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Lehtinen M, van Damme P, Beddows S, Pinto LA, Mariz F, Gray P, Dillner J. Scientific approaches to defining HPV vaccine-induced protective immunity. Int J Cancer 2025; 156:1848-1857. [PMID: 39945620 PMCID: PMC11924311 DOI: 10.1002/ijc.35345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2024] [Revised: 11/06/2024] [Accepted: 12/16/2024] [Indexed: 03/21/2025]
Abstract
Seventeen years after the licensure of prophylactic human papillomavirus (HPV) L1 virus-like-particle vaccines, a defined antibody level that correlates with vaccine-induced protection against HPV infections and associated neoplasia is missing. In contrast, correlates of protection have been defined for many viral vaccines, including for the hepatitis B virus (HBV) vaccine. This review includes lessons learned from vaccination against HBV and the use of an established protective HBV surface antigen antibody level: 10 mIU/mL, an overview of HPV infection-induced and HPV vaccine-induced antibody responses, successful efforts to establish international standardization of serological reagents and associated tools, and 15-year vigilance of HPV vaccine-induced antibody levels in a vaccination cohort against breakthrough infections. This report identifies progress but also gaps on the journey toward the definition of a HPV vaccine-induced correlate of protection.
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Affiliation(s)
- Matti Lehtinen
- Department of VaccinesInstitute for Health and WelfareHelsinkiFinland
- Center for Cervical Cancer Elimination, Department of Clinical Science, Intervention and TechnologyKarolinska InstituteStockholmSweden
| | - Pierre van Damme
- Centre for the Evaluation of Vaccination@VaccinopolisUniversiteit AntwerpAntwerpBelgium
| | - Simon Beddows
- Virus Reference Department, Public Health Microbiology DivisionUK Health Security AgencyLondonUK
| | - Ligia A. Pinto
- HPV Serology LaboratoryFrederick National Laboratory for Cancer ResearchFrederickMarylandUSA
| | - Filipe Mariz
- Division of Infections and CancerDeutsches KrebsforschungszentrumHeidelbergGermany
| | - Penelope Gray
- Center for Cervical Cancer Elimination, Department of Clinical Science, Intervention and TechnologyKarolinska InstituteStockholmSweden
| | - Joakim Dillner
- Center for Cervical Cancer Elimination, Department of Clinical Science, Intervention and TechnologyKarolinska InstituteStockholmSweden
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Abu-Freha N, Shibli S, Etzion O, Afianish Y, Amer J, Abu Kaf H, Zohar N, Yardeni D, Safadi R. Evaluating the influence of maternal anti-HBs status on the antibody levels in vaccinated children. Clin Res Hepatol Gastroenterol 2025; 49:102608. [PMID: 40315984 DOI: 10.1016/j.clinre.2025.102608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2025] [Revised: 04/18/2025] [Accepted: 04/28/2025] [Indexed: 05/04/2025]
Abstract
BACKGROUND AND AIMS The mother's Hepatitis B Virus (HBV) vaccination status may impact the child's response. We aimed to investigate the children's vaccine response based on the mother's vaccination status. METHODS In a retrospective study, we included children ≤10 years old born to HBsAg negative mothers, with available maternal and children anti-HBs antibodies. Children of vaccinated and unvaccinated mothers were compared and categorized based on anti-HBs titers: 0-9.9, 10-100, 101-500, 501-1000, and ≥1001 mlU/ml. RESULTS 14,485 children were included. No significant difference in the anti-HBs positivity rate was found among the children of vaccinated and unvaccinated mothers (70.4 % vs. 69.7 %, p = 0.337). Vaccine response in vaccinated vs. unvaccinated mothers was 93.5 % vs. 92.1 % for the first year of age, 87.7 % vs. 87.3 % for age 3 years, and 82.5 % vs. 82.2 % for age 5 years, respectively. Young children (7-36 months) had higher protective titer rates than older children. A higher proportion of the ≥1001 mlU/ml category was recorded among children of mothers with negative or low anti-HBs antibodies in the first year of age, reaching 40.9 %. With age, the proportion of children with 10-100 mlU/ml increased, corresponding to the mother's titer. CONCLUSION The maternal HBV vaccination status does not impact the children's response, but the mother's anti-HBs titers may affect the child's antibody level. Maternal anti-HBs antibody titers may neutralize the vaccine HBsAg to impair the reponse.
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Affiliation(s)
- Naim Abu-Freha
- Institute of Gastroenterology and Hepatology, Clalit, Southern Districit, Beer-Sheva, Israel; Institute of Gastroenterology and Hepatology, Soroka University Medical Center, Beer-Sheva, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Safa Shibli
- Department of Medicine, Liver Institute, Hebrew University, Hadassah Medical Organization, Jerusalem, Israel
| | - Ohad Etzion
- Institute of Gastroenterology and Hepatology, Soroka University Medical Center, Beer-Sheva, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yaser Afianish
- Institute of Gastroenterology and Hepatology, Soroka University Medical Center, Beer-Sheva, Israel
| | - Johnny Amer
- Department of Medicine, Liver Institute, Hebrew University, Hadassah Medical Organization, Jerusalem, Israel
| | - Heba Abu Kaf
- Institute of Gastroenterology and Hepatology, Soroka University Medical Center, Beer-Sheva, Israel
| | - Nachum Zohar
- Maternal and Fetal Medicine Service, Obstetrics & Gynecology, Emek Medical Center, Afula, Israel
| | - David Yardeni
- Institute of Gastroenterology and Hepatology, Soroka University Medical Center, Beer-Sheva, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Rifaat Safadi
- Department of Medicine, Liver Institute, Hebrew University, Hadassah Medical Organization, Jerusalem, Israel
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Sperle I, Lassen SG, Schlaud M, Dörre A, Dudareva S, Poethko-Müller C, Harder T. Prevalence of vaccine-derived hepatitis B surface antibodies in children and adolescents in Germany: results from a population-based survey, 2014-2017. BMC Infect Dis 2024; 24:318. [PMID: 38491438 PMCID: PMC10941582 DOI: 10.1186/s12879-024-09201-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 03/06/2024] [Indexed: 03/18/2024] Open
Abstract
INTRODUCTION Childhood vaccination against hepatitis B has been recommended in Germany since 1995. WHO defines a primary vaccination series as successful if the initial hepatitis B surface antibody (anti-HBs) level is ≥ 10 IU/L directly after vaccination. Anti-HBs levels vary depending on the number of doses, type of vaccine, and time interval between the last two doses. In 2021, Germany began to recommend three instead of four doses of polyvalent hepatitis-B-containing vaccines. Our aim was to estimate the proportion of vaccinated children in Germany with anti-HBs levels < 10 IU/L, 10-99 IU/L, and ≥ 100 IU/L by number and type of vaccine, and assess if number of doses and compliance with recommended time interval between the last two doses are associated with an anti-HBs level ≥ 10 IU/L when considering type of vaccine and time since last dose. METHODS We used data from a national cross-sectional study (2014-2017) of children (3-17 years). We excluded participants with unknown vaccination dates, unreadable or incomplete vaccination cards, and hepatitis B virus (HBV)-positive participants. We defined a recommended schedule as a vaccination series with at least six months between the two last doses and having three doses or more. We calculated weighted anti-HBs sero-prevalence for three anti-HBs levels: < 10 IU/L, 10-99 IU/L and ≥ 100 IU/L. We fitted two logistic regression models to examine the relationship between number of doses and recommended schedule on anti-HBs levels (≥ 10 IU/L and ≥ 100 IU/L) considering time since last dose and type of vaccine (Infanrix, Hexavac, Monovalent). RESULTS We included 2,489 participants. The weighted proportion of vaccinated children per anti-HBs level was < 10 IU/L: 36.3% [95%CI 34.0-38.7%], 10-99 IU/L: 35.7% [33.2-38.2%] and ≥ 100 IU/L: 28.0% [25.9-30.2%]. We did not find an association between a recommended schedule of three versus four doses and anti-HBs ≥ 10 IU/L or ≥ 100 IU/L. CONCLUSIONS Anti-HBs levels in later childhood were about equal, whether children received three or four doses. This implies that the change in the recommendations does not affect the anti-HBs level among children in Germany. Future studies are needed on the association of anti-HBs levels and adequate sustained protection against HBV.
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Affiliation(s)
- Ida Sperle
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
- Postgraduate Training for Applied Epidemiology (PAE), Robert Koch Institute, Berlin, Germany.
- ECDC Fellowship Programme, Field Epidemiology Path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
| | - Sofie Gillesberg Lassen
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
- PhD Programme, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Martin Schlaud
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Achim Dörre
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Sandra Dudareva
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | | | - Thomas Harder
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
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Geta M, Yizengaw E, Manyazewal T. Hepatitis B vaccine effectiveness among vaccinated children in Africa: a systematic review and meta-analysis. BMC Pediatr 2024; 24:145. [PMID: 38413906 PMCID: PMC10900737 DOI: 10.1186/s12887-024-04557-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 01/11/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Globally, 257 million people have chronic hepatitis. Even though a safe and effective prophylactic vaccine against HBV infection has been available, it causes significant morbidity and mortality. HBV vaccines were designed to improve or modulate the host immune responses. The effectiveness of the vaccine is determined by measuring serum hepatitis B surface antibody (Anti-HBs) level. Therefore, this systematic review aimed to evaluate the effectiveness of hepatitis B vaccine among vaccinated children. METHODS Preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines was applied for systematically searching of different databases. Only cross-section studies measuring the level of anti-HBs of vaccinated children were included. The seroprotective level with anti-HBs > 10mIU/ml was extracted. The meta-analysis was performed using statistical software for data sciences (STATA) version 14. Effectiveness estimates were reported as a proportion of anti-HBs level. The heterogeneity between studies was evaluated using the I2 test, and I2 > 50% and/or P < 0.10 was considered significant heterogeneity. Significant publication bias was considered when Egger's test P-value < 0.10. The new castle Ottawa scale was used to assess the quality of the studies. RESULTS A pooled sample size of the included papers for meta-analysis was 7430. The pooled prevalence of seroprotected children was 56.95%, with a heterogeneity index (I2) of 99.4% (P < 0.001). 35% of the participants were hypo-responders (10-99mIU/ml) and 21.46% were good responders (> 100mIU/ml). Based on subgroup analysis using country of studies conducted, the highest prevalence of anti-HBs was 87.00% (95% CI: 84.56, 89.44), in South Africa, and the lowest was 51.99% (95% CI: 20.41-83.58), with a heterogeneity index I2 = 70.7% (p = 0.009) in Ethiopia. CONCLUSION AND RECOMMENDATIONS Hepatitis B vaccine seroprotective level in the current pooled analysis have suboptimal, which failed to demonstrate consistent effectiveness for global hepatitis B virus elimination plan in 2030. Using consistent age group may have a significant value for the decision of the HB vaccine effectiveness. A significant heterogeneity was observed both in studies conducted in Ethiopia and Egypt. Therefore, the impact of HB vaccination on the prevention of hepatitis B virus infection should be assessed regularly in those countries. Future meta-analysis is needed to investigate all possible vaccines in a separate way of reviewing, which will lead to a strong conclusion and recommendations.
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Affiliation(s)
- Mekuanint Geta
- Translational Medicine Program, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
- Department of Medical Microbiology, School of Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Endalew Yizengaw
- Department of Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tsegahun Manyazewal
- Translational Medicine Program, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Genc DB, Yildirmak ZY, Apaydin S. Seroprevalence of Hepatitis A, B, and C in Syrian Refugee Children Newly Diagnosed With Cancer. J Pediatr Hematol Oncol 2023; 45:e823-e826. [PMID: 36897293 DOI: 10.1097/mph.0000000000002635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 01/02/2023] [Indexed: 03/11/2023]
Abstract
Adult survivors of childhood cancer have an increased incidence of hepatitis due to immunosuppression and frequent blood transfusions. The immunization of children with cancer is critical for hepatitis prevention, however, access to vaccination may be restricted during times of war, such as the Syrian armed conflict. The goal of this study was to assess the pretreatment serological status of hepatitis A, B, and C in 48 Syrian refugee children with cancer diagnosed in our center between 2014 and 2021. The control group consisted of 48 Turkish children with cancer who were age, sex, and disease-matched. Fifty-eight boys and 38 girls, with a median age of 4.8 years, were included. There were 42 patients with hematological malignancies, 20 with central nervous tumors, and 34 with other solid tumors. The frequency of hepatitis A seroprevalence was not statistically different between Syrian and Turkish patients, whereas hepatitis B seroprotectivity was found to be significantly lower in Syrian children with cancer than in Turkish children. Two Syrian patients were hepatitis C virus-positive. Thirty-seven percent and 45% of all patients were seronegative for hepatitis B and hepatitis A, respectively. Our findings support the need for hepatitis screening and, if necessary, vaccination of this vulnerable population before chemotherapy.
