Comparison of immunogenicity between hepatitis B vaccines with different dosages and schedules among healthy young adults in China: A 2-year follow-up study

The relationship of maternal hepatitis B e antigen and response to vaccination of infants born to women with chronic infection

BACKGROUND

The relationship of maternal HBeAg and infants' response to hepatitis B vaccine remains controversial. This study aims to observe the dynamic changes in infant birth HBV markers and study the time-varying effects of maternal HBeAg on vaccination response of infants born to women with chronic HBV infection.

METHODS

3163 infants born to HBsAg positive mothers including 1737 with maternal HBeAg positive in group A and 1426 negative in group B were enrolled eventually. Demographic information and laboratory tests were collected at birth, 7-12th and 24th month. The dynamic changes of infant HBV markers and HBsAb titers at different time points were compared between the two groups.

RESULTS

The infant HBV markers at birth displayed different modes. During the follow-up, we observed a significant downward trend in the positive rates of HBsAg, HBeAg, HBeAb and HBcAb. The HBsAg of two groups switched to negative at 7-12 months and HBeAg in Group A became negative at 24 months. The HBsAb titers of the infants in the two groups were 576.91(192.8-1000.0) vs 719.67(208.1-1000.0) at 7-12 months (Z = -3.049, P = 0.002) and 783.5(227.8-1000.0) vs 891.4(234.0-1000.0) at 24 months (Z = -0.853, P = 0.394). High HBV DNA viral load (OR 1.260, 95% CI 1.139-1.395, P < 0.001) and maternal HBeAg level (OR 1.003, 95% CI 1.002-1.003, P < 0.001) were associated with the higher HBeAg positive rate of infants.

CONCLUSIONS

Maternal HBeAg did affect the infants' immune response to vaccination and reduce the anti-response at 7-12th month temporarily, but these influences were negligible by 24th months after birth, which proved that the maternal HBeAg would not induce immune tolerance of infants from a long-term perspective.

Persistence of Immunity in Adults after 1, 5 and 10 Years with Recombinant Hepatitis B Vaccine in Beijing in 2010–2020

The persistence of immunity after hepatitis B vaccination is still under investigation in adults. In Chaoyang District, Beijing, people who were aged ≥ 18 years and completely immunized with HBV vaccine according to the standard procedure (0–1–6 months) were enrolled. Three groups were set for 1 (Y1), 5 (Y5) and 10 (Y10) years after the hepatitis B vaccination. The following data was collected and analyzed: antibody against hepatitis B virus surface antigen(anti-HBs) positive rates and geometric mean concentration (GMC) between the different compared groups through questionnaires and laboratory detection, including hepatitis B virus surface antigen (HBsAg), anti-HBs and antibody against hepatitis B virus core antigen(anti-HBc). All 600 subjects completed the questionnaires and serological tests. Among all subjects, the positive rates of HBsAg, anti-HBs and anti-HBc were 0, 70.5% (423/600) and 2.5% (15/600), respectively. The anti-HBs positive rates in Y1, Y5 and Y10 groups were 86.5% (173/200), 71.0% (142/200) and 54.0% (108/200) (χ² = 50.8, p < 0.001) and showed a linear decreasing trend year by year (trend χ² = 50.7, p < 0.001). The GMC in Y1, Y5 and Y10 groups were 296.6 mIU/mL, 51.6 mIU/mL and 25.5 mIU/mL (H = 64.8, p < 0.001), respectively. The anti-HBs positive rates and GMC decreased rapidly after the vaccination of adults against hepatitis B. Screening after 5–10 years and booster vaccination for the unprotected population is recommended.

Hepatitis B virus infection seromarkers among college freshmen and their immune responses to different vaccination policies of hepatitis B vaccine

BACKGROUND

College students are one of the susceptible population of Hepatitis B virus (HBV) infection. We aim to delineate HBV infection seromarkers among college freshmen and to evaluate immunological response of vaccination immunization for hepatitis B vaccine (HepB).

METHODS

A simple random sampling method was adopted to select subjects and who met the "inclusion and exclusion criteria" and who with history of vaccination were selected as the observation objects. HBsAg and anti-HBs levels were detected before revaccination. Subjects with negative anti-HBs before immunization were inoculated with 20 ug HepB according to the 0-1-6 procedure and those with weak positive anti-HBs before immunization were inoculated with 1-dose 20 ug HepB. Anti-HBs levels were detected after HepB booster. Combined with the results of anti-HBs, their immune response to HepB and influencing factors in freshmen were investigated. Anti-HBs before immunization was negative and ≥10 m IU/ml after immunization was considered positive conversion; anti-HBs before immunization was weak positive and anti-HBs≥100 m IU/ml after immunization was also considered positive conversion.

RESULTS

A total of 10645 freshmen were included. The total rate of HBsAg carriers was 0.6% (63/10645), and the strong positive rate of anti-HBs was 16.1% (1706/10645), the weak positive rate was 14.4% (1526/10645).1286 freshmen were vaccinated with HepB and completed the questionnaire survey. About 79.0% (154/195) of freshmen's anti-HBs turned strong positive after receiving 1-dose HepB and 100.0% (1091/1091) turned positive after receiving 3-doses HepB. The Geometrical Mean Titer (GMT) of anti-HBs was significantly influenced by gender, registration and the immunization doses of HepB.

