Evidence for positive selection of hepatitis A virus antigenic variants in vaccinated men-having-sex-with men patients: implications for immunization policies

Background: A huge outbreak in the men-having-sex-with-men (MSM) has hit Europe during the years 2016-2018. Outbreak control has been hampered by vaccine shortages in many countries, and to minimize their impact, reduction of antigen doses has been implemented. However, these measures may have conse...

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Detalles Bibliográficos
Autores: Sabrià Sunyé, Aurora, Gregori, Josep, Garcia-Cehic, Damir, Guix Arnau, Susana, Pumarola Suñé, Tomàs, Manzanares-Laya, Sandra, Caylà, Joan A., Bosch, Albert, Quer, Josep, Pintó Solé, Rosa María
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/193483
Acceso en línea:https://hdl.handle.net/2445/193483
Access Level:acceso abierto
Palabra clave:Hepatitis A
Virus de l'hepatitis A
Vacunes
Hepatitis A virus
Vaccines
Descripción
Sumario:Background: A huge outbreak in the men-having-sex-with-men (MSM) has hit Europe during the years 2016-2018. Outbreak control has been hampered by vaccine shortages in many countries, and to minimize their impact, reduction of antigen doses has been implemented. However, these measures may have conse-quences on the evolution of hepatitis A virus (HAV), leading to the emergence of antigenic variants. Cases in vac-cinated MSM patients have been detected in Barcelona, opening the possibility to study HAV evolution under immune pressure. Methods: We performed deep-sequencing analysis of ten overlapping fragments covering the complete capsid coding region of HAV. A total of 14578255 reads were obtained and used for the analysis of virus evolution in vaccinated versus non-vaccinated patients. We estimated maximum and minimum mutation frequencies, and Shan-non entropy in the quasispecies of each patient. Non-synonymous (NSyn) mutations affecting residues exposed in the capsid surface were located, with respect to epitopes, using the recently described crystal structure of HAV, as an indication of its potential role in escaping to the effect of vaccines. Findings: HAV evolution at the quasispecies level, in non-vaccinated and vaccinated patients, revealed higher diversity in epitope-coding regions of the vaccinated group. Although amino acid replacements occurring in and around the epitopes were observed in both groups, their abundance was significantly higher in the quasispecies of vaccinated patients, indicating ongoing processes of fixation. Interpretation: Our data suggest positive selection of antigenic variants in some vaccinated patients, raising concerns for new vaccination polices directed to the MSM group.