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Affiliation(s)
| | | | - Sebnem Apaydin
- Pediatrics, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Ward JW, Wanlapakorn N, Poovorawan Y, Shouval D. Hepatitis B Vaccines. PLOTKIN'S VACCINES 2023:389-432.e21. [DOI: 10.1016/b978-0-323-79058-1.00027-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2025]
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Wu JN, Huang LF, Lin ZQ, Zhou Y. Association between vaccine dose and risk of hepatitis B virus infection in Fujian Province, China. Hum Vaccin Immunother 2022; 18:2153533. [PMID: 36519244 PMCID: PMC9891677 DOI: 10.1080/21645515.2022.2153533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/11/2022] [Accepted: 11/27/2022] [Indexed: 12/23/2022] Open
Abstract
The increased dose of hepatitis B vaccine has been adopted for newborns since 2013 in Fujian, China. However, little is known about the impact of this measure on hepatitis B virus (HBV) prevention. We used the seroepidemiological surveys conducted in 2014 and 2020 to address the concern. Compared with subjects who received a 5 μg hepatitis B vaccine, participants who took a 10 μg hepatitis B vaccine were associated with a lower risk of HBV infection (adjusted odds ratio [OR] 0.26, 95% confidence interval [CI]: 0.10-0.68) and a marginal reduction risk of anti-HBc positive (OR, 0.37; 95% CI: 0.13-1.08; P = .07), but not for HBsAg carrier risk. The relation between vaccine dose and risk of anti-HBc positive (OR, 0.20; 95% CI: 0.05-0.81) became slightly stronger and significant among children investigated in 2020 who probably received universal vaccination. No significant association was found for subjects whose mothers were positive for HBsAg. The current 10 μg hepatitis B vaccines for universal vaccination for newborns are reasonable and effective in HBV prevention. More measures should be taken to reduce the risk of HBsAg carriers for infants whose mothers are positive for HBsAg.
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Affiliation(s)
- Jiang-Nan Wu
- Department of Clinical Epidemiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Li-Fang Huang
- Department of Expanded of National Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Zhi-Qiang Lin
- Department of Expanded of National Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Yong Zhou
- Department of Expanded of National Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
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Fonzo M, Bertoncello C, Trevisan A. Factors influencing long-term persistence of anti-HBs after hepatitis B vaccination. NPJ Vaccines 2022; 7:173. [PMID: 36572682 PMCID: PMC9792585 DOI: 10.1038/s41541-022-00596-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/07/2022] [Indexed: 12/27/2022] Open
Abstract
Long-term immunity after HBV vaccination is still debated. When assessing immune persistence, several variables must be considered, the clear definition of which is crucial. Our aim was to assess protection 10-20 years after primary vaccination and to estimate the effect of age at first dose, sex and time elapsed between doses on long-term protection. We conducted a retrospective cohort study between January 2004 and December 2020. Antibody titres above 10 IU/L were considered protective. Geometric mean titres (GMT) were calculated. The effect of the above variables on long-term protection was assessed by logistic regression analysis. Included participants were 9459. Among those vaccinated during infancy, GMT gradually increased from 11 IU/L (first dose in 1st trimester of life) to 68 IU/L (4th trimester), while the proportion of individuals <10 IU/L remained stable between 1st and 2nd trimester (51%) and it decreased substantially in 3rd (28%) and even more so in the 4th (18%). A one-month delay in first and third dose administration was correlated with a -16% (AOR: 0.84; 95% CI: 0.78-0.91) and a -11% (AOR: 0.89; 95% CI: 0.85-0.94) risk of a titre <10 IU/L, respectively, ~20 years after immunisation. In contrast, similar changes do not comparably affect vaccination in adolescence. The start of vaccination at the third month of age is a compromise between the development of acceptable immunogenicity and the need to protect the infant as early as possible. However, the chance of slightly delaying the vaccine administration within the first year of life may be considered given the impact on long-term persistence of anti-HBs.
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Affiliation(s)
- Marco Fonzo
- grid.5608.b0000 0004 1757 3470Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Chiara Bertoncello
- grid.5608.b0000 0004 1757 3470Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Andrea Trevisan
- grid.5608.b0000 0004 1757 3470Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
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Di Lello FA, Martínez AP, Flichman DM. Insights into induction of the immune response by the hepatitis B vaccine. World J Gastroenterol 2022; 28:4249-4262. [PMID: 36159002 PMCID: PMC9453777 DOI: 10.3748/wjg.v28.i31.4249] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 05/21/2022] [Accepted: 07/25/2022] [Indexed: 02/06/2023] Open
Abstract
After more than four decades of hepatitis B virus (HBV) vaccine implementation, its safety and efficacy in preventing HBV infection have been proven and several milestones have been achieved. Most countries have included HBV immunization schedules in their health policies and progress has been made regarding universalization of the first HBV vaccine dose at birth. All of these actions have significantly contributed to reducing both the incidence of HBV infection and its related complications. However, there are still many drawbacks to overcome. The main concerns are the deficient coverage rate of the dose at birth and the large adult population that has not been reached timely by universal immunization. Additionally, the current most widely used second-generation vaccines do not induce protective immunity in 5% to 10% of the population, particularly in people over 40-years-old, obese (body mass index > 25 kg/m2), heavy smokers, and patients undergoing dialysis or infection with human immunodeficiency virus. Recently developed and approved novel vaccine formulations using more potent adjuvants or multiple antigens have shown better performance, particularly in difficult settings. These advances re-launch the expectations of achieving the World Health Organization’s objective of completing hepatitis control by 2030.
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Affiliation(s)
- Federico Alejandro Di Lello
- Microbiology, Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Investigaciones en Bacteriología y Virología Molecular, Buenos Aires C1113AAD, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires C1425FQB, Argentina
| | - Alfredo Pedro Martínez
- Virology Section, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno “CEMIC”, Buenos Aires C1431FWO, Argentina
| | - Diego Martín Flichman
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires C1425FQB, Argentina
- Microbiology, Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y Síndrome de Inmunodeficiencia Adquirida, Buenos Aires C1121ABG, Argentina
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AlAteeq MA, AlEnazi LM, AlShammari MS, AlAnazi EE, Al-Hababi FH, Alateeq AM. Long-term Immunity Against Hepatitis B Virus After Routine Immunization Among Adults Visiting Primary Care Centers in Riyadh, Saudi Arabia. Cureus 2022; 14:e21266. [PMID: 35178320 PMCID: PMC8842465 DOI: 10.7759/cureus.21266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2022] [Indexed: 11/17/2022] Open
Abstract
Objective This study aimed to determine the persistence of induced immunity against hepatitis B virus (HBV) among adults routinely vaccinated during their infancy and correlate the level of induced immunity with participant characteristics. Methodology This was a cross-sectional study conducted among visitors to primary care centers of the Ministry of Health (MOH) in Riyadh, the Kingdom of Saudi Arabia (KSA) during the period from August 2020 to January 2021. The study population included healthy adults of both genders who had received full doses of the HBV vaccine in infancy. Data related to participant characteristics were collected using a self-administered questionnaire. A blood sample was then taken from each participant to measure the serum level of hepatitis B surface antigen (HBsAg), antibodies against HBsAg (anti-HBs), and antibodies against hepatitis B core antigen (ani-HBc). Results A total of 400 subjects participated in the study; the mean age of the cohort was 25 years. Almost all of them were Saudis (99.30%), and more than half (57.50%) were males. Only 24.30% had an anti-HBs antibodies level of ≥10 IU/L, and all respondents were negative for HBs antigen. No significant association between participant characteristics and anti-HBs antibody levels was found. Conclusion A decline in immunity many years after HBV vaccinations taken in infancy has been well-documented. However, for low-risk populations, the boosting of HBV vaccines is probably unnecessary since the immune memory provides sufficient protection despite low or undetectable anti-HBs antibodies.
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Affiliation(s)
- Mohammed A AlAteeq
- Family Medicine Department, Ministry of National Guard - Health Affairs, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Latifa M AlEnazi
- Academy for Postgraduate Studies in Family Medicine, King Saud Medical City, Ministry of Health, Riyadh, SAU
| | - Modhi S AlShammari
- Family Medicine Residency Training Program, Ministry of Health, AlJouf, SAU
| | - Essa E AlAnazi
- Microbiology Department, Regional Laboratory, Ministry of Health, Riyadh, SAU
| | - Fadel H Al-Hababi
- Microbiology Department, Regional Laboratory, Ministry of Health, Riyadh, SAU
| | - Abdulrahman M Alateeq
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
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Cornberg M, Sandmann L, Protzer U, Niederau C, Tacke F, Berg T, Glebe D, Jilg W, Wedemeyer H, Wirth S, Höner Zu Siederdissen C, Lynen-Jansen P, van Leeuwen P, Petersen J. S3-Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) zur Prophylaxe, Diagnostik und Therapie der Hepatitis-B-Virusinfektion – (AWMF-Register-Nr. 021-11). ZEITSCHRIFT FUR GASTROENTEROLOGIE 2021; 59:691-776. [PMID: 34255317 DOI: 10.1055/a-1498-2512] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Markus Cornberg
- Deutsches Zentrum für Infektionsforschung (DZIF), Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Hannover; Centre for individualised infection Medicine (CiiM), Hannover.,Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Hannover
| | - Lisa Sandmann
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Hannover
| | - Ulrike Protzer
- Institut für Virologie, Technische Universität München/Helmholtz Zentrum München, München
| | | | - Frank Tacke
- Medizinische Klinik m. S. Hepatologie und Gastroenterologie, Charité Universitätsmedizin Berlin, Berlin
| | - Thomas Berg
- Klinik und Poliklinik für Gastroenterologie und Rheumatologie, Universitätsklinikum Leipzig, Leipzig
| | - Dieter Glebe
- Institut für Medizinische Virologie, Nationales Referenzzentrum für Hepatitis-B-Viren und Hepatitis-D-Viren, Justus-Liebig-Universität Gießen, Gießen
| | - Wolfgang Jilg
- Institut für Medizinische Mikrobiologie und Hygiene, Universität Regensberg, Regensburg
| | - Heiner Wedemeyer
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Hannover
| | - Stefan Wirth
- Zentrum für Kinder- und Jugendmedizin, Helios Universitätsklinikum Wuppertal, Wuppertal
| | | | - Petra Lynen-Jansen
- Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS), Berlin
| | - Pia van Leeuwen
- Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS), Berlin
| | - Jörg Petersen
- IFI Institut für Interdisziplinäre Medizin an der Asklepios Klinik St. Georg, Hamburg
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Gomes LC, Sanson MCG, Brainin P, de Melo MDCV, de Souza RM, Mazaro J, Lima KO, Resende JS, Vieira IVM, Mesquita EDS, Matos LO, Dutra ICS, Palmisano G, Wrenger C, Marinho CRF, da Silva RDSU. Levels of hepatitis B antibody titers are affected by age and doses gap time in children from a high endemic area of the western Amazon. PLoS One 2021; 16:e0253752. [PMID: 34197516 PMCID: PMC8248698 DOI: 10.1371/journal.pone.0253752] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 06/14/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Despite completion of the vaccine schedule for hepatitis B virus (HBV), children may display levels of HBV surface antibodies (anti-HBs) that are considered inadequate for sufficient protection (<10 IU/L). AIMS Our aim was to investigate if age and gap time between HBV vaccine doses may negatively affect the levels of anti-HBs in children, and if these relationships are modified by sex. METHODS In a high-endemic HBV region of the western Brazilian Amazon we enrolled children who had completed the HBV vaccine schedule. All children underwent analysis of anti-HBs and a clinical examination. RESULTS We included 522 children (mean age 4.3 ± 0.8 years; 50% male). Median anti-HBs was 28.4 [interquartile range (IQR) 5.4 to 128.6] IU/L and 32% had anti-HBs <10 IU/L. The median gap time from last to preceding dose was 2.4 [IQR 2.1 to 3.3] months. Levels of anti-HBs decreased with higher age (-42% per year increase [95%CI -56% to -24%], p<0.001), but not with longer gap time (+23% per month increase [95%CI -16% to +62%], p = 0.249). After adjusting for relevant confounders, gap time became significant (p = 0.032) and age remained a significant predictor of anti-HBs (p<0.001). CONCLUSION One third of assessed children displayed anti-HBs <10 IU/L. Levels of anti-HBs decreased with higher age and increased with longer gap time between the last two doses.
