway in regulating CD4(+) T cell responses. Vaccine 2011; 29(17):3169-76.
18 Chen L, Liu WQ, Lei JH, Guan F, Li MJ, Song WJ, et al.Chronic Schistosoma japonicum infection reduces immune response to vaccine against hepatitis B in mice. PLoS One 2012; 7(12):e51512.
19 Hernandez-Bernal F, Aguilar-Betancourt A, Aljovin V, Arias G, Valenzuela C, de Alejo KP, et al. Comparison of four recombinant hepatitis B vaccines applied on an accelerated schedule in healthy adults. Hum Vaccin 2011;7(10):1026-36.
20 Feng L, Niu Y, Chen H, You H, Zang Y, Li L, et al.Immunogenicity of different hepatitis B virus vaccination schedules in liver transplant recipients. Hepatol Res 2013;43(5):495-501.
21 Tonnis WF, Amorij JP, Vreeman MA, Frijlink HW, Kersten GF, Hinrichs WL. Improved storage stability and immunogenicity of hepatitis B vaccine after spray-freeze drying in presence of sugars. Eur J Pharm Sci 2014;55:36-45
22 Gomber S, Sharma R, Ramachandran VG.Immunogenicity of low dose intradermal hepatitis B vaccine and its comparison with standard dose intramuscular vaccination. Indian Pediatr 2004;41(9):922-6.
23 Sangare L, Manhart L, Zehrung D, Wang CC.Intradermal hepatitis B vaccination: a systematic review and meta-analysis. Vaccine 2009; 27(12):1777-86.
24 Fakharzadeh S, Kalanaky S, Hafizi M, Goya MM,Masoumi Z, Namaki S, et al. The new nano-complex, Hep-c, improves the immunogenicity of the hepatitis B vaccine. Vaccine 2013; 31(22):2591-7.
25 Nouri-Aria K, Magrin S, Alexander G, Anderson M, Williams R, Eddleston AL. Abnormal T-cell activation in chronic hepatitis B viral infection: a consequence of monocyte dysfunction? Immunology 1988; 64(4):733-8.
26 Shokrgozar MA, Shokri F. Enumeration of hepatitis B surface antigen‐specific B lymphocytes in responder and non‐responder normal individuals vaccinated with recombinant hepatitis B surface antigen. Immunology 2001; 104(1):75-9.
27 Chedid MG, Deulofeut H, Yunis DE, Lara-Marquez ML, Salazar M, Deulofeut R, et al. Defect in Th1-like cells of nonresponders to hepatitis B vaccine. Hum Immunol 1997; 58(1):42-51.
28 Watanabs H, Okumura M, Hirayama K, Sasazuki T.HLA‐Bw54‐DR4‐DRw53‐DQw4 haplotype controls nonresponsiveness to hepatitis‐B surface antigen‐via CD8‐positive suppressor T cells. Tissue Antigens 2008;36(2):69-74.
29 del Pozo Balado Mdel M, Leal M, Mendez Lagares G, Mata RC, Lopez-Cortes LF, Viciana P, et al. Increased regulatory T cell counts in HIV-infected nonresponders to hepatitis B virus vaccine. J Infect Dis 2010;202(2):362-9.
30 Vingerhoets J, Vanham G, Kestens L, Penne G, Leroux- Roels G, Gigase P. Deficient T-cell responses in non- responders to hepatitis B vaccination: absence of TH1 cytokine production. Immunol Lett 1994; 39(2):163-8.
31 Jafarzadeh A, Shokri F. The antibody response to HBs antigen is regulated by coordinated Th1 and Th2 cytokine production in healthy neonates. Clin Exp Immunol 2003;131(3):451-6.
32 Kardar G, Jeddi‐Tehrani M, Shokri F. Diminished Th1 and Th2 cytokine production in healthy adult nonresponders to recombinant hepatitis B vaccine. Scand J Immunol 2002; 55(3):311-4.
33 Soroosh P, Shokri F, Azizi M, Jeddi-Tehrani M. Analysis of T-cell receptor beta chain variable gene segment usage in healthy adult responders and nonresponders to recombinant hepatitis B vaccine. Scand J Immunol 2003;57(5):423-31.
34 Barnaba V, Franco A, Alberti A, Benvenuto R, Balsano F. Selective killing of hepatitis B envelope antigen- specific B cells by class I-restricted, exogenous antigen- specific T lymphocytes. Nature 1990; 345(6272):258-60.
35 Salazar M, Deulofeut H, Granja C, Deulofeut R, Yunis DE, Marcus-Bagley D, et al. Normal HBsAg presentation and T-cell defect in the immune response of nonresponders. Immunogenetics 1995; 41(6):366-74.
