epidemiologyЭпидемиология и ВакцинопрофилактикаEpidemiology and Vaccinal Prevention2073-30462619-0494«Numicom» LLC10.31631/2073-3046-2017-16-4-65-72epidemiology-298Research ArticleОРИГИНАЛЬНАЯ СТАТЬЯORIGINAL ARTICLESСовременный взгляд на проблему выбора вакцины против гепатита ВModern View on the Problem of Choosing a Vaccine against Hepatitis BЧулановВ. П.ChulanovV. P.vladimir.chulanov@rcvh.ruСемененкоТ. А.SemenenkoT. A.semenenko@gamaleya.orgКарандашоваИ. В.KarandashovaI. V.inga.karadashova@rcvh.ruКомароваС. В.KomarovaS. V.svetlana.komarova@rcvh.ruКостюшевД. С.KostyushevD. S.dmitry.kostyushev@rcvh.ruСусловА. П.SuslovA. P.suslov.anatoly@gmail.comВолчковаЕ. В.VolchkovaE. V.antononina@rambler.ruФБУН «Центральный НИИ эпидемиологии» Роспотребнадзора; ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова» Минздрава РоссииРоссияFederal State Institution of Science «Central Research Institute of Epidemiology» Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing; Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of the Russian FederationRussian FederationФГАОУ ВО «Первый МГМУ им. И.М. Сеченова» Минздрава России; ФГБУ «ФНИЦ эпидемиологии и микробиологии имени почетного академика Н.Ф. Гамалеи» Минздрава РоссииРоссияFederal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of the Russian Federation; Federal State Budgetary Institution «National Research Center for Epidemiology and Microbiology named after the Honorable Academician N.F. Gamalei» of Ministry of Healthcare of the Russian FederationRussian FederationФБУН «Центральный НИИ эпидемиологии» РоспотребнадзораРоссияFederal State Institution of Science «Central Research Institute of Epidemiology» Federal Service for Surveillance on Consumer Rights Protection and Human WellbeingRussian FederationФГБУ «ФНИЦ эпидемиологии и микробиологии имени почетного академика Н.Ф. Гамалеи» Минздрава РоссииРоссияFederal State Institution of Science «Central Research Institute of Epidemiology» Federal Service for Surveillance on Consumer Rights Protection and Human WellbeingRussian FederationФГАОУ ВО «Первый МГМУ им. И.М. Сеченова» Минздрава РоссииРоссияFederal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of the Russian FederationRussian Federation2017200820171646572Copyright © Чуланов В.П., Семененко Т.А., Карандашова И.В., Комарова С.В., Костюшев Д.С., Суслов А.П., Волчкова Е.В., 20172017Чуланов В.П., Семененко Т.А., Карандашова И.В., Комарова С.В., Костюшев Д.С., Суслов А.П., Волчкова Е.В.Chulanov V.P., Semenenko T.A., Karandashova I.V., Komarova S.V., Kostyushev D.S., Suslov A.P., Volchkova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.epidemvac.ru/jour/article/view/298

В статье рассматривается проблема несоответствия между серотипами циркулирующих штаммов вируса гепатита В и серотипом поверхностного антигена вируса, входящего в состав вакцины. Опубликованные в настоящее время научные данные свидетельствуют о том, что вакцинные препараты против гепатита В, содержащие HBsAg серотипа ad, обеспечивают хорошую, но не оптимальную защиту в отношении гетерологичных серотипов вируса. Сделан вывод о приоритетности использования вакцин, содержащих актуальный для данной территории серотип HBsAg. Необходимо проведение дальнейших углубленных исследований по данной проблеме с целью уточнения имеющихся научных данных.

The problem of the discrepancy between serotypes of the circulating strains of hepatitis B virus and serotype of the HBsAg in the vaccine is discussed. The results of published scientific studies show that hepatitis B vaccines containing HBsAg serotype ad provide good, but not optimal, protection against heterologous serotypes of the virus. The authors conclude that the use of vaccines containing HBsAg serotype typical for given territory is a priority. Further in-depth studies on this issue are needed to clarify the available scientific evidence.