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Affiliation(s)
- Laura Cordeiro Gomes
- Health and Sport Science Center, Federal University of Acre, Rio Branco, Acre, Brazil
| | | | | | | | | | | | - Karine Oliveira Lima
- Multidisciplinary Center, Federal University of Acre, Cruzeiro do Sul, Acre, Brazil
| | - Júnia Silva Resende
- Multidisciplinary Center, Federal University of Acre, Cruzeiro do Sul, Acre, Brazil
| | | | | | - Luan Oliveira Matos
- Multidisciplinary Center, Federal University of Acre, Cruzeiro do Sul, Acre, Brazil
| | | | - Giuseppe Palmisano
- Department of Parasitology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Carsten Wrenger
- Department of Parasitology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
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14
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Duarte G, Pezzuto P, Barros TD, Mosimann G, Martinez-Espinosa FE. Brazilian Protocol for Sexually Transmitted Infections 2020: viral hepatitis. Rev Soc Bras Med Trop 2021; 54:e2020834. [PMID: 33729415 PMCID: PMC8210490 DOI: 10.1590/0037-8682-834-2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/10/2021] [Indexed: 12/09/2022] Open
Abstract
This article discusses viral hepatitis, a theme addressed by the Clinical Protocol and Therapeutic Guidelines to Comprehensive Care for People with Sexually Transmitted Infections and, more precisely, by the Clinical Protocols and Therapeutic Guidelines for Hepatitis B and Hepatitis C and Coinfections, published by the Brazilian Ministry of Health. Besides the broad spectrum of health impairment, hepatitis A, B, and C viruses also present different transmission forms, whether parenteral, sexual, vertical, or fecal-oral. Among the strategies suggested for the control of viral hepatitis, in addition to behavioral measures, are expanded diagnosis, early vaccination against hepatitis A and hepatitis B viruses, and access to available therapeutic resources. Considering vertical transmission of the hepatitis B and hepatitis C viruses, screening for pregnant women with chronic hepatitis B and C is an essential perinatal health strategy, indicating with precision those who can benefit from the prophylactic interventions. Viral hepatitis A, B, and C are responsible for more than 1.34 million deaths worldwide every year, from which 66% are the result of hepatitis B, 30% of hepatitis C, and 4% of hepatitis A.
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Affiliation(s)
- Geraldo Duarte
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brasil
| | - Paula Pezzuto
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brasil
| | - Tiago Dahrug Barros
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brasil
| | - Gláucio Mosimann
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brasil
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15
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Doran Brubaker S, Ward JW, Hiebert L, Morgan RL. Developing an Evidence Base for the Delivery of Hepatitis B Virus Birth Dose Vaccination: An Evidence Map and Critical Appraisal of Systematic Reviews and Guidelines. Clin Liver Dis (Hoboken) 2021; 17:375-381. [PMID: 34136145 PMCID: PMC8177836 DOI: 10.1002/cld.1103] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 02/04/2023] Open
Affiliation(s)
| | | | | | - Rebecca L. Morgan
- Evidence FoundationCleveland HeightsOH
- Department of Health Research Methods, Evidence and ImpactMcMaster UniversityHamiltonONCanada
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16
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Luoto S, Krama T, Rubika A, Borráz-León JI, Trakimas G, Elferts D, Skrinda I, Krams R, Moore FR, Birbele E, Kaminska I, Contreras-Garduño J, Rantala MJ, Krams IA. Socioeconomic position, immune function, and its physiological markers. Psychoneuroendocrinology 2021; 127:105202. [PMID: 33756285 DOI: 10.1016/j.psyneuen.2021.105202] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/23/2021] [Accepted: 03/12/2021] [Indexed: 02/07/2023]
Abstract
The development of costly traits such as immune function and secondary sexual traits is constrained by resource availability. The quality of developmental conditions and the availability of resources in ontogeny may therefore influence immune system functions and other biological traits. We analyzed causal pathways between family socioeconomic position, strength of immune response, and five physiological biomarkers in young Latvian men (n = 93) using structural equation modeling. Men from wealthier families had higher testosterone levels (rs = 0.280), stronger immune response (rs = 0.551), and higher facial attractiveness (rs = 0.300). There were weak, non-significant correlations between family income, body fat percentage (rs = -0.147), and fluctuating asymmetry (rs = -0.159). Testosterone partially (33.8%) mediated the effect of family income on facial masculinity. Testosterone (positively) and adiposity (negatively) partially (4%) mediated the relationship between family income and immune function. Higher facial masculinity, higher facial symmetry, and lower adiposity were reliable and independent cues of better immune function (R2 = 0.238) in a larger sample of young Latvian men (N = 146). Resource availability in ontogeny has an important role for the development of immune function and physical appearance, and it is a key parameter to be included in human eco-immunological research.
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Affiliation(s)
- Severi Luoto
- School of Psychology, University of Auckland, Auckland, New Zealand
| | - Tatjana Krama
- Institute of Ecology and Earth Sciences, University of Tartu, Tartu, Estonia; Chair of Plant Health, Estonian University of Life Sciences, Tartu, Estonia; Department of Biotechnology, Daugavpils University, Daugavpils, Latvia
| | - Anna Rubika
- Department of Anatomy and Physiology, Daugavpils University, Daugavpils, Latvia
| | - Javier I Borráz-León
- Department of Biology, University of Turku, Turku, Finland; Department of Ethology, National Institute of Psychiatry "Ramón de la Fuente Muñiz", Mexico City, Mexico
| | - Giedrius Trakimas
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Didzis Elferts
- Department of Botany and Ecology, Faculty of Biology, University of Latvia, Rīga, Latvia
| | | | - Ronalds Krams
- Chair of Plant Health, Estonian University of Life Sciences, Tartu, Estonia; Department of Biotechnology, Daugavpils University, Daugavpils, Latvia; Department of Anatomy and Physiology, Daugavpils University, Daugavpils, Latvia
| | - Fhionna R Moore
- Institute of Health and Wellbeing, University of Glasgow, United Kingdom
| | - Elza Birbele
- Department of Zoology and Animal Ecology, Faculty of Biology, University of Latvia, Rīga, Latvia
| | - Irena Kaminska
- Department of Anatomy and Physiology, Daugavpils University, Daugavpils, Latvia
| | - Jorge Contreras-Garduño
- Escuela Nacional de Estudios Superiores Unidad Morelia, Universidad Nacional Autónoma de México, Morelia, Mexico
| | - Markus J Rantala
- Department of Biology & Turku Brain and Mind Centre, University of Turku, Turku, Finland
| | - Indrikis A Krams
- Institute of Ecology and Earth Sciences, University of Tartu, Tartu, Estonia; Department of Biotechnology, Daugavpils University, Daugavpils, Latvia; Department of Zoology and Animal Ecology, Faculty of Biology, University of Latvia, Rīga, Latvia.
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17
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Duarte G, Pezzuto P, Barros TD, Mosimann Junior G, Martínez-Espinosa FE. [Brazilian Protocol for Sexually Transmitted Infections 2020: viral hepatitis]. ACTA ACUST UNITED AC 2021; 30:e2020834. [PMID: 33729415 DOI: 10.1590/s1679-4974202100016.esp1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/03/2020] [Indexed: 01/01/2023]
Abstract
This article discusses viral hepatitis, a theme addressed by the Clinical Protocol and Therapeutic Guidelines to Comprehensive Care for People with Sexually Transmitted Infections and, more precisely, by the Clinical Protocols and Therapeutic Guidelines for Hepatitis B and Hepatitis C and Coinfections, published by the Brazilian Ministry of Health. Besides the broad spectrum of health impairment, hepatitis A, B and C viruses also present different forms of transmission, whether parenteral, sexual, vertical or oral. Among the strategies suggested for the control of viral hepatitis, in addition to behavioral measures, are expanded diagnosis, early vaccination against hepatitis A and hepatitis B viruses, and access to available therapeutic resources. Considering vertical transmission of the hepatitis B and hepatitis C viruses, screening for pregnant women with chronic hepatitis B and C is an important perinatal health strategy, indicating with precision those who can benefit from the prophylactic interventions.
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Affiliation(s)
- Geraldo Duarte
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brasil
| | - Paula Pezzuto
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brasil
| | - Tiago Dahrug Barros
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brasil
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18
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Virta M, Soininen A, Patel DM, Petit C, Tabar C, Lyabis O. Persistence of Hepatitis B Immune Memory Until 6 Years of Age Following Hexavalent DTaP-IPV-HB-PRP~T Vaccination in a 3-, 5- and 11- to 12-month Schedule and Response to a Subsequent Hepatitis B Challenge Vaccination. Pediatr Infect Dis J 2021; 40:e28-e30. [PMID: 33284254 DOI: 10.1097/inf.0000000000002954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Anti-hepatitis B (HBs) antibody persistence and hepatitis B challenge were evaluated at 6 years of age following vaccination of fully liquid DTaP-IPV-HB-PRP~T or reconstituted DTaP-IPV-HB//PRP~T at 3, 5, 11-12 months of age. At 6 years, 53.8% and 73.5% had seroprotective anti-HBs antibodies (≥10 mIU/mL), increasing to 96.7% and 95.9% postchallenge, confirming a strong anamnestic response in primed vaccinees.
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Affiliation(s)
- Miia Virta
- From the Vaccine Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere
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19
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Jung LS, Gund TM, Narayan M. Comparison of Binding Site of Remdesivir and Its Metabolites with NSP12-NSP7-NSP8, and NSP3 of SARS CoV-2 Virus and Alternative Potential Drugs for COVID-19 Treatment. Protein J 2020; 39:619-630. [PMID: 33185784 PMCID: PMC7662030 DOI: 10.1007/s10930-020-09942-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2020] [Indexed: 01/18/2023]
Abstract
Remdesivir was approved by the U.S.A. Food and Drug administration for emergency use to interfere with the replication of SARS CoV-2 virus (the agent that causes COVID-19) in adults and children hospitalized with severe disease. The crystal structure of the metabolite of remdesivir (Monophosphate of GS-441524) and NSP12-NSP8-NSP7 of SARS CoV-2 virus was recently reported. The crystal structures of ADP-Ribose or AMP and NSP3 of SARS CoV-2 virus were also released, recently. This study compared their binding sites and suggests the crystal structure of NSP3 of SARS CoV-2 virus as an alternative binding site of AMP or ADP-ribose to treat COVID-19. We virtually screened 682 FDA-approved compounds, and the top 10 compounds were selected by analysis of docking scores, (G-score, D-score, and Chemscore) and visual analysis using a structure-based docking approach of NSP3 of SARS CoV-2 virus. All immunization approaches are based on the SARS-CoV-2 virus spike protein. A recent study reported that the D614G mutation in the SARS-CoV-2 virus spike protein reduces S1 shedding and increases infectivity of SARS COV-2 virus. Therefore, if there is a severe change in the spike protein of a modified Coronavirus, all developed vaccines can lose their efficacy, necessitating the need for an alternative treatment method. The top 10 compounds (FDA-approved) in this study are selected based on NSP 3 binding site, and therefore are a potential viable treatment because they will show potential activity for all mutations in the SARS-CoV-2 virus spike protein.
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Affiliation(s)
| | - Tamara M Gund
- Department of Chemistry and Environmental Science, New Jersey Institute of Technology, University Heights, Newark, NJ, 07102, USA
| | - Mahesh Narayan
- Department of Chemistry and Biochemistry, The University of Texas at El Paso, 500 W. University Ave., El Paso, TX, 79968, USA.
