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Zhao M, Wang C, Li P, Sun T, Wang J, Zhang S, Ma Q, Ma F, Shi W, Shi M, Ma Y, Pan Y, Zhang H, Xie X. Single-cell RNA sequencing reveals the transcriptomic characteristics of peripheral blood mononuclear cells in hepatitis B vaccine non-responders. Front Immunol 2023; 14:1091237. [PMID: 37593735 PMCID: PMC10431960 DOI: 10.3389/fimmu.2023.1091237] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 04/12/2023] [Indexed: 08/19/2023] Open
Abstract
The emergence of a vaccine against hepatitis B has proven to be an important milestone in the prevention of this disease; however, 5%-10% of vaccinated individuals do not generate an immune response to the vaccine, and its molecular mechanism has not been clarified. In this study, single-cell RNA sequencing was performed on peripheral blood mononuclear cells (PBMCs) from three volunteers with a high immune response (HR) and three with no immune response (NR) to the hepatitis B vaccine. We found that the antigen-presenting activity scores of various antigen-presenting cells, the mitogen-activated protein kinase (MAPK) pathway activity scores of naive B cells, and the cell activity scores of three types of effector T cells were significantly decreased, whereas the cytotoxicity scores of CD3highCD16lowKLRG1high natural killer T (NKT) cells were significantly increased in the NR group compared with those in the HR group. Additionally, the expression levels of some classical molecules associated with distinct signaling pathways-including HLA-B, HLA-DRB5, BLNK, BLK, IL4R, SCIMP, JUN, CEBPB, NDFIP1, and TXNIP-were significantly reduced in corresponding subsets of PBMCs from the NR group relative to those of the HR group. Furthermore, the expression of several cytotoxicity-related effector molecules, such as GNLY, NKG7, GZMB, GZMM, KLRC1, KLRD1, PRF1, CST7, and CTSW, was significantly higher in CD3highCD16lowKLRG1high NKT cells derived from non-responders. Our study provides a molecular basis for the lack of response to the hepatitis B vaccine, including defective antigen presentation, decreased T cell activity, and reduced IL-4 secretion, as well as novel insight into the role of NKT cells in the immune response to the hepatitis B vaccine.
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Affiliation(s)
- Meie Zhao
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
- Department of Laboratory Medicine, The First People’s Hospital of Lanzhou, Lanzhou, Gansu, China
| | - Chunxia Wang
- Department of Laboratory Medicine, The First People’s Hospital of Lanzhou, Lanzhou, Gansu, China
| | - Peiqiang Li
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Tao Sun
- Clinical Laboratory, Huzhou Central Hospital, Huzhou Hospital Affiliated with Zhejiang University, Huzhou, Zhejiang, China
| | - Jing Wang
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Shasha Zhang
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Qinglong Ma
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Fengdie Ma
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Wenjing Shi
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Maoning Shi
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Yapeng Ma
- Department of Laboratory Medicine, The First People’s Hospital of Tianshui, Tian Shui, Gansu, China
| | - Yunyan Pan
- Department of Laboratory Medicine, The Second Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Hui Zhang
- Virus Laboratory, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China
| | - Xiaodong Xie
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
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The First Assessments of Pediatric HBV Immunization Coverage in Mauritania and Persistence of Antibody Titers Post Infant Immunizations. Vaccines (Basel) 2023; 11:vaccines11030588. [PMID: 36992174 DOI: 10.3390/vaccines11030588] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
Background: The Hepatitis B virus (HBV) vaccine is used worldwide as an efficient tool to prevent the occurrence of chronic HBV infection and the subsequent liver disease. However, despite decades of vaccination campaigns, millions of new infections are still reported every year. Here, we aimed to assess the nationwide HBV vaccination coverage in Mauritania as well as the presence of protective levels of the antibodies against HBV surface antigen (HBsAb) following vaccination in a sample of children immunized as infants. Methods: To evaluate the frequency of fully vaccinated and seroprotected children in Mauritania, a prospective serological study was conducted in the capital. First, we evaluated the pediatric HBV vaccine coverage in Mauritania between 2015 and 2020. Then, we examined the level of antibodies against HBV surface antigen (HBsAb) in 185 fully vaccinated children (aged 9 months to 12 years) by ELISA using the VIDAS hepatitis panel for Minividas (Biomerieux). These vaccinated children were sampled in 2014 or 2021. Results: In Mauritania, between 2016 and 2019, more than 85% of children received the complete HBV vaccine regimen. While 93% of immunized children between 0 and 23 months displayed HBsAb titer >10 IU/L, the frequency of children with similar titers decreased to 63, 58 and 29% in children aged between 24–47, 48–59 and 60–144 months, respectively. Conclusions: A marked reduction in the frequency of HBsAb titer was observed with time, indicating that HBsAb titer usefulness as marker of protection is short lived and prompting the need for more accurate biomarkers predictive of long-term protection.