вирус гепатита Ввакцинацияпрофилактиказаболеваемостьсубтипсеротипштаммантигенная детерминантаHepatitis B virusvaccinationpreventionmorbiditysubtypeserotypestrainantigenic determinantReferencesGlobal hepatitis report, 2017. World Health Organization; 2017. Доступно на: http://www.who.int/hepatitis/publications/global-hepatitis-report2017/en/ (дата обращения 15.04.2017).Global hepatitis report, 2017. World Health Organization; 2017. Aviable at: http://www.who.int/hepatitis/publications/global-hepatitis-report2017/en/(15.04.2017).World Health Organization. Fact sheet: Hepatitis B. Updated April 2017. Доступно на: http://www.who.int/mediacentre/factsheets/fs204/en/ (дата обращения 15.04.2017).World Health Organization. Fact sheet: Hepatitis B. Updated April 2017. Aviable at: http://www.who.int/mediacentre/factsheets/fs204/en/ (15.04.2017).Пименов Н.Н., Вдовин А.В., Комарова С.В., Мамонова Н.А., Чуланов В.П., Покровский В.И. Актуальность и перспективы внедрения в России единого федерального регистра больных вирусными гепатитами B и C. Терапевтический архив. 2013: 4 - 9.Pimenov N.N., Vdovin A.V., Komarova S.V., Mamonova N.A., Chulanov V.P, Pokrovsky V.I. Urgency and prospects for the introduction in Russia of a single federal register of patients with viral hepatitis B and C. Terapevtichesky arhiv. [Therapeutic archive]. 2013: 4 – 9 (in Russian).О состоянии санитарно-эпидемиологического благополучия населения в Российской Федерации в 2016 году: Государственный доклад. Москва: Роспотребнадзор; 2017: 220.On the state of sanitary and epidemiological welfare of the population in the Russian Federation in 2016: State report. Moscow: Rospotrebnadzor; 2017: 220 (in Russian).Romano’ L., Paladini S., van Damme P., Zanetti A.R. The worldwide impact of vaccination on the control and protection of viral hepatitis B. Digestive and Liver Disease. 2011; 43: S2 - S7.Romano’ L., Paladini S., van Damme P., Zanetti A.R. The worldwide impact of vaccination on the control and protection of viral hepatitis B. Digestive and Liver Disease. 2011; 43: S2 – S7.Szmuness W, Stevens CE, Zang EA, Harley EJ, Kellner A. A controlled clinical trial of the efficacy of the hepatitis B vaccine (Heptavax B): a final report. Hepatology. 1981; 1: 377 - 385.Szmuness W, Stevens CE, Zang EA, Harley EJ, Kellner A. A controlled clinical trial of the efficacy of the hepatitis B vaccine (Heptavax B): a final report. Hepatology. 1981; 1: 377 – 385.Andr F.E. Overview of a 5-year clinical experience with a yeast-derived hepatitis B vaccine. Vaccine. 1990; 8 Suppl: S74 - 8; discussion S79 - 80.André F.E.. Overview of a 5-year clinical experience with a yeast-derived hepatitis B vaccine. Vaccine. 1990; 8 Suppl: S74 – 8; discussion S79 – 80.van Damme P., Kane M., Meheus A. Integration of hepatitis B vaccination into national immunisation programmes. Viral Hepatitis Prevention Board. BMJ. 1997; 314: 1033 - 1036.van Damme P., Kane M., Meheus A. Integration of hepatitis B vaccination into national immunisation programmes. Viral Hepatitis Prevention Board. BMJ. 1997; 314: 1033 – 1036.Шулакова Н.И., Акимкин В.Г., Кистенева Л.Б. Иммунологическая эффективность массовой вакцинопрофилактики против гепатита В. Эпидемиология и инфекционные болезни. Актуальные вопросы. 2016; 4: 33 - 6.Shulakova N.I., Akimkin V.G., Kisteneva L.B .Immunological effectiveness of mass vaccine prophylaxis against hepatitis B. Epidemiologia i infekcionnie bolezni. Aktualnie problemi. [Epidemiology and Infectious Diseases. Topical issues].2016; 4: 33 – 36 (in Russian).