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20
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Zheng Z, Li G, Liao F, Zhang L, Wang X, Fang Z, Chen Q, Liu H, Hu L. Seroconversion of hepatitis B surface antigen among those with previously successful immune response in Southern China. Hum Vaccin Immunother 2020; 17:845-851. [PMID: 32961084 PMCID: PMC7996079 DOI: 10.1080/21645515.2020.1801076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Recommendations promoted worldwide have suggested a period of protection lasting more than 20 years against hepatitis B (HB) following primary immunization. Starting in 1987, universal HB vaccinations were carried out in Long An County, Guangxi Province, one of the earliest counties in which plasma-derived HB vaccine was delivered to newborns across China. Data collection targeted toward understanding the long term (26–33 years since primary immunization) immune effects of the plasma-derived HB vaccine was conducted in 2015; a second data collection was carried out in 2019 to assess seroconversion in the same cohort. This study qualitatively compared positive vs negative results and quantitatively assessed HB biomarkers – HB surface antigen (HBsAg), antibody to HBsAg (anti-HBs), HB e-antigen (HBeAg), antibody to HBeAg (anti-HBe), and antibody to HB core antigen (anti-HBc) – in serum 26–33 years after the full initial course of HB vaccination, then analyzed anti-HBs seroconversion using the two-phase sampling method in the same cohort and calculated the anti-HBs seroconversion rate from 2015 to 2019. The protective sero-conversion rate (anti-HBs ≥10mIU/mL) was 37.6% (192/511); the HBsAg-positive rate was 5.3% (27/511); the anti-HBs mean geometric titer (GMT) was 11.1 mIU/mL. Among the 143 participants involved in both 2015 and 2019 data collections, the seroconversion rate was 3.5% (5/143); two individuals had protective anti-HBs levels in 2015. These findings indicate that anti-HBs status can be seroconverted to a protective concentration level 4 years earlier in a high HBV epidemic region. The role of genomic mutations and the disappearance of immune memory and seroconversion should be investigated.
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Affiliation(s)
- Zhigang Zheng
- Department of Epidemiology and Statistic, School of Public Health, Guangxi Medical University, Nanning, China.,Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, China
| | - Guojian Li
- Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, China
| | - Fuhui Liao
- Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, China
| | - Lujuan Zhang
- Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, China
| | - Xueyan Wang
- Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, China
| | - Zhongliao Fang
- Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, China
| | - Qinyan Chen
- Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, China
| | - Huabin Liu
- Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, China
| | - Liping Hu
- Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, China
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21
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Papadopoli R, De Sarro C, Torti C, Pileggi C, Pavia M. Is There Any Opportunity to Provide an HBV Vaccine Booster Dose Before Anti-Hbs Titer Vanishes? Vaccines (Basel) 2020; 8:E227. [PMID: 32429396 PMCID: PMC7349749 DOI: 10.3390/vaccines8020227] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 12/14/2022] Open
Abstract
Whether the primary Hepatitis B vaccination confers lifelong protection is debated. The aim of the study was to assess the effectiveness of booster doses in mounting a protective HBV immune response in subjects vaccinated 18-20 years earlier. The study population consisted of vaccinated students attending medical and healthcare professions schools. A booster dose was offered to subjects with a <10 mIU/mL anti-HBs titer. The post-booster anti-HBs titer was evaluated after four weeks. The subjects with a <10 mIU/mL post-booster anti-HBs titer, received a second and third dose of the vaccine and after one month they were retested. A <10 mIU/mL anti-HBs titer was found in 35.1% of the participants and 92.2% of subjects that were boosted had a ≥10 mIU/mL post-booster anti-HBs titer, whereas 7.8% did not mount an anamnestic response. A low post-booster response (10-100 mIU/mL anti-HBs) was significantly more likely in subjects with a <2.00 mIU/mL pre-booster titer compared to those with a 2.00-9.99 mIU/mL pre-booster titer. The anamnestic response was significantly related to the baseline anti-HBs levels. A booster dose of the HBV vaccine may be insufficient to induce an immunological response in subjects with undetectable anti-HBs titers. A booster dose might be implemented when an anamnestic response is still present.
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Affiliation(s)
- Rosa Papadopoli
- Department of Health Sciences, University of Catanzaro “Magna Græcia”, Campus Universitario “Salvatore Venuta”, Viale Europa, 88100 Catanzaro, Italy; (R.P.); (C.D.S.); (M.P.)
| | - Caterina De Sarro
- Department of Health Sciences, University of Catanzaro “Magna Græcia”, Campus Universitario “Salvatore Venuta”, Viale Europa, 88100 Catanzaro, Italy; (R.P.); (C.D.S.); (M.P.)
| | - Carlo Torti
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Græcia”, Campus Universitario “Salvatore Venuta”, Viale Europa, 88100 Catanzaro, Italy;
| | - Claudia Pileggi
- Department of Health Sciences, University of Catanzaro “Magna Græcia”, Campus Universitario “Salvatore Venuta”, Viale Europa, 88100 Catanzaro, Italy; (R.P.); (C.D.S.); (M.P.)
| | - Maria Pavia
- Department of Health Sciences, University of Catanzaro “Magna Græcia”, Campus Universitario “Salvatore Venuta”, Viale Europa, 88100 Catanzaro, Italy; (R.P.); (C.D.S.); (M.P.)
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via L. Armanni, 5, 80138 Naples, Italy
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22
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Ren W, Ren J, Wu Z, Shen L, Shan H, Dai X, Li J, Liu Y, Qiu Y, Yao J, Li L. Long-term persistence of anti-HBs after hepatitis B vaccination among adults: 8-year results. Hum Vaccin Immunother 2020; 16:687-692. [PMID: 31526223 DOI: 10.1080/21645515.2019.1666612] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The long-term persistence of hepatitis B surface antibody (anti-HBs) after hepatitis B vaccination among adults was not known clearly. This study aimed to assess the immunogenicity and persistence of antibodies 8 years after hepatitis B immunization with different vaccination schedules among adults who tested negative for hepatitis B surface antigen (HBsAg), anti-HBs, and hepatitis B core antibody (anti-HBc). A total of 771 participants who received the full vaccination course (three doses) and also had a blood sample taken 1 month after the first vaccination were recruited. Of these, 529 were excluded due to the missing data of anti-HBs 8 years after the first vaccination. Vaccinations were carried out at 0-1-3, 0-1-6 and 0-1-12 month vaccination schedules, and 104, 45, and 93 participants were included, respectively. The positive seroprotection rate was 85.9% 1 month after the third vaccination, and 58.3% 8 years later (χ2 = 54.52, P < .001), while the geometric mean titer (GMT) of anti-HBs was 158.49 mIU/mL [95% confidence interval (CI): 131.83-190.55)] and 15.14 mIU/mL (95% CI: 10.96-20.42) after 1 month and 8 years, respectively. Compared with the standard 0-1-6 month vaccination schedule, the positive seroprotection rate and the GMT of the 0-1-3 month vaccination schedule had no difference. The long-term immune effect of the 0-1-3 month vaccination schedule was better than that of the 0-1-12 month vaccination schedule. No correlation was found between the GMT of anti-HBs 1 month and 8 years later.
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Affiliation(s)
- Wen Ren
- The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jingjing Ren
- The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Zikang Wu
- Department of Immunology, Zhejiang Provincial Center for Disease Control and prevention, Hangzhou, Zhejiang, China
| | - Lingzhi Shen
- Department of Immunology, Zhejiang Provincial Center for Disease Control and prevention, Hangzhou, Zhejiang, China
| | - Huan Shan
- Department of Quality Management, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Xuewei Dai
- Department of Information, Jingdezhen Center for Disease Control and prevention, Jingdezhen, Jiangxi, China
| | - Jing Li
- Department of Quality Management, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Ying Liu
- The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yan Qiu
- The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jun Yao
- Department of Immunology, Zhejiang Provincial Center for Disease Control and prevention, Hangzhou, Zhejiang, China
| | - Lanjuan Li
- The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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23
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Accrombessi M, Adetola CV, Bacharou S, Dossou Y, Avokpaho E, Yakoubou A, Koumakpai-Adeothy S, Lozes E, Issifou S. Assessment of the anti-HBs antibody response in Beninese infants following 4 doses of HBV vaccine, including administration at birth, compared to the standard 3 doses regime; a cross-sectional survey. Vaccine 2019; 38:1787-1793. [PMID: 31866185 DOI: 10.1016/j.vaccine.2019.12.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 10/31/2019] [Accepted: 12/12/2019] [Indexed: 01/26/2023]
Abstract
Hepatitis B virus (HBV) infection remains one of the major neglected health issues worldwide. In sub-Saharan Africa (SSA), HBV endemicity is high, with more than 8% of the population being chronic HBV carriers. Recently, WHO recommended that all infants should receive their first dose of the HBV vaccine as soon as possible after birth. Unfortunately, the incorporation of a birth dose of HBV in the expanded programme immunization (EPI) has not occurred in the majority of countries in SSA. From April to September 2017, a cross-sectional survey was conducted in two vaccine units located in southern Benin. We assessed the sustained anti-HBs antibody response in infants induced by a standard scheme of 3 doses of HBV vaccination (6, 10, 14 weeks) in comparison to a scheme of 4 doses with a birth dose included (0, 6, 10, 14 weeks). Blood samples were systematically collected in the first 140 children aged 9 months and their mothers who had consented to participate for the detection of HBs antigen and the quantification of anti-HBs antibodies. The prevalence of HBV infection among infants and mothers was 2.2% and 7.1%, respectively. Infants who received 4 doses of HBV vaccine had a significantly higher level of anti-HBs antibody than those who received 3 doses of vaccine (557.9 UI/L vs. 386.9 UI/L, respectively, P = 0.03). We also showed that the scheme of 4 doses was associated with a significantly higher sustained protective response in comparison to the scheme of 3 doses (aOR 2.49, 95% CI 1.03-6.03, P = 0.04). This result provides further evidence of the importance of administering HBV vaccine at birth, but also highlights the importance for the prevention of vertical transmissions. Additional studies are needed to better establish the cost-effectiveness of such a 4 doses immunization strategy before implementing the HBV vaccination at birth in the EPI.
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Affiliation(s)
- Manfred Accrombessi
- Fondation pour la Recherche Scientifique (FORS), Cotonou, Benin; Institut de Recherche Clinique du Benin (IRCB), Abomey-Calavi, Benin; Faculty of Infectious and Tropical Diseases, Disease Control Department, London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - Crepin Victor Adetola
- Laboratoire de l'Antenne Départementale de l'Agence Nationale pour la Transfusion Sanguine, Porto-Novo, Benin
| | - Salwane Bacharou
- Unité de Vaccination du Centre Hospitalier Universitaire de la Mère et de l'Enfant Lagune (CHU-MEL), Cotonou, Benin; Unité de Vaccination du Centre de Santé de Cotonou I, Cotonou, Benin
| | - Yannelle Dossou
- Fondation pour la Recherche Scientifique (FORS), Cotonou, Benin; Institut de Recherche Clinique du Benin (IRCB), Abomey-Calavi, Benin
| | - Euripide Avokpaho
- Fondation pour la Recherche Scientifique (FORS), Cotonou, Benin; Institut de Recherche Clinique du Benin (IRCB), Abomey-Calavi, Benin
| | - Annatou Yakoubou
- Unité de Vaccination du Centre Hospitalier Universitaire de la Mère et de l'Enfant Lagune (CHU-MEL), Cotonou, Benin
| | - Sikiratou Koumakpai-Adeothy
- Unité de Vaccination du Centre Hospitalier Universitaire de la Mère et de l'Enfant Lagune (CHU-MEL), Cotonou, Benin; Unité de Vaccination du Centre de Santé de Cotonou I, Cotonou, Benin
| | - Evelyne Lozes
- Ecole Polytechnique d'Abomey-Calavi (EPAC), Université d'Abomey-Calavi, Abomey-Calavi, Benin
| | - Saadou Issifou
- Fondation pour la Recherche Scientifique (FORS), Cotonou, Benin; Institut de Recherche Clinique du Benin (IRCB), Abomey-Calavi, Benin
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Tfifha M, Kacem S, Ben Rejeb M, Naija S, Boujaafar N, Abroug S, Trabelsi A. Evaluation of antibody persistence after a four-dose primary hepatitis B vaccination and anamnestic immune response in children under 6 years. J Med Microbiol 2019; 68:1686-1693. [PMID: 31592765 DOI: 10.1099/jmm.0.001086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Introduction. Tunisia is an intermediate hepatitis B virus (HBV) endemic country. The vaccination against hepatitis B was introduced in 1995 including four doses with a first dose administrated at birth. Decreasing the level of antibodies against hepatitis B surface antigen (anti-HBs) over time can be alarming. This study was conducted to explore the anti-HBV immune response among children under 6 years old, vaccinated according to the national vaccination schedule, by evaluating the immunological response to primary vaccination and by exploring the anamnestic immune response to a booster dose.Methods. We conducted a cross-sectional prospective study from June 2016 to June 2017 (n=180), based on voluntary participation. Children were recruited from the public pediatric ward sectors in Sahloul University Hospital of Sousse in Central Tunisia. An anti-HB titre was determined based on electro-chemiluminescence micro-particle immunoassay (ECLIA), using Elecsys Anti-HBs II kit, Roche.Results. Mean age at the time of enrollment in the study was 33±14.8 months. The seroprotection rate was 77.2 %. The anti-HB titre differed significantly between the different age groups (P=0.002). The predicting variable for having no seroprotective antibody level was older age. Children with anti-HB levels <10 IU l- 1 were offered an additional dose of HBV vaccine. Anamnestic response 1 month after the challenge dose was observed in 100 % of subjects. The probability of developing a high antibody response, following the booster dose increased in conjunction with an increased pre-booster antibody level.Conclusion. The response to a booster dose suggests the persistence of immune memory in almost all vaccinated individuals. Although a booster dose increases substantially anti-HB titre, the clinical relevance of such an increase remains unknown.