CONCLUSION

The HBsAg carrying rate and anti-HBs positive rate of college freshmen were low, and the HepB has a good effect on the immunity of college freshmen. Increasing the immunization rate of HepB is very important for the prevention and control of hepatitis B.

Analysis of antibody-negative medical students after hepatitis B vaccination in Japan

Hepatitis B virus (HBV) vaccination is recommended for health-care professionals because of their frequent contact with blood. At one medical school, new students undergo HBV antibody tests upon admission, and antibody-negative individuals receive the HBV vaccine. We aimed to characterize individuals who remained antibody negative after HBV vaccination. Between 2009 and 2017, we enrolled 1064 first-year students from a medical school where their HBV antibody test and vaccination records remained. We analyzed data regarding the hepatitis B surface antibody (anti-HBs) test record during admission, vaccination record for antibody-negative participants, anti-HBs test result after completing the three vaccination doses, drug name of the vaccine used, sex, body mass index (BMI), and age. We calculated the yearly percentage of antibody-negative individuals and analyzed the characteristics of vaccine-refractory cases by logistic regression analysis. Of the 1064 participants, 999 were initially antibody negative. They were vaccinated with HBV thrice and tested for antibodies after vaccination. The average age of participants was 20.1 y, with 677 males. Although the type of vaccine has been changed since 2016, the average rate of refractoriness from 2009 to 2015 was 6.9% per year and 18.6% after 2016. Logistic regression analyses showed that sex (male vs. female; OR, 1.787), BMI (OR. 1.171), and vaccine type (genotype A vs. genotype C: OR, 3.144) were significant factors associated with antibody-negative individuals. Vaccine type differences altered the proportion of antibody-refractory individuals, with no association with age. The data on vaccine refractoriness will be continuously analyzed in the future while considering other factors.

Comparison of antibody response to hepatitis B vaccination in infants with positive or negative maternal hepatitis B e antigen (HBeAg) in cord blood: implication for the role of HBeAg as an immunotolerogen

Hepatitis B e antigen (HBeAg) has been considered to cause immunotolerance to hepatitis B virus (HBV) in newborn infants after fetal HBeAg exposure. This study compared anti-HBs responses to hepatitis B vaccination in infants who were born to HBeAg-positive and -negative mothers respectively, to investigate whether fetal HBeAg exposure may induce immunotolerance to HBV. Totally 265 infants who received recommended neonatal immunoprophylaxis against hepatitis B and had no HBV infection were included. Anti-HBs levels were compared between 124 infants with cord blood positive HBeAg and 141 infants with cord blood negative HBeAg at 7-12 months of age. The infants in two groups had similar age at the follow-up (10.0 ± 2.3 vs 10.1 ± 2.3 months, P = 0.590). Overall, 259 (97.7%) of 265 infants achieved anti-HBs levels (mIU/ml) ≥10 and 6 (2.3%) others had anti-HBs <10. Of 124 HBeAg-positive infants at birth, 46.0%, 39.5%, 12.1%, and 2.4% had anti-HBs levels (mIU/ml) ≥1000, 100-999.9, 10-99.9, and <10, respectively. Of 141 HBeAg-negative infants at birth, 35.5%, 48.9%, 13.5%, and 2.1% showed ≥1000, 100-999.9, 10-99.9, and <10, respectively. The proportions of each anti-HBs level between the two groups were comparable (all P > 0.05). Additionally, the distribution of anti-HBs response levels were also comparable in infants with high and low HBeAg levels (P = 0.818). In conclusions, the fetal HBeAg exposure does not inhibit the antibody response to neonatal hepatitis B vaccination. The data suggest that HBeAg appears not inducing immunotolerance to HBV.

Comparison of anti-HBs persistence after hepatitis B vaccination on two-dose schedule and three-dose schedule among adults: results from a 12-year follow up study in China

Comparison of anti-HBs persistence after hepatitis B vaccination on two-dose schedule and three-dose schedule among adults is still controversial. In this study, adults were followed up at 12 years after the primary immunization. Three hundred and forty-one and 288 adults with age 15 through 40 years old were given anti-HBV vaccination on a 0-, 1-, and 6-month schedule or on a 0- and 6-month one, respectively (in 2003). Blood samples of 202 patients on 0-, 1- and 6-month schedule and 194 patients on 0- and 6-month regimen were collected at one month and twelve years (in 2015) after the primary series and anti-HBs levels were measured. The seroprotection rate for 3-dose schedule and 2-dose one was 71.78% (95%CI = 65.04%, 77.87%) and 53.61% (95%CI = 46.07%, 60.49%). The GMC of anti-HBs was 31 mIU/mL (95%CI = 24, 41) and 12 mIU/mL (95%CI = 9, 17), respectively. Participants using three doses had higher seroprotection rate and GMC (P < 0.001). Multivariable analysis showed that subjects with anti-HBs titers ≥100 mIU/ml just after the primary series had a higher probability of anti-HBs levels than <10 mIU/ml and 10-100 mIU/ml at follow-up (OR = 8.36, 95%CI: 3.41-20.49, P< 0.001; OR = 43.28, 95%CI: 11.45-163.51, P< 0.001; β = 0.77, 95%CI: 0.48-1.06, P< 0.001; β = 1.20, 95%CI: 0.86 ~ 1.54, P< 0.001). In conclusions, adults receiving HepB primary immunization on 0-, 1- and 6-month schedule might have more prolonged anti-HBs than those on 0-, 6-month schedule, although good anti-HBs persistence could be achieved after HepB immunization on both schedules.