Всемирная организация здравоохранения. Глобальная стратегия сектора здравоохранения по вирусному гепатиту на 2016 - 2021 гг. Доступно на: http://www.who.int/hepatitis/strategy2016-2021/ghss-hep/ru/ (дата обращения 20.03.2017).World Health Organization. Global Health Sector Strategy for Viral Hepatitis for 2016-2021 Aviable at: http://www.who.int/hepatitis/strategy2016-2021/ghss-hep/ru/ (20.03.2017) (in Russian).Bancroft W.H., Mundon F.K., Russell P.K. Detection of additional antigenic determinants of hepatitis B antigen. J. Immunol. 1972; 109: 842-8.Bancroft W.H, Mundon F.K., Russell P.K. Detection of additional antigenic determinants of hepatitis B antigen. J. Immunol. 1972; 109: 842– 848.Courouce A.M., Drouet J., Muller J.Y. Australia antigen subtypes identification. Results. Bibl. Haematol. 1976; 42: 89 - 127.Courouce A.M., Drouet J., Muller J.Y. Australia antigen subtypes identification. Results. Bibl. Haematol. 1976; 42: 89 – 127.Le Bouvier G.L. The heterogeneity of Australia antigen. J. Infect. Dis. 1971; 123: 671 - 675.Le Bouvier G.L. The heterogeneity of Australia antigen. J. Infect. Dis. 1971; 123: 671 – 675.Velu V., Saravanan S., Nandakumar S., Dhevahi E., Shankar E.M., Murugavel K.G. et al. Transmission of «a» determinant variants of hepatitis B virus in immunized babies born to HBsAg carrier mothers. Jpn. J. Infect. Dis. 2008; 61: 73 - 76.Velu V., Saravanan S., Nandakumar S., Dhevahi E., Shankar E.M., Murugavel K.G. et al. Transmission of «a» determinant variants of hepatitis B virus in immunized babies born to HBsAg carrier mothers. Jpn. J. Infect. Dis. 2008; 61: 73 – 76.Okamoto H., Imai M., Tsuda F., Tanaka T., Miyakawa Y., Mayumi M. Point mutation in the S gene of hepatitis B virus for a d/y or w/r subtypic change in two blood donors carrying a surface antigen of compound subtype adyr or adwr. J. Virol. 1987; 61: 3030 - 3034.Okamoto H., Imai M., Tsuda F., Tanaka T., Miyakawa Y., Mayumi M. Point mutation in the S gene of hepatitis B virus for a d/y or w/r subtypic change in two blood donors carrying a surface antigen of compound subtype adyr or adwr. J. Virol. 1987; 61: 3030 – 3034.Stirk H.J., Thornton J.M., Howard C.R. A topological model for hepatitis B surface antigen. Intervirology. 1992; 33: 148 - 158.Stirk H.J., Thornton J.M., Howard C.R. A topological model for hepatitis B surface antigen. Intervirology. 1992; 33: 148 – 158.Okamoto H., Tsuda F., Sakugawa H., Sastrosoewignjo R.I., Imai M., Miyakawa Y., Mayumi M. Typing hepatitis B virus by homology in nucleotide sequence: comparison of surface antigen subtypes. J. Gen. Virol. 1988; 69 (Pt 10): 2575 - 2583.Okamoto H., Tsuda F., Sakugawa H., Sastrosoewignjo R.I., Imai M., Miyakawa Y., Mayumi M. Typing hepatitis B virus by homology in nucleotide sequence: comparison of surface antigen subtypes. J. Gen. Virol. 1988; 69 (Pt 10): 2575 – 2583.Moriya T., Kuramoto I.K., Yoshizawa H., Holland P.V. Distribution of hepatitis B virus genotypes among American blood donors determined with a PreS2 epitope enzyme-linked immunosorbent assay kit. J. Clin. Microbiol. 2002; 40: 877 - 880.Moriya T., Kuramoto I.K., Yoshizawa H., Holland P.V. Distribution of hepatitis B virus genotypes among American blood donors determined with a PreS2 epitope enzyme-linked immunosorbent assay kit. J. Clin. Microbiol. 2002; 40: 877 – 880.Norder H., Hammas B., Lofdahl S., Courouce A.M., Magnius L.O. Comparison of the amino acid sequences of nine different serotypes of hepatitis B surface antigen and genomic classification of the corresponding hepatitis B virus strains. J. Gen Virol. 