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Affiliation(s)
- Miniar Tfifha
- Pediatric department, Sahloul University Hospital, 4054 Sousse, Tunisia
| | - Saoussen Kacem
- LR14SP02, Epidemiology and Immunogenetics of Human Viral Infections, Laboratory of Microbiology, Sahloul University Hospital, 4054 Sousse, Tunisia.,Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
| | - Mohamed Ben Rejeb
- Department of Prevention and Care Safety, Sahloul University Hospital, 4054 Sousse, Tunisia
| | - Said Naija
- LR14SP02, Epidemiology and Immunogenetics of Human Viral Infections, Laboratory of Microbiology, Sahloul University Hospital, 4054 Sousse, Tunisia
| | - Noureddine Boujaafar
- Laboratory of Microbiology, Sahloul University Hospital, 4054 Sousse, Tunisia.,Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
| | - Saoussen Abroug
- Pediatric department, Sahloul University Hospital, 4054 Sousse, Tunisia
| | - Abdelhalim Trabelsi
- LR14SP02, Epidemiology and Immunogenetics of Human Viral Infections, Laboratory of Microbiology, Sahloul University Hospital, 4054 Sousse, Tunisia.,Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
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Shin HJ, Lee ES, Han SB, Lee JW, Chung NG, Cho B, Kang JH. Serological Changes against Hepatitis B Surface Antigen in Children and Adolescents Receiving Chemotherapy for Acute Leukemia. Mediterr J Hematol Infect Dis 2019; 11:e2019052. [PMID: 31528318 PMCID: PMC6736336 DOI: 10.4084/mjhid.2019.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 08/09/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Vaccination for hepatitis B virus (HBV) after chemotherapy among pediatric patients with acute Leukemia is still a debated issue. We investigated HBV immunity before and after chemotherapy and assessed immune response to re-vaccination after chemotherapy. METHODS We retrospectively analyzed data of children and adolescents aged <19 years requested for vaccination after chemotherapy for acute leukemia to evaluate hepatitis B surface antibody (HBsAb) status before and after chemotherapy and to identify factors related to HBsAb positivity after chemotherapy. RESULTS Of 89 enrolled patients, 61 (68.5%) with acute leukemia were HBsAb positive before chemotherapy. Of these 61 patients, 48 (78.7%) seroconverted to HBsAb negative status after chemotherapy; there were 76 (85.4%) HBsAb negative patients after chemotherapy. HBsAb positive patients when compared to HBsAb negative patients after chemotherapy had a significantly higher HBsAb positive rate (100.0% vs. 63.2%, p=0.008) before chemotherapy. Following HBsAb testing after one dose of the HBV vaccination, 33 (43.4%) of the 76 HBsAb negative patients seroconverted to an HBsAb positive status. HBsAb positive patients after a single dose of HBV vaccination had a significantly higher HBsAb positive rate at the time of diagnosis compared to HBsAb negative patients (84.8% vs. 48.8%, p=0.001). CONCLUSIONS Based on these results, HBV re-vaccination after chemotherapy is recommended for all children and adolescents with acute leukemia. In addition, further investigation is required to improve the immunogenicity of HBV re-vaccination.
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Affiliation(s)
- Hye Jo Shin
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eui Soo Lee
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung Beom Han
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
- The Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae Wook Lee
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Catholic Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Nack-Gyun Chung
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Catholic Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bin Cho
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Catholic Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin Han Kang
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
- The Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
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26
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Miyasaka A, Yoshida Y, Wang T, Takikawa Y. Next-generation sequencing analysis of the human T-cell and B-cell receptor repertoire diversity before and after hepatitis B vaccination. Hum Vaccin Immunother 2019; 15:2738-2753. [PMID: 30945971 PMCID: PMC6930056 DOI: 10.1080/21645515.2019.1600987] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The hepatitis B (HB) vaccine effectively prevents the incidence of hepatitis B virus (HBV) infection. However, vaccine failure occurs in 5-10% of the recipients. The precise mechanisms leading to responsiveness to the HB vaccine are poorly understood. High-throughput sequencing (HTS) may help clarify the immune response to the HB vaccine, so we applied this method to investigate whether the HB vaccine induced a specific change in the T-cell receptor (TCR) and B-cell receptor (BCR) repertoires. We conducted HTS of the TCR β chain and BCR IgG heavy (H) chain complementary determining region 3 (CDR3) repertoires in five volunteers before and after the second and third immunizations with the HB vaccine. The HB surface antibody (HBsAb) levels were >10 mIU/ml after the third vaccination in all five participants. The TCR β chain CDR3 repertoire diversity significantly increased, while the BCR IgG H chain CDR3 repertoire diversity significantly decreased after the second vaccination. Although there was no marked inter-individual variation in terms of the numbers of unique reads, it is possible that the TCR β chain and BCR IgG H chain CDR3 repertoires may have changed within the same numbers of unique reads. Our data failed to identify the specific dominant clones that responded to the HB vaccine. In summary, the TCR β chain CDR3 repertoire diversity significantly increased, while the BCR IgG H chain CDR3 repertoire diversity significantly decreased, after the second HB vaccination. These diversity changes might be associated with a better response to the HB vaccine.
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Affiliation(s)
- Akio Miyasaka
- Division of Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Morioka, Japan
| | - Yuichi Yoshida
- Division of Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Morioka, Japan
| | - Ting Wang
- Division of Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Morioka, Japan
| | - Yasuhiro Takikawa
- Division of Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Morioka, Japan
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Abstract
Globally, infant hepatitis B virus (HBV) immunization programs are markedly reducing the rate of chronic HBV infections among children <5 years of age. Desirable improvements include increased birth dose coverage and better prevention of perinatal HBV transmission. Follow-up studies show that by the teenage years most of those immunized as infants have lost circulating anti-HBs antibody and some fail to respond to challenge HBV vaccination, implying loss of protection from infection. With high exposure to HBV, such individuals can develop breakthrough HBV infection but this rarely leads to chronic infection, the main goal of prevention programs. While longer-term follow-up studies into adulthood are needed, current evidence does not support a need for booster immunization of otherwise healthy teens or young adults.
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28
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Zhao YL, Han BH, Zhang XJ, Pan LL, Zhou HS, Gao Z, Hao ZY, Wu ZW, Ma TL, Wang F, Li Q, Bi SL, Ma JC. Immune persistence 17 to 20 years after primary vaccination with recombination hepatitis B vaccine (CHO) and the effect of booster dose vaccination. BMC Infect Dis 2019; 19:482. [PMID: 31146699 PMCID: PMC6543564 DOI: 10.1186/s12879-019-4134-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 05/27/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND To assess the immune persistence conferred by a Chinese hamster ovary (CHO)-derived hepatitis B vaccine (HepB) 17 to 20 years after primary immunization during early life. METHODS Participants born between 1997 and 1999 who received a full course of primary vaccination with HepB (CHO) and who had no experience with booster vaccination were enrolled. Blood samples were required from each participant for measurement of hepatitis B surface antibody (anti-HBs), surface antigen and core antibody levels. For those who possessed an anti-HBs antibody < 10 mIU/mL, a single dose of HepB was administered, and 30 days later, serum specimens were collected to assess the booster effects. RESULTS A total of 1352 participants were included in this study. Of these, 1007 (74.5%) participants could retain an anti-HBs antibody ≥10 mIU/mL, with a geometric mean concentration (GMC) of 57.4 mIU/mL. HBsAg was detected in six participants, resulting in a HBsAg carrier rate of 0.4% (6/1352). Of those participants with anti-HBs antibodies < 10 mIU/mL, after a challenge dose, 231 (93.1%) presented an anti-HBs antibody ≥10 mIU/mL, with a GMC of 368.7 mIU/mL. A significant increase in the anti-HBs positive rate (≥ 10 mIU/mL) after challenge was observed in participants with anti-HBs antibodies between 2.5 and 10 mIU/mL and participants boosted with HepB (CHO), rather than those with anti-HBs antibodies < 2.5 mIU/mL and those boosted with HepB (SC). CONCLUSION Since satisfactory immune protection against HBV infection conferred by primary vaccination administered 17-20 years ago was demonstrated, there is currently no urgent need for booster immunization.
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Affiliation(s)
- Yu-Liang Zhao
- Institute for Vaccine Clinical Research, Hebei Province Center for Disease Control and Prevention, 97 Huai'an East Road, Yuhua District, Shijiazhuang, 050021, Hebei Province, People's Republic of China.
| | - Bi-Hua Han
- Institute for Vaccine Clinical Research, Hebei Province Center for Disease Control and Prevention, 97 Huai'an East Road, Yuhua District, Shijiazhuang, 050021, Hebei Province, People's Republic of China
| | - Xin-Jiang Zhang
- Zhengding County Center for Disease Control and Prevention, Zhengding, 050800, People's Republic of China
| | - Lu-Lu Pan
- Institute for Vaccine Clinical Research, Hebei Province Center for Disease Control and Prevention, 97 Huai'an East Road, Yuhua District, Shijiazhuang, 050021, Hebei Province, People's Republic of China
| | - Hai-Song Zhou
- Zhengding County Center for Disease Control and Prevention, Zhengding, 050800, People's Republic of China
| | - Zhao Gao
- Institute for Vaccine Clinical Research, Hebei Province Center for Disease Control and Prevention, 97 Huai'an East Road, Yuhua District, Shijiazhuang, 050021, Hebei Province, People's Republic of China
| | - Zhi-Yong Hao
- Zhengding County Center for Disease Control and Prevention, Zhengding, 050800, People's Republic of China
| | - Zhi-Wei Wu
- Institute for Vaccine Clinical Research, Hebei Province Center for Disease Control and Prevention, 97 Huai'an East Road, Yuhua District, Shijiazhuang, 050021, Hebei Province, People's Republic of China
| | - Tian-Li Ma
- Institute for Vaccine Clinical Research, Hebei Province Center for Disease Control and Prevention, 97 Huai'an East Road, Yuhua District, Shijiazhuang, 050021, Hebei Province, People's Republic of China
| | - Feng Wang
- Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Changing District, Beijing, 100052, People's Republic of China
| | - Qi Li
- Institute for Vaccine Clinical Research, Hebei Province Center for Disease Control and Prevention, 97 Huai'an East Road, Yuhua District, Shijiazhuang, 050021, Hebei Province, People's Republic of China
| | - Sheng-Li Bi
- Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Changing District, Beijing, 100052, People's Republic of China
| | - Jing-Chen Ma
- Institute for Vaccine Clinical Research, Hebei Province Center for Disease Control and Prevention, 97 Huai'an East Road, Yuhua District, Shijiazhuang, 050021, Hebei Province, People's Republic of China
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29
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Hepatitis B s-Antigen Seroconversion Rate After Primary Immunization Series with Newly Introduced Pentavalent Vaccine: A Report of Regional Study in Alborz Province, Iran, 2016. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2019. [DOI: 10.5812/pedinfect.83565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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30
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Lu J, Yan B, Liu J, Wu W, Feng Y, Xu A, Zhang L. 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. Hum Vaccin Immunother 2019; 15:1171-1176. [PMID: 30499752 PMCID: PMC6605823 DOI: 10.1080/21645515.2018.1554972] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 11/13/2018] [Accepted: 11/27/2018] [Indexed: 01/29/2023] Open
Abstract
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.