36 Höhler T, Meyer CU, Notghi A, Stradmann- Bellinghausen B, Schneider PM, Starke R, et al. The influence of major histocompatibility complex class II genes and T-cell Vβ repertoire on response to immunization with HBsAg. Hum Immunol 1998;59(4):212-8.
37 Desombere I, Willems A, Leroux‐Roels G. Response to hepatitis B vaccine: multiple HLA genes are involved. Tissue Antigens 2008; 51(6):593-604.
38 Wataya M, Sano T, Kamikawaji N, Tana T, Yamamoto K, Sasazuki T. Comparative analysis of HLA restriction and cytokine production in hepatitis B surface antigen- specific T cells from low-and high-antibody responders in vaccinated humans. J Hum Genet 2001; 46(4):197-206.
39 Martinetti M, De Silvestri A, Belloni C, Pasi A, Tinelli C, Pistorio A, et al. Humoral response to recombinant hepatitis B virus vaccine at birth: role of HLA and beyond. Clin Immunol 2000; 97(3):234-40.
40 Langö‐Warensjö A, Cardell K, Lindblom B. Haplotypes comprising subtypes of the DQB1* 06 allele direct the antibody response after immunisation with hepatitis B surface antigen. Tissue Antigens 1998; 52(4):374-80.
41 Jafarzadeh A, Shokri F. TH1 and TH2 responses are influenced by HLA antigens in healthy neonates vaccinated with recombinant hepatitis B vaccine. Iran J Allergy Asthma Immunol 2012; 11(4):308-15.
42 Weissler KA, Caton AJ. The role of T-cell receptor recognition of peptide:MHC complexes in the formation and activity of Foxp3(+) regulatory T cells. Immunol Rev 2014; 259(1):11-22.
43 Lo WL, Allen PM. Self-awareness: how self- peptide/MHC complexes are essential in the development of T cells. Mol Immunol 2013; 55(2):186-9.
44 McDermott A, Cohen S, Zuckerman J, Madrigal JA.Human leukocyte antigens influence the immune response to a pre-S/S hepatitis B vaccine. Vaccine 1999;17(4):330-9.
45 Golsaz Shirazi F, Amiri MM, Mohammadi H, Bayat AA, Roohi A, Khoshnoodi J, et al. Construction and expression of hepatitis B surface antigen escape variants within the "a" determinant by site directed mutagenesis. Iran J Immunol 2013; 10(3):127-38.
46 Schillie SF, Murphy TV. Seroprotection after recombinant hepatitis B vaccination among newborn infants: A review. Vaccine 2013; 31(21):2506-16.
47 Jafarzadeh A, Khoshnoodi J, Ghorbani S, Hazrati SM, Faraj Mazaheri B, Shokri F: Differential immunogenicity of a recombinant hepatitis B vaccine in Iranian neonates: influence of ethnicity and environmental factors. Irn J Immunol 2004; 1:98-104.
48 Desombere I, Gijbels Y, Verwulgen A, Leroux-Roels G.Characterization of the T cell recognition of hepatitis B surface antigen (HBsAg) by good and poor responders to hepatitis B vaccines. Clin Exp Immunol 2000;122(3):390-9.
49 Oh H, Ghosh S. NF-kappaB: roles and regulation in different CD4(+) T-cell subsets. Immunol Rev 2013;252(1):41-51.
50 Honorati M, Dolzani P, Mariani E, Piacentini A, Lisignoli G, Ferrari C, et al. Epitope specificity of Th0/Th2 CD4+ T-lymphocyte clones induced by vaccination with rHBsAg vaccine. Gastroenterology 1997; 112(6):2017-27.
51 Bian G, Cheng Y, Wang Z, Hu Y, Zhang X, Wu M, et al.Whole recombinant Hansenula polymorpha expressing hepatitis B virus surface antigen (yeast-HBsAg) induces potent HBsAg-specific Th1 and Th2 immune responses. Vaccine 2009; 28(1):187-94.
52 Livingston BD, Alexander J, Crimi C, Oseroff C, Celis E, Daly K, et al. Altered helper T lymphocyte function associated with chronic hepatitis B virus infection and its role in response to therapeutic vaccination in humans. J Immunol 1999; 162(5):3088-95.
53 Larsen CE, Xu J, Lee S, Dubey DP, Uko G, Yunis EJ, Alper CA. Complex cytokine responses to hepatitis B surface antigen and tetanus toxoid in responders, nonresponders and subjects naive to hepatitis B surface antigen. Vaccine 2000; 18(26):3021-30.