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Evaluation of factors associated the expression of anti-HBs in children in Hunan Province, China. BMC Pediatr 2022; 22:697. [PMID: 36471266 PMCID: PMC9724425 DOI: 10.1186/s12887-022-03718-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 10/25/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Vaccine is the most essential avenue to prevent hepatitis B virus (HBV) infection in infants and preschool children in China, with the largest populations carrying HBV in the world. This study aimed to evaluate the factors associating the response level of anti-HBs in children, providing instructions for HBV prevention clinically. METHODS The children taking physical examinations in the Third Xiangya Hospital from January 2013 to April 2020 were recruited. Telephone follow-up were adopted to collect further information. Univariate logistic regression was used to analyse the relationship between age and anti-HBs expression. Grouping by age and anti-HBs expression, we used chi-square test and T test to compare qualitative and quantitative data between positive group and negative group in each age subgroup. The meaningful variables (P < 0.10) in chi-square test or T test were further assessed with collinearity and chosen for univariate and multivariate logistic regression analysis by the stepwise backward maximum likelihood method (αin = 0.05, αout = 0.10). RESULTS A total of 5838 samples (3362 males, 57.6%) were enrolled. In total, the incidence of negative anti-HBs increased with age[OR = 1.037(1.022-1.051)]. Multivariate logistic regression analysis illustrated that anemia[OR = 0.392(0.185-0.835)], age[OR = 2.542(1.961-3.295)] and Vit D[OR = 0.977(0.969-0.984)] in 0.5-2.99 years subgroup, Zinc deficiency[OR = 0.713(0.551-0.923] and age[OR = 1.151(1.028-1.289)] in 3-5.99 years subgroup, Vit D[OR = 0.983(0.971-0.995)] in 12-18 years subgroup had significant association with anti-HBs. CONCLUSIONS This retrospective study illustrated that age, anemia status, zinc deficiency and vitamin D were associated with anti-HBs expression in specific age groups of children, which could serve as a reference for the prevention of HBV.
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Yang Y, Xiao J, Zhang X, Yang H, Zhang Z, Xu H, Huang A, Zhao Y. Protective Effect of Neonatal Hepatitis B Vaccine Against HBV Breakthrough Infection in Children with Leukemia: A Real-world Study. J Clin Transl Hepatol 2022; 10:860-866. [PMID: 36304512 PMCID: PMC9547253 DOI: 10.14218/jcth.2021.00291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 09/06/2021] [Accepted: 12/27/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND AND AIMS Hepatitis B vaccine is the most effective preventive measure against hepatitis B virus (HBV) infection. However, the risk of HBV breakthrough infection in fully immunized children (neonatal hepatitis B immunization) who receive immunosuppressive therapy and transfusion of blood components is not well characterized. In this real-world study, we aimed to investigate the immune protection conferred by neonatal hepatitis B vaccine in children with acute lymphoblastic leukemia (ALL) who were treated with immunosuppressive therapy and blood component transfusions. METHODS Children with ALL who had received all three doses of neonatal hepatitis B vaccine were included in this study. HBV seromarkers were detected before and after the initiation of immunosuppressive therapy. RESULTS A total of 1,011 children with ALL who were fully vaccinated against hepatitis B in infancy before the initiation of immunosuppressive therapy were eligible for inclusion. HBV infection was detected in four of 410 children (0.98%) with an HBsAg test after the initiation of immunosuppressive therapy. The median interval from treatment initiation was 19 months. CONCLUSIONS Three doses of neonatal hepatitis B vaccine conferred adequate protection. In endemic regions, there is a low risk of HBV breakthrough infection in fully immunized children with immunosuppressive therapy.