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Affiliation(s)
- Jingjing Lu
- School of Public Health, Shandong University, Ji’nan, China
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Ji’nan, China
| | - Bingyu Yan
- School of Public Health, Shandong University, Ji’nan, China
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Ji’nan, China
| | - Jiaye Liu
- School of Public Health, Shandong University, Ji’nan, China
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Ji’nan, China
| | - Wenlong Wu
- School of Public Health, Shandong University, Ji’nan, China
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Ji’nan, China
| | - Yi Feng
- School of Public Health, Shandong University, Ji’nan, China
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Ji’nan, China
| | - Aiqiang Xu
- School of Public Health, Shandong University, Ji’nan, China
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Ji’nan, China
| | - Li Zhang
- School of Public Health, Shandong University, Ji’nan, China
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Ji’nan, China
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31
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Mak LY, Seto WK, Fung J, Yuen MF. Novel developments of hepatitis B: treatment goals, agents and monitoring tools. Expert Rev Clin Pharmacol 2019; 12:109-120. [DOI: 10.1080/17512433.2019.1567327] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Lung-Yi Mak
- Department of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Wai-Kay Seto
- Department of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
- Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong, Hong Kong
| | - James Fung
- Department of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
- State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong, Hong Kong
| | - Man-Fung Yuen
- Department of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
- State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong, Hong Kong
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Mahmood S, Shah KU, Khan TM. Immune Persistence After Infant Hepatitis-B Vaccination: A Systematic Review and Meta-Analysis. Sci Rep 2018; 8:12550. [PMID: 30135554 PMCID: PMC6105718 DOI: 10.1038/s41598-018-30512-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 07/27/2018] [Indexed: 01/10/2023] Open
Abstract
A systematic review was performed to estimate the duration of protection of Hepatitis-B vaccine after primary vaccination during infancy. The number of seropositive participants with anti-HBs antibody titer ≥ 10 mIU/ml and seronegative participants who had anti-HBs antibody titer ≤ 10 mIU/ml after booster dose was the main outcome criteria to find out the protection time of Hepatitis-B vaccine. Twelve studies were selected for systematic review. Overall, results from the meta-analysis have revealed that the risk of Anti-HBs Titer ≤ 10 mIU/ml reduced by 50%. Upon performing the sub-group analysis it was revealed that the overall risk of having Anti-HBs Titre ≤ 10 mIU/ml was reduced up to 62% among the subjects age 21–30 years (0.38 [0.34, 0.44]; I2 = 0.0%, p = 0.938). Furthermore, it was observed that the risk of having titre level less than 10 mIU/ml for plasma derived vaccines were to be 56% [0.44, CI 0.33–0.57, I2 90.9%, p = <0.001]. Vaccination in early infancy does not ensure protection against Hepatitis-B infection. There is a strong correlation between the duration of protection and time elapsed after primary immunization during infancy.
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Affiliation(s)
- Sajid Mahmood
- Faculty of Pharmacy, Quaid-e-Azam University, Islamabad, 45320, Pakistan
| | - Kifayat Ullah Shah
- Faculty of Pharmacy, Quaid-e-Azam University, Islamabad, 45320, Pakistan
| | - Tahir Mehmood Khan
- School of Pharmacy, Monash University, Bandar Sunway, 45700, Selangor, Malaysia. .,The Institute of Pharmaceutical Sciences (IPS), University of Veterinary & Animal Sciences (UVAS), Outfall road, Lahore, Pakistan.
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33
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Wu W, Lv J, Liu J, Yan B, Feng Y, Xu A, Zhang L. Persistence of immune memory among adults with normal and high antibody response to primary hepatitis B vaccination: Results from a five-year follow-up study in China. Hum Vaccin Immunother 2018; 14:2485-2490. [PMID: 29993330 DOI: 10.1080/21645515.2018.1477911] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Immune memory after hepatitis B vaccination among adults is still under investigation. In this study, adults who had normal and high antibody response to the primary series of hepatitis B vaccination (HepB) were followed up at 5 years after the primary immunization. A booster dose was given to those who had low hepatitis B surface antibody (anti-HBs) titers, defined as anti-HBs levels < 10 mIU/mL. Blood samples were collected at two weeks after the booster and anti-HBs levels were measured. We assumed those with ant-HBs levels > = 10 mIU/mL after the booster had anamnestic response. In total, 242 persons completed the booster and the anti-HBs test. The anamnestic response rate was 99.59% (241/242) and geometric mean concentration (GMC) of anti-HBs after the booster was 2989 mIU/mL (95% CI: 255, 35085). Anti-HBs titer after the booster dose had a positive correlation with anti-HBs titers measured right after the primary immunization as well as anti-HBs titers 5 years later just before the booster. After the booster, no significant difference was found in anti-HBs titers between participants who were immunized with the 10μg HepB vaccine and those with the 20μg vaccine. Multivariable analysis showed that 1) vaccine brand used for the primary vaccination, 2) anti-HBs titers after primary vaccination and 3) anti-HBs titers before the booster dose were independently associated with the anti-HBs titers after the booster 1) β = -0.21, 95% CI: -0.33, -0.09, P = 0.001; 2) β = 0.07, 95% CI: 0.05, 0.09, P < 0.001; 3) β = 0.04, 95% CI: 0.02, 0.07, P < 0.001). In summary, anamnestic response exists among almost all adults at five years after HepB primary immunization. Vaccine brand used for primary vaccination, initial anti-HBs titers after primary immunization and anti-HBs titers before the booster were the independent predictive factors of HepB anamnestic response titers.
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Affiliation(s)
- Wenlong Wu
- a School of Public Health, Shandong University , Jinan , China.,b Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention; Shandong Provincial Center for Disease Control and Prevention , Jinan , China
| | - Jingjing Lv
- a School of Public Health, Shandong University , Jinan , China.,b Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention; Shandong Provincial Center for Disease Control and Prevention , Jinan , China
| | - Jiaye Liu
- a School of Public Health, Shandong University , Jinan , China.,b Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention; Shandong Provincial Center for Disease Control and Prevention , Jinan , China
| | - Bingyu Yan
- a School of Public Health, Shandong University , Jinan , China.,b Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention; Shandong Provincial Center for Disease Control and Prevention , Jinan , China
| | - Yi Feng
- a School of Public Health, Shandong University , Jinan , China.,b Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention; Shandong Provincial Center for Disease Control and Prevention , Jinan , China
| | - Aiqiang Xu
- a School of Public Health, Shandong University , Jinan , China.,b Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention; Shandong Provincial Center for Disease Control and Prevention , Jinan , China
| | - Li Zhang
- a School of Public Health, Shandong University , Jinan , China.,b Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention; Shandong Provincial Center for Disease Control and Prevention , Jinan , China
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Zhao X, Pang X, Wang F, Cui F, Wang L, Zhang W. Maternal folic acid supplementation and antibody persistence 5 years after hepatitis B vaccination among infants. Hum Vaccin Immunother 2018; 14:2478-2484. [PMID: 29923793 PMCID: PMC6284482 DOI: 10.1080/21645515.2018.1482168] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 05/08/2018] [Accepted: 05/18/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Maternal exposure to dietary factors during pregnancy may modulate the immunity of offspring by epigenetic programming. But the relationship between intrauterine environment and persistence of protective antibody after hepatitis B vaccination has not been reported. This study was to investigate the 5-year persistence of protective antibody response after primary hepatitis B vaccination, and its relationship with maternal folic acid supplementation. MATERIALS AND METHODS A total of 1461 children who completed a 3-dose 10 μg recombinant hepatitis B vaccine at birth and did not infect hepatitis B virus were followed up. Logistic regression and mediation analysis was used to explore the relationship between 5-year persistence of protective antibody and maternal nutrition. RESULTS Of 1403 children who did not revaccinated during the follow-up, 76.1% had protective hepatitis B surface antibody (anti-HBs) levels. Twenty percent of mothers did not take folate during pregnancy. Mediation analysis showed a total effect of folic acid supplementation on good persistence (odds ratio: 1.10, 95% CI: 1.03-1.17, p = 0.0010), a direct effect was 1.07 (95% CI: 1.01-1.13, p = 0.0128) and an indirect effect was 1.03 (95% CI: 1.00-1.06, p = 0.0672); the proportion of good persistence mediated by primary response was 30.3%. CONCLUSION This study indicated a good protective anti-HBs persistence at year 5 after 10 μg recombination hepatitis B vaccination in infants. Maternal folic acid supplementation may improve the persistence of protective antibodies through other pathways. Multi-center cohort studies should be conducted to verify this conclusion.
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Affiliation(s)
- Xinyu Zhao
- Dept of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Xinghuo Pang
- Beijing Center for Disease Control and Prevention, Beijing, China
| | - Fuzhen Wang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fuqiang Cui
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Li Wang
- Dept of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Wei Zhang
- Beijing Center for Disease Control and Prevention, Beijing, China
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Osiowy C. From infancy and beyond… ensuring a lifetime of hepatitis B virus (HBV) vaccine-induced immunity. Hum Vaccin Immunother 2018; 14:2093-2097. [PMID: 29641290 PMCID: PMC6150009 DOI: 10.1080/21645515.2018.1462428] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Despite the long-term efficacy and immune persistence observed following HBV vaccination of infants, the need for a booster dose following infant immunization continues to be deliberated. Evidence from HBV booster dose response studies and long-term immunization program reviews are the basis for the recommendation that a vaccine booster is not necessary. However, further studies continue to emerge and highlight the need for standardization among observational studies in order to appropriately compare outcomes. There is an assumption that neonatal and infant (within 12 months of age) vaccine immune responses are equivalent; however, evidence exists for distinct vaccine responses within the first year of life. HBV vaccine programs have evolved over time, particularly regarding the type and dosage of vaccine used. Several universal neonatal immunization programs initially incorporated a 2.5 μg dosage (Recombivax-HB, Merck). This dosage has been shown in multiple long-term studies and meta-analyses to be associated with a lower primary response, decreased antibody persistence over time, and a reduced booster response 10 to 20 years following immunization. Ongoing surveillance of this and other HBV neonatally-vaccinated populations, particularly in low endemic regions, is necessary to understand the impact on long-term protection in order to ensure lifelong protection against hepatitis B infection.
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Affiliation(s)
- Carla Osiowy
- a National Microbiology Laboratory , Public Health Agency of Canada , Winnipeg , Manitoba , Canada
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Efficacy of Hepatitis B Vaccination in Under Five-Year-Old Children in Iran: A Systematic Review and Meta-Analysis Study. HEPATITIS MONTHLY 2018. [DOI: 10.5812/hepatmon.65385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Wang ZZ, Gao YH, Wang P, Wei L, Xie CP, Yang ZX, Lan J, Fang ZL, Zeng Y, Yan L, Liu XE, Zhuang H. Comparison of immunogenicity between hepatitis B vaccines with different dosages and schedules among healthy young adults in China: A 2-year follow-up study. Hum Vaccin Immunother 2018; 14:1475-1482. [PMID: 29420134 DOI: 10.1080/21645515.2018.1438090] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Immunogenicity of hepatitis B vaccine between 20 μg with 3-dose schedule and 60 μg with 2-dose regimens was compared 2 years after primary immunization. A total of 353 healthy adults aged 18-25 years were enrolled in the study and randomly assigned (1: 1: 1) into 3 vaccine groups: A (20 μg, 0-1-6 month), B (60 μg, 0-1 month) and C (60 μg, 0-2 month). Serum samples were collected at 1 month after a series vaccination and 12 months, 24 months after the first-dose. The GMC level of anti-HBs antibody was measured using Chemiluminescent Microparticle ImmunoAssay (CMIA). There were 59, 45 and 55 vaccinees available to follow-up with 2 year later in vaccine groups A, B and C, respectively. No significant differences existed in sex ratio, age and body mass index (BMI) among vaccinees at month 24 and the corresponding participants at baseline in each group (P > 0.05). The seroprotection rates in group A, B and C were 98.31%, 88.37% and 85.19%, respectively (P = 0.014), reflecting the fact that the rate of group A was significantly higher than that in group C (P = 0.026). Also, the GMC level of anti-HBs antibody in group A was significantly higher than those of other two groups (427.46 mIU/ml vs. 89.74 mIU/ml, 89.80 mIU/ml, respectively; all P < 0.01). This data suggested that the standard 20 μg (0-1-6 month) regimen of hepatitis B vaccine should be recommended as a priority on the premise of complete compliance in adults.