1992; 73 (Pt 5): 1201 - 1208.Norder H., Hammas B., Lofdahl S., Courouce A.M., Magnius L.O. Comparison of the amino acid sequences of nine different serotypes of hepatitis B surface antigen and genomic classification of the corresponding hepatitis B virus strains. J. Gen Virol. 1992; 73 (Pt 5): 1201 – 1208.Norder H., Courouce A.M., Magnius L.O. Complete nucleotide sequences of six hepatitis B viral genomes encoding the surface antigen subtypes ayw4, adw4q-, and adrq- and their phylogenetic classification. Arch. Virol. 1993; 8: 189 - 199.Norder H., Courouce A.M., Magnius L.O. Complete nucleotide sequences of six hepatitis B viral genomes encoding the surface antigen subtypes ayw4, adw4q-, and adrq- and their phylogenetic classification. Arch. Virol. 1993; 8: 189 – 199.Stuyver L., De G., Van G., Zoulim F., Fried M., Schinazi R.F., Rossau R. A new genotype of hepatitis B virus: complete genome and phylogenetic relatedness. J. Gen. Virol. 2000; 81: 67 - 74.Stuyver L., De G., Van G., Zoulim F., Fried M., Schinazi R.F., Rossau R. A new genotype of hepatitis B virus: complete genome and phylogenetic relatedness. J. Gen. Virol. 2000; 81: 67 – 74.Arauz-Ruiz P., Norder H., Robertson B., Magnius L. Genotype H: a new Amerindian genotype of hepatitis B virus revealed in Central America. J. Gen. Virol. 2002; 83: 2059 - 2073.Arauz-Ruiz P., Norder H., Robertson B., Magnius L. Genotype H: a new Amerindian genotype of hepatitis B virus revealed in Central America. J. Gen. Virol. 2002; 83: 2059 – 2073.Kidd-Ljunggren K., Miyakawa Y., Kidd A.H. Genetic variability in hepatitis B viruses. J. Gen. Virol. 2002; 83: 1267 - 1280.Kidd-Ljunggren K., Miyakawa Y., Kidd A.H. Genetic variability in hepatitis B viruses. J. Gen. Virol. 2002; 83: 1267 – 1280.Huy TT, Ngoc T.T., Abe K. New complex recombinant genotype of hepatitis B virus identified in Vietnam. J. Virol. 2008; 82: 5657 - 5663.Huy TT, Ngoc T.T., Abe K. New complex recombinant genotype of hepatitis B virus identified in Vietnam. J. Virol. 2008; 82: 5657 – 5663.Tatematsu K., Tanaka Y., Kurbanov F., Sugauchi F., Mano S., Maeshiro T. et al. A genetic variant of hepatitis B virus divergent from known human and ape genotypes isolated from a Japanese patient and provisionally assigned to new genotype J. J. Virol. 2009; 83: 10538 - 10547.Tatematsu K., Tanaka Y., Kurbanov F., Sugauchi F., Mano S., Maeshiro T. et al. A genetic variant of hepatitis B virus divergent from known human and ape genotypes isolated from a Japanese patient and provisionally assigned to new genotype J. J. Virol. 2009; 83: 10538 – 10547.Kramvis A. Genotypes and genetic variability of hepatitis B virus. Intervirology. 2014; 57: 141 - 150.Kramvis A. Genotypes and genetic variability of hepatitis B virus. Intervirology. 2014; 57: 141 – 150.Нетесов С.В., Калашникова Т.В., Нетесова И.Г., Фаворов М.О., Swenson P.D. Субтипы HBsAg вируса гепатита В в Западной Сибири. Вопросы вирусологии. 2004; 1: 17 - 20.Netesov S.V., Kalashnikova T.V., Netesova I.G., Favorov M.O., Swenson P.D. Subtypes of HBsAg of hepatitis B virus in Western Siberia. Voprosi virusologii. [Problems of virology]. 2004; 1: 17 – 20.Ярош Л.В. Эпидемиологическая характеристика HBsAg-мутантов и «скрытых» форм гепатита В среди различных групп населения: Автореф. дисс.. канд. мед. наук. Москва; 2013.Yarosh LV The epidemiological characteristics of HBsAg mutants and «hidden» forms of hepatitis B among different population groups. Doctorate of med. sci. diss.. Moscow; 2013 (in Russian).