54 Velu V, Saravanan S, Nandakumar S, Shankar EM, Vengatesan A, Jadhav SS, et al. Relationship between T- lymphocyte cytokine levels and sero-response to hepatitis B vaccines. World J Gastroenterol 2008; 14(22):3534-40.
55 Holzer U, Kwok WW, Nepom GT, Buckner JH.Differential antigen sensitivity and costimulatory requirements in human Th1 and Th2 antigen-specific CD4+ cells with similar TCR avidity. J Immunol 2003;170(3):1218-23.
56 Kruger A, Adams P, Hammer J, Böcher W, Schneider P, Rittner C, et al. Hepatitis B surface antigen presentation and HLA‐DRB1*–lessons from twins and peptide binding studies. Clin Exp Immunol 2005; 140(2):325-32.
57 Murray JS. How the MHC selects Th1/Th2 immunity.Immunol Today 1998; 19(4):157-62.
58 Newport M, Goetghebuer T, Weiss H, Whittle H, Siegrist C, Marchant A. Genetic regulation of immune responses to vaccines in early life. Genes Immun 2004; 5(2):122-9.
59 Höhler T, Reuss E, Evers N, Dietrich E, Rittner C, Freitag CM, et al. Differential genetic determination of immune responsiveness to hepatitis B surface antigen and to hepatitis A virus: a vaccination study in twins. The Lancet 2002; 360(9338):991-5.
60 Egea E, Iglesias A, Salazar M, Morimoto C, Kruskall M, Awdeh Z, et al. The cellular basis for lack of antibody response to hepatitis B vaccine in humans. J Exp Med 1991; 173(3):531-8.
61 McDermott A, Zuckerman J, Sabin C, Marsh S, Madrigal J. Contribution of human leukocyte antigens to the antibody response to hepatitis B vaccination. Tissue Antigens 2008; 50(1):8-14.
62 McDermott A, Madrigal J, Sabin C, Zuckerman J, Cohen SB. The influence of host factors and immunogenetics on lymphocyte responses to Hepagene< sup>®</sup> vaccination. Vaccine 1999; 17(11-12):1329-37.
63 Milich D, Chisari FV. Genetic regulation of the immune response to hepatitis B surface antigen (HBsAg). I. H-2 restriction of the murine humoral immune response to the a and d determinants of HBsAg. J Immunol 1982;129(1):320-5.
64 Jafarzadeh A, Shokrgozar M. Unresponsiveness to recombinant hepatitis B vaccine in healthy Iranian neonates: Association with HLA antigens. Iran J Med Sci 2002; 27:51-5.
65 Shokrgozar M, Shokri F: HLA-associated antibody response to recombinant hepatitis B vaccine in healthy Iranian adults. Iran J Med Sci 1999; 24:98-103.
66 Das K, Gupta R, Kumar V, Singh S, Kar P. Association of HLA phenotype with primary non-response to recombinant hepatitis B vaccine: a study from north India. Trop Gastroenterol 2004; 25(3):113-5.
67 Vingerhoets J, Goilav C, Vanham G, Kestens L, Muylle L, Kegels E, et al. Non-response to a recombinant pre-S2- containing hepatitis B vaccine: association with the HLA- system. Ann Soc Belg Med Trop 1995; 75(2):125-9.
68 Peces R, de la Torre M, Alcazar R, Urra JM. Prospective analysis of the factors influencing the antibody response to hepatitis B vaccine in hemodialysis patients. Am J Kidney Dis 1997; 29(2):239-45.
69 Stachowski J, Kramer J, Fust G, Maciejewski J, Baldamus CA, Petranyi GG. Relationship between the reactivity to hepatitis B virus vaccination and the frequency of MHC class I, II and III alleles in haemodialysis patients. Scand J Immunol 1995; 42(1):60-5.
70 Liu P, Xu H, Wang X, Li H, Zhuang G, Wu Z, Zhang K. [Field epidemiological and experimental study on relationship between genetic factor and nonresponse or hyporesponse to hepatitis B vaccine]. Chin Med J (Engl)2000; 113(6):547-50.
71 Durupinar B, Okten G. HLA tissue types in nonresponders to hepatitis B vaccine. Indian J Pediatr 1996; 63(3):369-73.
72 Mineta M, Tanimura M, Tana T, Yssel H, Kashiwagi S, Sasazuki T. Contribution of HLA class I and class II alleles to the regulation of antibody production to hepatitis B surface antigen in humans. Int Immunol 1996;8(4):525-31.