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Affiliation(s)
- Zhen-Zi Wang
- a Department of Microbiology and Center of Infectious Diseases , School of Basic Medical Sciences, Peking University Health Science Center , Beijing , China.,b Clinical Laboratory Center, Beijing Friendship Hospital, Capital Medical University , Beijing , China
| | - Yu-Hua Gao
- a Department of Microbiology and Center of Infectious Diseases , School of Basic Medical Sciences, Peking University Health Science Center , Beijing , China
| | - Ping Wang
- c Department of Nutrition and School Hygien , Liuzhou Municipal Center for Disease Control and Prevention , Liuzhou , Guangxi , China
| | - Lin Wei
- c Department of Nutrition and School Hygien , Liuzhou Municipal Center for Disease Control and Prevention , Liuzhou , Guangxi , China
| | - Chang-Ping Xie
- c Department of Nutrition and School Hygien , Liuzhou Municipal Center for Disease Control and Prevention , Liuzhou , Guangxi , China
| | - Zhen-Xing Yang
- c Department of Nutrition and School Hygien , Liuzhou Municipal Center for Disease Control and Prevention , Liuzhou , Guangxi , China
| | - Jian Lan
- c Department of Nutrition and School Hygien , Liuzhou Municipal Center for Disease Control and Prevention , Liuzhou , Guangxi , China
| | - Zhong-Liao Fang
- d Guangxi Key Laboratory of the Prevention and Control of Viral Hepatitis, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control , Nanning , Guangxi , China
| | - Ying Zeng
- e Department of Medical , Shenzhen Kangtai Biological Products Co., LTD. , Shenzhen , Guangdong , China
| | - Ling Yan
- a Department of Microbiology and Center of Infectious Diseases , School of Basic Medical Sciences, Peking University Health Science Center , Beijing , China
| | - Xue-En Liu
- a Department of Microbiology and Center of Infectious Diseases , School of Basic Medical Sciences, Peking University Health Science Center , Beijing , China
| | - Hui Zhuang
- a Department of Microbiology and Center of Infectious Diseases , School of Basic Medical Sciences, Peking University Health Science Center , Beijing , China
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Anderson CL, Remschmidt C, Drobnitzky FP, Falkenhorst G, Zimmermann R, Wichmann O, Harder T. Hepatitis B immune status in adolescents vaccinated during infancy: A retrospective cohort study from a pediatric practice in Germany. Hum Vaccin Immunother 2017; 12:779-84. [PMID: 26633195 DOI: 10.1080/21645515.2015.1105414] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
In Germany, vaccination of infants against hepatitis B is recommended since 1995. However, data on long-term immunity is sparse and the necessity of a booster dose remains uncertain. Aims of this study were to assess the long-term persistence of antibodies to the hepatitis B surface antigen (anti-HBs) after immunization during infancy and the effect of a subsequent hepatitis B booster vaccination during adolescence on anti-HBs levels. Patients from a private pediatric practice who had received a full vaccination course of hepatitis B as infants and who were quantitatively tested for anti-HBs during adolescence (pre-booster levels) were included. In those participants who received a hepatitis B booster, post-booster anti-HBs levels were measured. Univariate analyses were conducted to determine factors associated with pre- and post-booster anti-HBs levels, respectively. 106 participants (53% male) were included in the study. At an average of 13.7 y after primary vaccination, 14% of participants had an anti-HBs level of ≥100 IU/l, while 46% were at 10-99 IU/l and 40% had anti-HBs levels of <10 IU/l. In total, 34 received a booster vaccination. Of those, 97% (33/34) had post-booster anti-HBs levels ≥ 100 IU/l, which were independent from pre-booster levels. No other patient characteristics were associated with pre-booster or post-booster anti-HBs≥ 100 IU/l. Although almost half of study participants showed low anti-HBs levels at follow-up, robust responses to booster vaccination suggest that adolescents who received the full vaccination course during infancy are still protected against hepatitis B infection.
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Affiliation(s)
- Carrie L Anderson
- a Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin , Berlin , Germany.,b Robert Koch Institute, Immunization Unit , Berlin , Germany
| | | | | | | | - Ruth Zimmermann
- d Robert Koch Institute, Unit for HIV/AIDS, STI and Blood-borne infections , Berlin , Germany
| | - Ole Wichmann
- b Robert Koch Institute, Immunization Unit , Berlin , Germany
| | - Thomas Harder
- b Robert Koch Institute, Immunization Unit , Berlin , Germany
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Pileggi C, Papadopoli R, Bianco A, Pavia M. Hepatitis B vaccine and the need for a booster dose after primary vaccination. Vaccine 2017; 35:6302-6307. [PMID: 28988867 DOI: 10.1016/j.vaccine.2017.09.076] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 08/07/2017] [Accepted: 09/25/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Protective antibodies levels, induced by Hepatitis B virus (HBV) vaccine, persist for long-term after primary immunization, but there is evidence that, as the time since vaccination increases, there is a reduced ability to maintain immune memory. The study aim was to determine the prevalence and the duration of persistence of an anti-HBs titer with ≥10mIU/mL and eventual predictors of reduced seroprotection. METHODS The study was conducted among students attending medical and healthcare professions schools from January 2014 to June 2016. Data were collected through the review of medical records completed during the medical surveillance visit. All subjects had received HBV vaccine according to the Italian Ministry of Health indications. RESULTS The results are reported for 722 subjects. Positive anti-HBs titer was found in 72.6% (95% CI=69-76). The mean age of the subjects was 25.5years. Subjects vaccinated during adolescence and students that had received an adult vaccine dose were significantly more likely to be seroprotected. The longer the time interval since vaccination the lower the probability of being seroprotected; however if the role of time since vaccination was considered after stratification by vaccine dose, a statistically significant association with a lower percentage of seroprotected remains only in the subgroup of subjects who received the pediatric dose. The findings of the multivariate regression analysis partially confirmed those of the univariate analysis. CONCLUSIONS In conclusion, our findings show that over 25% of HBV vaccine recipients had an antiHBs titer <10mIU/ml after 18years of more from the primary vaccination. Furthermore, in the case a booster dose would be needed, our results suggest that the vaccination strategy should prefer administration of a vaccine adult dose during early adolescence, since it might offer longer-term protection through adulthood.
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Affiliation(s)
- Claudia Pileggi
- Department of Health Sciences, University of Catanzaro "Magna Græcia", Catanzaro, Italy
| | - Rosa Papadopoli
- Department of Health Sciences, University of Catanzaro "Magna Græcia", Catanzaro, Italy
| | - Aida Bianco
- Department of Health Sciences, University of Catanzaro "Magna Græcia", Catanzaro, Italy
| | - Maria Pavia
- Department of Health Sciences, University of Catanzaro "Magna Græcia", Catanzaro, Italy.
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Serological and molecular epidemiological outcomes after two decades of universal infant hepatitis B virus (HBV) vaccination in Nunavut, Canada. Vaccine 2017; 35:4515-4522. [DOI: 10.1016/j.vaccine.2017.07.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 06/28/2017] [Accepted: 07/13/2017] [Indexed: 12/12/2022]
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Obando-Pacheco P, Rivero-Calle I, Gómez-Rial J, Rodríguez-Tenreiro Sánchez C, Martinón-Torres F. New perspectives for hexavalent vaccines. Vaccine 2017; 36:5485-5494. [PMID: 28676382 DOI: 10.1016/j.vaccine.2017.06.063] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 05/13/2017] [Accepted: 06/20/2017] [Indexed: 10/19/2022]
Abstract
With the increase in the number of routine vaccinations the development of pentavalent and hexavalent combination vaccines fitting the routine vaccination schedules became a necessity. In this respect, Europe has taken the lead in comparison with other world regions, and routine vaccination with pentavalent and hexavalent combinations including DTPa, Hib, HepB and IPV has been on European vaccination programs for >15years. Since the marketing authorization of Hexavac® and Infanrix Hexa® in 2000, immunization schedules in most European countries have included hexavalent vaccines. In the last years, two new hexavalent vaccines have been licensed and commercialized worldwide. This paper presents a review of the pharmaceutical profiles of the three hexavalent vaccines currently available. In addition, we aim to review safety, co-administration, tolerability and other practical concerns of their use.
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Affiliation(s)
- Pablo Obando-Pacheco
- Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Galicia, Spain; GENVIP Research Group, Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela, Galicia, Spain
| | - Irene Rivero-Calle
- Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Galicia, Spain; GENVIP Research Group, Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela, Galicia, Spain
| | - José Gómez-Rial
- Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Galicia, Spain; GENVIP Research Group, Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela, Galicia, Spain
| | - Carmen Rodríguez-Tenreiro Sánchez
- Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Galicia, Spain; GENVIP Research Group, Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela, Galicia, Spain
| | - Federico Martinón-Torres
- Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Galicia, Spain; GENVIP Research Group, Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela, Galicia, Spain.
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Will Infant Hepatitis B Vaccination Protect Into Adulthood?: Extended Canadian Experience After a 2-, 4- and 6-month Immunization Schedule. Pediatr Infect Dis J 2017; 36:609-615. [PMID: 28134742 DOI: 10.1097/inf.0000000000001543] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Hepatitis B virus (HBV) vaccination programs generally target infants to prevent chronic HBV infection and/or preadolescents to reduce transmission in adulthood. To assess whether infant HBV immunization can potentially accomplish both objectives, we measured residual immunity 10-16 years after vaccination in Canadian children. METHODS A prospective, parallel group, single center study enrolled adolescents given HBV vaccine at 2, 4 and 6 months of age. Exclusion criteria included prior HBV infection and additional vaccinations. At follow-up anti-HBs testing, participants were 10-11 or 15-16 years old; those with <12 mIU/mL anti-HBs by the assay used were challenged with HBV vaccine to assess immune memory-based responsiveness. RESULTS A total of 137 tested participants were 10-11 and 213 were 15-16 years old, respectively; none had evidence of prior HBV infection. At baseline, 78% of younger and 64% of older participants had <12 mIU/mL anti-HBs (P = 0.006) and were challenged with vaccine: 103/106 (97.2%) younger and 123/135 (91.1%) older participants developed ≥12 mIU/mL anti-HBs (P = 0.06), with geometric mean antibody concentration of 590 (95% confidence interval: 473-737) and 319 mIU/mL (95% confidence interval: 229-445; P = 0.004), respectively. Immune memory loss may have occurred in 3 younger (2.2%) and 12 older children (5.6%; P = 0.06) who were nonresponsive to first but not second vaccine challenge. CONCLUSIONS After HBV vaccination at 2, 4 and 6 months of age, most adolescents had little or no residual antibody but nearly all responded to HBV challenge, confirming immune memory persistence. However, anamnestic responses were weaker in 15- to 16-year olds and lost in some. Booster responses in 10- to 11-year olds were vigorous in comparison. Extended evaluation of protection is warranted.
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Altan H, Demirtaş S, Taş D, Budakoğlu Iİ. Ankara’da Bir Devlet Hastanesine Başvuran Çocuklarda Hepatit B Seroprevalansının Belirlenmesi. ANKARA MEDICAL JOURNAL 2017. [DOI: 10.17098/amj.304659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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Jafarzadeh A, Keshavarz J, Bagheri-Jamebozorgi M, Nemati M, Frootan R, Shokri F. The association of the vitamin D status with the persistence of anti-HBs antibody at 20years after primary vaccination with recombinant hepatitis B vaccine in infancy. Clin Res Hepatol Gastroenterol 2017; 41:66-74. [PMID: 27459879 DOI: 10.1016/j.clinre.2016.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 05/31/2016] [Accepted: 06/07/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVE Vitamin D has potent immunoregulatory effects due to the expression of its receptor on the majority of immune cells. The aim was to evaluate the association of the vitamin D status with the persistence of anti-HBs antibody and immune response to booster immunization at 20years after primary vaccination with hepatitis B (HB) vaccine. METHODS Blood samples were collected from 300 adults 20years after completion of the primary HB vaccination in infancy. The serum levels of vitamin D and anti-HBs antibody were measured by ELISA. A single booster dose of a recombinant HB vaccine was administered to a total of 138 subjects, whose anti-HBs titer was<10IU/L. The sera of revaccinated subjects were re-tested for anti-HBs antibody, 4weeks after booster vaccination. RESULTS At 20years after primary vaccination, the mean vitamin D concentrations were significantly higher in seroprotective subjects as compared to non-seroprotective individuals (P<0.01). The levels of anti-HBs were significantly increased with advanced concentrations of vitamin D (P<0.01). Overall, 125/138 (90.6%) of the revaccinated subjects showed an anamnestic response to booster vaccination. The concentrations of vitamin D were significantly higher in subjects with an anamnestic response to booster vaccination as compared with subjects without this response (P<0.01). CONCLUSION Vitamin D status may influence the persistence of anti-HBs antibody and durability of protection after primary vaccination with a recombinant HB vaccine in infancy.