Чуланов В.П. Эпидемиологическое и клиническое значение генетической гетерогенности вирусов гепатита А и В: Автореф. дисс.. д-ра мед. наук. Москва; 2013.Chulanov V.P. Epidemiological and clinical significance of genetic heterogeneity of hepatitis A and B viruses. PhD of med. sci. diss. Moscow 2013 (in Russian).Cassidy A., Mossman S., Olivieri A., De R., Leroux-Roels G. Hepatitis B vaccine effectiveness in the face of global HBV genotype diversity. Expert. Rev. Vaccines. 2011; 10: 1709 -1715.Cassidy A., Mossman S., Olivieri A., De R., Leroux-Roels G. Hepatitis B vaccine effectiveness in the face of global HBV genotype diversity. Expert. Rev. Vaccines. 2011; 10: 1709 –1715.Hauser P., Voet P, Simoen E., Thomas H.C., P tre J., Wilde M. de, Stephenne J. Immunological properties of recombinant HBsAg produced in yeast. Postgrad. Med. J. 1987 63 Suppl 2: 83 - 91.Hauser P., Voet P., Simoen E., Thomas H.C., Pêtre J., Wilde M. de, Stephenne J. Immunological properties of recombinant HBsAg produced in yeast. Postgrad. Med. J. 1987 63 Suppl 2: 83 – 91.Shokrgozar M.A., Shokri F. Subtype specificity of anti-HBs antibodies produced by human B-cell lines isolated from normal individuals vaccinated with recombinant hepatitis B vaccine. Vaccine. 2002; 20: 2215 - 2220.Shokrgozar M.A., Shokri F. Subtype specificity of anti-HBs antibodies produced by human B-cell lines isolated from normal individuals vaccinated with reco binant hepatitis B vaccine. Vaccine. 2002; 20: 2215 – 2220.Waters J.A., Brown S.E., Steward M.W., Howard C.R., Thomas H.C. Analysis of the antigenic epitopes of hepatitis B surface antigen involved in the induction of a protective antibody response. Virus Res. 1991; 22: 1 - 12.Waters J.A., Brown S.E., Steward M.W., Howard C.R., Thomas H.C. Analysis of the antigenic epitopes of hepatitis B surface antigen involved in the induction of a protective antibody response. Virus Res. 1991; 22: 1 – 12.Iwarson S., Tabor E., Thomas H.C., Goodall A., Waters J., Snoy P. et al. Neutralization of hepatitis B virus infectivity by a murine monoclonal antibody: an experimental study in the chimpanzee. J. Med. Virol. 1985; 16: 89 - 96.Iwarson S., Tabor E., Thomas H.C., Goodall A., Waters J., Snoy P. et al. Neutralization of hepatitis B virus infectivity by a murine monoclonal antibody: an experimental study in the chimpanzee. J. Med. Virol. 1985; 16: 89 – 96.Hamada-Tsutsumi S., Iio E., Watanabe T., Murakami S., Isogawa M., Iijima S., et al. Validation of cross-genotype neutralization by hepatitis B virus-specific monoclonal antibodies by in vitro and in vivo infection. PLoS One. 2015; 10: e0118062.Hamada-Tsutsumi S., Iio E., Watanabe T., Murakami S., Isogawa M., Iijima S., et al. Validation of cross-genotype neutralization by hepatitis B virus-specific monoclonal antibodies by in vitro and in vivo infection. PLoS One. 2015; 10: e0118062.Zanetti A.R., Tanzi E., Romano L., Vigano P., Cargnel A., Hojvat S., Zuckerman A.J. Kinetics of antibody response to hepatitis B virus determinants and to recombinant vaccines in Italy. J. Med. Virol. 1990; 32: 219 - 224.Zanetti A.R., Tanzi E., Romano L., Vigano P., Cargnel A., Hojvat S., Zuckerman A.J. Kinetics of antibody response to hepatitis B virus determinants and to recombinant vaccines in Italy. J. Med. Virol. 1990; 32: 219 – 224.Cupps T.R., Tibbles J., Hurni W.M., Miller W.J., Ellis R.W., Milich D., Wetter N. In vitro T cell immune responses to the preS2 antigen of the hepatitis B virus envelope protein in preS2 + S vaccine recipients. Absence of cross-reactivity of subtypes at a major T cell recognition site. J. Immunol. 