73 Vitaliti G, Pratico AD, Cimino C, Di Dio G, Lionetti E, La Rosa M, et al. Hepatitis B vaccine in celiac disease: yesterday, today and tomorrow. World J Gastroenterol 2013; 19(6):838-45.
74 Lin HH, Liao HW, Lin SK, Wang LY. HLA and response to booster hepatitis B vaccination in anti-HBs- seronegative adolescents who had received primary infantile vaccination. Vaccine 2008; 26(27-28):3414-20.
75 Kacprzak-Bergman I, Nowakowska B. Influence of genetic factors on the susceptibility to HBV infection, its clinical pictures, and responsiveness to HBV vaccination. Arch Immunol Ther Exp (Warsz) 2005; 53(2):139-42.
76 Candore G, Romano GC, D’Anna C, Di Lorenzo G, Gervasi F, Lio D, et al. Biological basis of the HLA-B8, DR3-associated progression of acquired immune deficiency syndrome. Pathobiology 1998;66(1):33-7.
77 Thio CL, Thomas DL, Karacki P, Gao X, Marti D, Kaslow RA, et al. Comprehensive analysis of class I and class II HLA antigens and chronic hepatitis B virus infection. J Virol 2003; 77(22):12083-7.
78 Mignini F, Streccioni V, Baldo M, Vitali M, Indraccolo U, Bernacchia G, et al. Individual susceptibility to hexavalent chromium of workers of shoe, hide, and leather industries. Immunological pattern of HLA-B8, DR3-positive subjects. Prev Med 2004; 39(4):767-75.
79 Amirzargar AA, Mohseni N, Shokrgozar MA, Arjang Z, Ahmadi N, Behzadi MY, et al. HLA-DRB1, DQA1 and DQB1 alleles and haplotypes frequencies in Iranian healthy adult responders and non-responders to recombinant hepatitis B vaccine. Iran J Immunol 2008;5(2):92-9.
80 Godkin A, Davenport M, Hill AV. Molecular analysis of HLA class II associations with hepatitis B virus clearance and vaccine nonresponsiveness. Hepatology 2005;41(6):1383-90.
81 Li Y, Ni R, Song W, Shao W, Shrestha S, Ahmad S, et al.Clear and independent associations of several HLA- DRB1 alleles with differential antibody responses to hepatitis B vaccination in youth. Hum Genet 2009;126(5):685-96.
82 McDermott A, Zuckerman J, Sabin C, Marsh S, Madrigal JA. Contribution of human leukocyte antigens to the antibody response to hepatitis B vaccination. Tissue Antigens 1997; 50(1):8-14.
83 Caillat-Zucman S, Gimenez JJ, Wambergue F, Albouze G, Lebkiri B, Naret C, et al. Distinct HLA class II alleles determine antibody response to vaccination with hepatitis B surface antigen. Kidney Int 1998; 53(6):1626-30.
84 Mert G, Sengul A, Gul HC, Karakas A, Eyigun CP. The role of human leukocyte antigen tissue groups in hepatitis B virus vaccination in Turkey. J Microbiol Immunol Infect 2014; 47(1):9-14.
85 Martinetti M, Cuccia M, Daielli C, Ambroselli F, Gatti C, Pizzochero C, et al. Anti-HBV neonatal immunization with recombinant vaccine. Part II. Molecular basis of the impaired alloreactivity. Vaccine 1995; 13(6):555-60.
86 Fletcher G, Samuel P, Christdas J, Gnanamony M, Ismail A, Anantharam R, et al. Association of HLA and TNF polymorphisms with the outcome of HBV infection in the South Indian population. Genes Immun 2011; 12(7):552-8.
87 Yan ZH, Fan Y, Wang XH, Mao Q, Deng GH, Wang YM. Relationship between HLA-DR gene polymorphisms and outcomes of hepatitis B viral infections: a meta-analysis. World J Gastroenterol 2012;18(24):3119-28.
88 Watanabe H, Okumura M, Hirayama K, Sasazuki T.HLA-Bw54-DR4-DRw53-DQw4 haplotype controls nonresponsiveness to hepatitis-B surface antigen via CD8-positive suppressor T cells. Tissue Antigens 1990;36(2):69-74.
89 Lango-Warensjo A, Cardell K, Lindblom B. Haplotypes comprising subtypes of the DQB1*06 allele direct the antibody response after immunisation with hepatitis B surface antigen. Tissue Antigens 1998; 52(4):374-80.
90 Vidan-Jeras B, Brinovec V, Jurca B, Levicnik Steyinar S,Jeras M, Bohinjec M. The contribution of HLA-Class II antigens in humoral non-response and delayed response to HBsAG vaccination. Pflugers Arch 2000; 440(5Suppl):R188-9.