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Affiliation(s)
- A Jafarzadeh
- Department of Immunology, School of Medicine, Rafsanjan University of Medical Sciences, Enghlab Sq., Rafsanjan, Iran; Molecular Medicine Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; Department of Immunology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
| | - J Keshavarz
- Department of Immunology, School of Medicine, Rafsanjan University of Medical Sciences, Enghlab Sq., Rafsanjan, Iran; Molecular Medicine Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - M Bagheri-Jamebozorgi
- Molecular Medicine Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - M Nemati
- Department of Immunology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - R Frootan
- Islamic Azad University of Flavarjan, Isfahan, Iran
| | - F Shokri
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Wang ZZ, Gao YH, Lu W, Jin CD, Zeng Y, Yan L, Ding F, Li T, Liu XE, Zhuang H. Long-term persistence in protection and response to a hepatitis B vaccine booster among adolescents immunized in infancy in the western region of China. Hum Vaccin Immunother 2016; 13:909-915. [PMID: 27874311 DOI: 10.1080/21645515.2016.1250990] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To evaluate the persistence of protection from hepatitis B (HB) vaccination among adolescents immunized with a primary series of HB vaccine as infants, and the immune response to booster doses. METHODS Healthy adolescents aged 15-17 y vaccinated with HB vaccine only at birth were enrolled. Baseline serum hepatitis B surface antigen (HBsAg), antibody against hepatitis B surface antigen (anti-HBs) and antibody against hepatitis B core antigen (anti-HBc) were detected by Enzyme-Linked Immunosorbent Assay (ELISA) and anti-HBs level was measured using Chemiluminescent Microparticle Immunoassay (CMIA). The rate of HBV infection was calculated. The seroprotection rate of anti-HBs (≥ 10 mIU/ml) and GMC level were used to evaluate the persistence of immunity from HB vaccination. Those with anti-HBs < 10 mIU/ml were immunized with booster doses of HB vaccine and the anamnestic response was assessed. RESULTS Of 180 adolescents who received a primary series of HB vaccinations as infants, 3 (1.7%) had HBV infection and 74 (41.1%) had anti-HBs ≥ 10 mIU/ml with a GMC of 145.11 mIU/ml. The remaining 103 (57.2%) with anti-HBs < 10 mIU/ml received a booster dose of 20 μg HB vaccine and achieved the seroprotection rate of 84% (84/100) and a GMC of 875.19 mIU/ml at one month post-booster. An additional dose of 60 μg HB vaccine was administered to the 16 adolescents with anti-HBs < 10 mIU/ml after the first booster. All of them obtained anti-HBs seroprotection with a GMC of 271.02 mIU/ml at 1.5 months after an additional dose. CONCLUSIONS Vaccine-induced immunity persisted for up to 15-17 y in 89.3% (158/177) of participants after a primary HB vaccination in infancy. Administering a booster dose of 20μg HB vaccine elicited an anamnestic immune responses in the majority of individuals with baseline anti-HBs <10 mIU/ml.
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Affiliation(s)
- Zhen-Zi Wang
- a Department of Microbiology and Infectious Disease Center , School of Basic Medical Sciences, Peking University Health Science Center , Beijing , China
| | - Yu-Hua Gao
- a Department of Microbiology and Infectious Disease Center , School of Basic Medical Sciences, Peking University Health Science Center , Beijing , China
| | - Wei Lu
- a Department of Microbiology and Infectious Disease Center , School of Basic Medical Sciences, Peking University Health Science Center , Beijing , China
| | - Cun-Duo Jin
- b Beijing 302 Hospital of People's Liberation Army , Beijing , China
| | - Ying Zeng
- c Shenzhen Kangtai Biological Products Co., LTD. , Shenzhen , Guangdong , China
| | - Ling Yan
- a Department of Microbiology and Infectious Disease Center , School of Basic Medical Sciences, Peking University Health Science Center , Beijing , China
| | - Feng Ding
- a Department of Microbiology and Infectious Disease Center , School of Basic Medical Sciences, Peking University Health Science Center , Beijing , China
| | - Tong Li
- a Department of Microbiology and Infectious Disease Center , School of Basic Medical Sciences, Peking University Health Science Center , Beijing , China
| | - Xue-En Liu
- a Department of Microbiology and Infectious Disease Center , School of Basic Medical Sciences, Peking University Health Science Center , Beijing , China
| | - Hui Zhuang
- a Department of Microbiology and Infectious Disease Center , School of Basic Medical Sciences, Peking University Health Science Center , Beijing , China
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Katoonizadeh A, Sharafkhah M, Ostovaneh MR, Norouzi A, Khoshbakht N, Mohamadkhani A, Eslami L, Gharravi A, Shayanrad A, Khoshnia M, Esmaili S, George J, Poustchi H, Malekzadeh R. Immune responses to hepatitis B immunization 10-18 years after primary vaccination: a population-based cohort study. J Viral Hepat 2016; 23:805-811. [PMID: 27126365 DOI: 10.1111/jvh.12543] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 03/16/2016] [Indexed: 01/05/2023]
Abstract
We evaluated the immune response to neonatal HBV immunization in children of infected parents 10-18 years after primary vaccination. Healthy individuals immunized with an infantile course of three doses of HBV vaccine were tested for persistence of anti-HB surface antibody (HBsAb). Those with an HBsAb level of <10 IU/mL received a booster dose of the vaccine with subsequent doses to those without protective titres. HBsAb concentrations were determined 4 weeks after each dose of the booster vaccine. The data were analysed separately for three age groups: 10-11, 12-14 and 15-18 years old. A total of 541 healthy individuals were studied. The highest seroprotection rate of 48% was observed in the youngest vaccinees (10-11 years old). This declined to 26.5% in the oldest (15-18 years old) group (P = 0.008). The youngest vaccinees showed the highest rate of anamnestic immune responses (96%). However, 25% of oldest individuals failed to mount an anamnestic immune response in challenge with a booster dose of the vaccine (P = 0.005), suggesting waning immunity with increasing age. Age (OR: 0.80; P = 0.01) and prebooster HBsAb levels (OR: 0.37; P = 0.01) identified responders to first booster doses of the vaccine by logistic regression analysis. The majority of high-risk vaccinees showed anamnestic immune response 10-11 years after primary immunization. However, we found a significant proportion (25%) of older individuals with no anamnetic response, which suggests a waning of immune memory. Detailed long-term follow-up studies are necessary to determine the risk of natural infection among these individuals before a booster schedule can be recommended.
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Affiliation(s)
- A Katoonizadeh
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - M Sharafkhah
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - M R Ostovaneh
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MA, USA
| | - A Norouzi
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - N Khoshbakht
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - A Mohamadkhani
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - L Eslami
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - A Gharravi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - A Shayanrad
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - M Khoshnia
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - S Esmaili
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Westmead, NSW, Australia
| | - J George
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Westmead, NSW, Australia
| | - H Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - R Malekzadeh
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Impact and long-term protection of hepatitis B vaccination: 17 years after universal hepatitis B vaccination in Tunisia. Epidemiol Infect 2016; 144:3365-3375. [PMID: 27535719 DOI: 10.1017/s0950268816001849] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Hepatitis B virus (HBV) vaccination has been part of the Expanded Programme of Immunization (EPI) in Tunisia since 1995. The aim of this study was to evaluate, for the first time, the impact of mass vaccination in Tunisia 17 years after this programme was implemented, and in parallel, assess the long-term persistence of anti-HBs antibody in the vaccinated Tunisian population. A total of 1422 students were recruited (703 vaccinated, 719 non-vaccinated). HBV seromarkers were checked. None of the students from either group had positive HBsAg. The overall prevalence of anti-HBc was 0·8%. A Significantly higher prevalence of anti-HBc was noted in unvaccinated students than in vaccinated (1·4% vs. 0·3%, P = 0·02). The overall seroprotection rate (anti-HBs titre ⩾10 mIU/ml) was 68·9% in vaccinated subjects. Seroprotection rates and geometric mean titres decreased significantly with increasing age, reflecting waning anti-HBs titre over time. No significant difference was detected between seroprotection rates and gender or students' area of origin. Incomplete vaccination was the only factor associated with an anti-HBs titre <10 mIU/ml. This study demonstrates the excellent efficacy of the HBV vaccination programme in Tunisia 17 years after its launch. However, a significant decline of anti-HBs seroprotection has been observed in ⩾15-year-old adolescents which places them at risk of infection. Additional studies are needed in hyperendemic regions in Tunisia.
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Markers of Protection in Children and Adolescents Six to Fourteen Years After Primary Hepatitis B Vaccination in Real Life: A Pilot Study. Pediatr Infect Dis J 2016; 35:286-91. [PMID: 26569192 DOI: 10.1097/inf.0000000000000994] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Not many data are available on long-term immunity against hepatitis B (HB) for children vaccinated under real-life conditions. METHODS Two hundred and thirty-two children and adolescents vaccinated 6-14 years earlier in pediatric practices were examined for conditions of vaccination and markers of protection as anti-HBs, anamnestic response to a booster dose and cell-mediated immunity. RESULTS Fifty-six percent of the participants were vaccinated according to the German vaccination recommendations (group 1). In 44.0% (group 2), these recommendations were not followed. Anti-HBs concentrations of ≥10 IU/L were found in 53.1% of group 1 and 45.1% of group 2 participants. A booster dose resulted in 91 of 99 participants in having an anamnestic response, in 3 (5.9%) of group 1 and 5 (10.4%) of group 2 anti-HBs remained below 10 IU/L. In group 1, postbooster anti-HBs concentration was inversely correlated with time since the last vaccination. Cellular immune responses were seen in only 5% of revaccinated individuals before the booster, increasing to 30% thereafter. CONCLUSIONS Under real-life conditions about half of vaccinees have lost protecting antibodies 6-14 years after vaccination in infancy, but in approximately 90% of them, immune memory was demonstrated. However, as memory may wane, revaccination at a time when boostability is still present might be considered.
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Brunskole Hummel I, Zitzmann A, Erl M, Wenzel JJ, Jilg W. Characteristics of immune memory 10-15 years after primary hepatitis B vaccination. Vaccine 2015; 34:636-642. [PMID: 26718687 DOI: 10.1016/j.vaccine.2015.12.033] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 11/08/2015] [Accepted: 12/11/2015] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND AIMS The definition of immune memory after hepatitis B vaccination is still under debate. Therefore, we analysed hepatitis B surface antigen (HBsAg)-specific memory in more detail by investigating the kinetics of humoral and cellular responses after hepatitis B booster vaccination. METHODS The anti-HBs kinetics of 23 individuals with anti-HBs titres below 10 IU/l, who had been vaccinated 10-15 years ago, was monitored at day 0, 3, 7, 14 and 28 after booster vaccination. HBsAg-specific IFNγ- and IL5-secreting cells in enriched CD4(+) fraction were measured at day 0, 7 and 28 post-booster by enzyme-linked immunospot assay (ELISpot). RESULTS 22 of 23 subjects showed similar anti-HBs kinetic curves, including 3 of 4 subjects who did not reach anti-HBs titres of 10 IU/l. The steep anti-HBs increase started between day 3 and 7 and peaked around day 14. A plateau or only minimal changes were visible between day 14 and 28. 17.4% of subjects showed pre-booster cellular responses, and this rate had increased to 47.8% and 56.5% after 7 and 28 days, respectively. The kinetic patterns of T cell responses differed considerably among subjects. A dominance of Th2 responses (IL5 secretion) over Th1 responses (IFNγ secretion) could be observed. CONCLUSIONS The presence of B cell memory could be shown by a typical anamnestic anti-HBs response curve after a booster dose in all but one individual. In contrast, T cell responses to booster vaccination, which occurred in approximately 50% of participants, were rather heterogeneous.
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Affiliation(s)
- Irena Brunskole Hummel
- Institute of Medical Microbiology and Hygiene, University of Regensburg, 93053 Regensburg, Germany.
| | - Anita Zitzmann
- Institute of Medical Microbiology and Hygiene, University of Regensburg, 93053 Regensburg, Germany.
| | - Monika Erl
- Institute of Medical Microbiology and Hygiene, University of Regensburg, 93053 Regensburg, Germany.
| | - Jürgen J Wenzel
- Institute of Clinical Microbiology and Hygiene, University Medical Centre Regensburg, 93053 Regensburg, Germany.
| | - Wolfgang Jilg
- Institute of Medical Microbiology and Hygiene, University of Regensburg, 93053 Regensburg, Germany.
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