1993; 151: 3353 - 3360.Cupps T.R., Tibbles J., Hurni W.M., Miller W.J., Ellis R.W., Milich D., Wetter N. In vitro T cell immune responses to the preS2 antigen of the hepatitis B virus envelope protein in preS2 + S vaccine recipients. Absence of cross-reactivity of subtypes at a major T cell recognition site. J. Immunol. 1993; 151: 3353 – 3360.Zhang P., Yu M.-Y.W., Venable R., Alter H.J., Shih J.W.-K. Neutralization epitope responsible for the hepatitis B virus subtype-specific protection in chimpanzees. Proc. Natl. Acad. Sci. U S A. 2006; 103: 9214 - 9219.Zhang P., Yu M.-Y.W., Venable R., Alter H.J., Shih J.W.-K. Neutralization epitope responsible for the hepatitis B virus subtype-specific protection in chimpanzees. Proc. Natl. Acad. Sci. U S A. 2006; 103: 9214 – 9219.Heijtink R.A., van Bergen P., Melber K., Janowicz Z.A., Osterhaus, A D M E. Hepatitis B surface antigen (HBsAg) derived from yeast cells (Hansenula polymorpha) used to establish an influence of antigenic subtype (adw2, adr, ayw3) in measuring the immune response after vaccination. Vaccine. 2002; 20: 2191 - 2196.Heijtink R.A., van Bergen P., Melber K., Janowicz Z.A., Osterhaus, A D M E. Hepatitis B surface antigen (HBsAg) derived from yeast cells (Hansenula polymorpha) used to establish an influence of antigenic subtype (adw2, adr, ayw3) in measuring the immune response after vaccination. Vaccine. 2002; 20: 2191 – 2196.Койко Р, Саншайн Д., Бенджамини Э. Иммунология: учебное пособие: пер. с англ. А. В. Камаева, А. Ю. Кузнецовой; ред.: Н.Б. Серебряной. Mосква; Издательский центр «Академия»; 2008: 368.Koiko R., Sunshine D., Benjamin E.E. Immunology: a study guide: Translation from english. A.V. Kamaeva, A.Yu. Kuznetsova; Ed.: N.B. Silver. Moscow; Publishing Center «Academy»; 2008: 368 (in Russian).Tacke F., Amini-Bavil-Olyaee S., Heim A., Luedde T., Manns M.P., Trautwein C. Acute hepatitis B virus infection by genotype F despite successful vaccination in an immune-competent German patient. J. Clin. Virol. 2007; 38: 353 - 357.Tacke F., Amini-Bavil-Olyaee S., Heim A., Luedde T., Manns M.P., Trautwein C. Acute hepatitis B virus infection by genotype F despite successful vaccination in an immune-competent German patient. J. Clin. Virol. 2007; 38: 353 – 357.O’Halloran J.A., Gascun C.F. de, Dunford L., Carr M.J., Connell J., Howard R., et al. Hepatitis B virus vaccine failure resulting in chronic hepatitis B infection. J. Clin. Virol. 2011; 52: 151 - 154.O’Halloran J.A., Gascun C.F. de, Dunford L., Carr M.J., Connell J., Howard R., et al. Hepatitis B virus vaccine failure resulting in chronic hepatitis B infection. J. Clin. Virol. 2011; 52: 151 – 154.Stramer S., Wend U., Candotti D., Foster G., Hollinger F., Dodd R. et al. Nucleic acid testing to detect HBV infection in blood donors. N. Engl. J. Med. 2011; 364: 236 - 247.Stramer S., Wend U., Candotti D., Foster G., Hollinger F., Dodd R. et al. Nucleic acid testing to detect HBV infection in blood donors. N. Engl. J. Med. 2011; 364: 236 – 247.Zheng X., Ye X., Du P., Zeng J., Zhu W., Yang B. et al. High prevalence of anti-hepatitis B core antigen in hepatitis B virus-vaccinated Chinese blood donors suggests insufficient protection but little threat to the blood supply. Transfusion. 2015; 55: 890 - 897.Zheng X., Ye X., Du P., Zeng J., Zhu W., Yang B. et al. High prevalence of anti-hepatitis B core antigen in hepatitis B virus-vaccinated Chinese blood donors suggests insufficient protection but little threat to the blood supply. Transfusion. 