91 Hohler T, Stradmann-Bellinghausen B, Starke R, Sanger R, Victor A, Rittner C, et al. C4A deficiency and nonresponse to hepatitis B vaccination. J Hepatol 2002;37(3):387-92.
92 Milich DR. Influence of C4A deficiency on nonresponse to HBsAg vaccination: a new immune response gene. J Hepatol 2002; 37(3):396-9.
93 Fischer MB, Ma M, Goerg S, Zhou X, Xia J, Finco O, et al. Regulation of the B cell response to T-dependent antigens by classical pathway complement. J Immunol 1996; 157(2):549-56.
94 Roozendaal R, Carroll MC. Complement receptors CD21 and CD35 in humoral immunity. Immunol Rev 2007;219:157-66.
95 Singh R, Kaul R, Kaul A, Khan K. A comparative review of HLA associations with hepatitis B and C viral infections across global populations. World J Gastroenterol 2007; 13(12):1770-87.
96 Kramer J, Stachowski J, Barth C, Ujhelyi E, Tarjan V, Sulowicz W, et al. Genetic regulation of the impaired immune response to hepatitis-B vaccine associated with low TCR density in end stage renal disease patients: contribution of complement C4 and factor B alleles. Immunol Lett 1997; 59(1):13-9.
97 Desombere I, Willems A, Leroux-Roels G. Response to hepatitis B vaccine: multiple HLA genes are involved. Tissue Antigens 1998; 51(6):593-604.
98 Hatae K, Kimura A, Okubo R, Watanabe H, Erlich HA, Ueda K, et al. Genetic control of nonresponsiveness to hepatitis B virus vaccine by an extended HLA haplotype. Eur J Immunol 1992; 22(7):1899-905.
99 Desombere I, Gijbels Y, Verwulgen A, Leroux‐Roels G.Characterization of the T cell recognition of hepatitis B surface antigen (HBsAg) by good and poor responders to hepatitis B vaccines. Clin Exp Immunol 2000;122(3):390-9.
100 Desombere I, Cao T, Gijbels Y, Leroux‐Roels G.Non‐responsiveness to hepatitis B surface antigen vaccines is not caused by defective antigen presentation or a lack of B7 co‐stimulation. Clin Exp Immunol 2005;140(1):126-37.
101 Avanzini M, Belloni C, De Silvestri A, Castellazzi A, Marconi M, Moretta A, et al. Antigen-specific T cell response in infants after recombinant hepatitis B virus vaccination at birth: evaluation of T helper lymphocyte diversity. Clin Immunol 2003; 107(2):122-8.
102 Jafarzadeh A, Kardar GA, Khoshnoodi J, Shokri F.Downregulation of IL-12 production in healthy non- responder neonates to recombinant hepatitis B vaccine. Iranian Biomedical Journal 2004; 8:41-5.
103 Höhler T, Gerken G, Notghi A, Lubjuhn R, Taheri H, Protzer U, et al. HLA-DRB1* 1301 and* 1302 protect against chronic hepatitis B. J Hepatol 1997; 26(3):503-7.
104 Kummee P, Tangkijvanich P, Poovorawan Y, Hirankarn N. Association of HLA‐DRB1* 13 and TNF‐α gene polymorphisms with clearance of chronic hepatitis B infection and risk of hepatocellular carcinoma in Thai population. J Viral Hepat 2007; 14(12):841-8.
105 Diepolder H, Jung M, Keller E, Schraut W, Gerlach J, Grüner N, et al. A vigorous virus-specific CD4+ T cell response may contribute to the association of HLA-DR13 with viral clearance in hepatitis B. Clin Exp Immunol 1998; 113(2):244-51.
106 Shokrgozar MA, Shokri F. Enumeration of HBsAg- specific B-lymphocytes in Iranian healthy adult responders and non-responders vaccinated with recombinant hepatitis B vaccine. Immunology 2001;104(1):75-9.
107 Lazizi Y, Badur S, Perk Y, Ilter O, Pillot J. Selective unresponsiveness to HBsAg vaccine in newborns related with an in utero passage of hepatitis B virus DNA. Vaccine 1997; 15(10):1095-100.
108 Milich DR, Jones JE, Hughes JL, Price J, Raney AK, McLachlan A. Is a function of the secreted hepatitis B e antigen to induce immunologic tolerance in utero? Proc Natl Acad Sci U S A 1990; 87(17):6599-603.
Files | ||
Issue | Vol 14, No 3 (2015) | |
Section | Review Article(s) | |
Keywords | ||
Hepatitis B vaccine Hepatitis B antibodies Human leukocyte antigen |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |