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Chronic hepatitis B infection in adolescents who received primary infantile vaccination
Author(s) -
Wu TzuWei,
Lin Hans Hsienhong,
Wang LiYu
Publication year - 2013
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.25988
Subject(s) - medicine , hbsag , hbeag , hepatitis b , vaccination , hepatitis b virus , titer , hepatitis b vaccine , odds ratio , booster dose , immunology , gastroenterology , confidence interval , antibody , virus
Abstract Hepatitis B virus (HBV) infection is a global health issue. Universal infantile hepatitis B (HB) vaccination is very efficacious. However, HBV infections among those immunized subjects have been reported. The long‐term efficacy of postnatal passive‐active HB vaccination in high‐risk subjects is not well explored. A total of 8,733 senior high school students who were born after July 1987 were assayed for hepatitis B surface antigen (HBsAg) and antibodies to HBsAg (anti‐HBs). The overall HBsAg and anti‐HBs‐positive rates were 1.9% and 48.3%, respectively. The HBsAg‐positive rate was 15% in HB immunoglobulin (HBIG) recipients (adjusted odds ratio [OR]: 15.63; 95% confidence interval [CI]: 10.99‐22.22). Among students who did not receive HBIG, there was a significantly negative association between HB vaccination dosage and HBsAg‐positive rate ( P for trend = 0.011). Adjusted ORs for those who received 4, 3, and 1 to 2 doses were 1.00, 1.52 (95% CI: 0.91‐2.53), and 2.85 (95% CI: 1.39‐5.81), respectively. Among HBIG recipients, the HBsAg‐positive rate was significantly higher in subjects with maternal hepatitis B e antigen (HBeAg) positivity and who received HBIG off‐schedule. A booster dose of HB vaccination was administered to 1974 HBsAg‐ and anti‐HBs‐negative subjects. Prebooster and a postbooster blood samples were drawn for anti‐HBs quantification. The proportions of postbooster anti‐HBs titer <10 mIU/mL was 27.9%. Subjects with prebooster anti‐HBs titers of 1.0‐9.9 mIU/mL had significantly higher postbooster anti‐HBs titers than those with prebooster anti‐HBs titers of <1.0 mIU/mL ( P < 0.0001). Conclusion: Having maternal HBeAg positivity is the most important determinant for HBsAg positivity in adolescents who received postnatal passive‐active HB vaccination 15 years before. A significant proportion of complete vaccinees may have lost their immunological memories against HBsAg. (H EPATOLOGY 2013)