2015; 55: 890 – 897.Carman W.F., Zanetti A.R., Karayiannis P., Waters J., Manzillo G., Tanzi E. et al. Vaccine-induced escape mutant of hepatitis B virus. Lancet. 1990; 336: 325 - 359.Carman W.F., Zanetti A.R., Karayiannis P., Waters J., Manzillo G., Tanzi E. et al. Vaccine-induced escape mutant of hepatitis B virus. Lancet. 1990; 336: 325 – 359.Gerlich WH. Breakthrough of hepatitis B virus escape mutants after vaccination and virus reactivation. J. Clin. Virol. 2006; 36 (Suppl 1): S18 - 22.Gerlich WH. Breakthrough of hepatitis B virus escape mutants after vaccination and virus reactivation. J. Clin. Virol. 2006; 36 (Suppl 1): S18 – 22.Alavian S.M., Carman W.F., Jazayeri S.M. HBsAg variants: diagnostic-escape and diagnostic dilemma. J. Clin. Virol. 2013; 57: 201 - 208.Alavian S.M., Carman W.F., Jazayeri S.M. HBsAg variants: diagnostic-escape and diagnostic dilemma. J. Clin. Virol. 2013; 57: 201 – 208.Wu C., Deng W., Deng L., Cao L., Qin B., Li S. et al. Amino acid substitutions at positions 122 and 145 of hepatitis B virus surface antigen (HBsAg) determine the antigenicity and immunogenicity of HBsAg and influence in vivo HBsAg clearance. J. Virol. 2012; 86: 4658 - 4669.Wu C., Deng W., Deng L., Cao L., Qin B., Li S. et al. Amino acid substitutions at positions 122 and 145 of hepatitis B virus surface antigen (HBsAg) determine the antigenicity and immunogenicity of HBsAg and influence in vivo HBsAg clearance. J. Virol. 2012; 86: 4658 – 4669.Баженов А.И., Эльгорт Д.А., Фельдшерова А.А., Будницкая П.З., Никитина Г.И., Хац Ю.С. и др. Сравнительная оценка активности анти-HBs, индуцированных естественным путем или вакцинацией, в отношении различных вариантов HBsAg. Эпидемиология и Вакцинопрофилактика. 2012; 2 (63): 76 - 81.Bazhenov A.I., El’gort D.A., Fel’dsherova A.A., Budnitskaya P.Z., Nikitina G.I., Khats Yu.S. et al. A comparative evaluation of the activity of naturally-induced anti-HBs or vaccination against various HBsAg variants. Epidemiologiya i Vakcinoprofilaktika. [Epidemiology & Vaccinal Prevention]. 2012; 2 (63): 76 – 81 (in Russian).Bian T., Yan H., Shen L., Wang F., Zhang S., Cao Y. et al. Change in hepatitis B virus large surface antigen variant prevalence 13 years after implementation of a universal vaccination program in China. J. Virol. 2013; 87: 12196 - 12206.Bian T., Yan H., Shen L., Wang F., Zhang S., Cao Y. et al. Change in hepatitis B virus large surface antigen variant prevalence 13 years after implementation of a universal vaccination program in China. J. Virol. 2013; 87: 12196 – 12206.Столбиков А.С., Букин Ю.С., Джиоев Ю.П., Злобин В.И. Биоинформационный поиск вариантов -антигенной детерминанты белка S вируса гепатита B для создания поливалентной вакцины. Эпидемиология и Вакцинопрофилактика. 2014; 3 (76): 94 - 103.Stolbikov A.S., Bukin Yu.S., Dzhioev Yu.P., Zlobin V.I. Bioinformation search for variants of the α-antigenic determinant of protein S of the hepatitis B virus to create a polyvalent vaccine. Epidemiologiya i Vakcinoprofilaktika. [Epidemiology & Vaccinal Prevention]. 2014; 3 (76): 94 – 103 (in Russian).Perazzo P, Eguibar N., Gonz lez R.H., Nusblat A.D., Cuestas M. Hepatitis B Virus (HBV) and S-Escape Mutants: From the Beginning until Now. JHVRV. 2015; 2 (3): 46.Perazzo P., Eguibar N., González R.H., Nusblat A.D., Cuestas M. Hepatitis B Virus (HBV) and S-Escape Mutants: From the Beginning until Now. JHVRV. 2015; 2 (3): 46.

The authors declare that there are no conflicts of interest present.