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Affiliation(s)
- Yuting Yang
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Jianwen Xiao
- Department of Hematology, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Xiuyu Zhang
- Department of Laboratory, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hui Yang
- Department of Hematology, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Zhenzhen Zhang
- Department of Infection, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Hongmei Xu
- Department of Infection, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Ailong Huang
- Institute for Viral Hepatitis, Ministry of Education Key Laboratory of Molecular Biology on Infectious Diseases, Chongqing Medical University, Chongqing, China
| | - Yao Zhao
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Correspondence to: Yao Zhao, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China. ORCID: https://orcid.org/0000-0003-4550-9436. Tel: +86-23-6360-3083, Fax: +86-23-6360-2136, E-mail:
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Huang Y, Yang Y, Wu T, Li Z, Xu H, Huang A, Zhao Y. Complementary Presence of HBV Humoral and T-cell Response Provides Protective Immunity after Neonatal Immunization. J Clin Transl Hepatol 2022; 10:660-668. [PMID: 36062290 PMCID: PMC9396322 DOI: 10.14218/jcth.2021.00272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/08/2021] [Accepted: 10/14/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND AND AIMS Hepatitis B vaccination is the most cost effective way to prevent hepatitis B virus (HBV) infection. Hepatitis B vaccine (HepB) efficacy is usually assessed by anti-hepatitis B surface antigen (HBsAg) level, but there are few reports of humoral and cellular immune responses to HepB in children after neonatal vaccination. METHODS A group of 100 children with a history of primary hepatitis B immunization were included in this study to evaluate the efficacy of HepB. Blood samples were obtained from 80 children before, and 41 children after, a single HepB booster dose. Children with low anti-HBsAg (HBs) titers of <100 mIU/mL received a booster dose after giving their informed consent. Anti-HBsAg, T-cell response and percentage of B-cell subsets were assayed before and after the booster. RESULTS Of the 80 children, 81.36% had positive T cell and anti-HBsAg responses at baseline. After the booster dose, the anti-HBsAg titer (p<0.0001), positive HBsAg-specific T-cell response (p=0.0036), and spot-forming cells (p=0.0003) increased significantly. Compared with pre-existing anti-HBsAg titer <10 mIU/mL, the anti-HBsAg (p=0.0005) and HBsAg-specific T-cell responses (p<0.0001) increased significantly in preexisting anti-HBsAg titer between 10 and 100 mIU/mL group. Change of the HBV-specific humoral response was the reverse of the T-cell response with age. Peripheral blood lymphocytes, B cells, and subset frequency decreased. CONCLUSIONS HBV immunization protection persisted at least 13 years after primary immunization because of the complementary presence of HBV-specific humoral antibodies and a T-cell immune response. One dose of a HepB booster induced protective anti-HBsAg and promoted an HBsAg-specific T-cell response. In HBV endemic regions, a HepB booster is recommended to children without anti-HBsAg because of effectiveness in HBV prevention.
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Affiliation(s)
- Yunmei Huang
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Yuting Yang
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Tingting Wu
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Zhiyu Li
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Hongmei Xu
- Department of Infection, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Ailong Huang
- Institute for Viral Hepatitis, Ministry of Education Key Laboratory of Molecular Biology on Infectious Diseases, Chongqing Medical University, Chongqing, China
| | - Yao Zhao
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Correspondence to: Yao Zhao, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China. ORCID: https://orcid.org/0000-0003-4550-9436. Tel: +86-23-6363-3083, Fax: +86-23-6360-2136, E-mail:
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Ocak S, Karaman S, Vural S, Keskindemirci G, Tugcu D, Unuvar A, Karakas Z. Hepatitis B Vaccination in Children With Ongoing Cancer Treatment: A Safety and Efficacy Study of Super-Accelerated Vaccination Scheme. Turk Arch Pediatr 2022; 56:469-473. [PMID: 35110116 PMCID: PMC8849218 DOI: 10.5152/turkarchpediatr.2021.21090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Children with cancer have an increased risk for hepatitis B virus (HBV) infections due to chemotherapy-induced secondary immunodeficiency and frequent blood transfusions. The aim of this study is to evaluate the efficacy and safety of hepatitis B vaccination during the intensive induction chemotherapy in children with cancer found to be seronegative for hepatitis B on admission. MATERIALS AND METHODS Children newly diagnosed with cancer were evaluated for the presence of hepatitis B surface antigen (HBsAg) and antibody on admission. The children negative for both were included in the study. A super-accelerated vaccination scheme (3 booster doses at days 1-5, 8-12, and 28-33) was administered to these seronegative children concurrently with induction chemotherapy. Antibody response was checked 4-8 weeks after the last vaccination and 6 months after the end of the treatment. RESULTS Eleven out of 122 children were seronegative for hepatitis B on admission (9%). Acute lymphoblastic leukemia, lymphoma, and solid tumors were diagnosed in 5, 4, and 2 children, respectively. Complete seroconversion was achieved in 4-8 weeks after the last vaccination with high titers of anti-HBs antibody, and all patients remained antibody-positive until 6 months after the completion of chemotherapy. CONCLUSION The risk of transfusion-related infections increases with a number of transfused products and donor exposures, and it is more significant for immunosuppressed children with hematologic and oncologic malignancies. Hepatitis B vaccination could safely be applied with brisk and sustained responses in this vulnerable population, based on the local epidemiological data.
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Affiliation(s)
- Suheyla Ocak
- Department of Pediatric Hematology-Oncology, Istanbul University School of Medicine, Istanbul, Turkey
| | - Serap Karaman
- Department of Pediatric Hematology-Oncology, Istanbul University School of Medicine, Istanbul, Turkey
| | - Sema Vural
- Department of Pediatric Hematology-Oncology, University of Health Sciences, Sisli Research and Training Hospital, Istanbul, Turkey
| | - Gonca Keskindemirci
- Department of Social Pediatrics, Istanbul University School of Medicine, Istanbul, Turkey
| | - Deniz Tugcu
- Department of Pediatric Hematology-Oncology, Istanbul University School of Medicine, Istanbul, Turkey
| | - Aysegul Unuvar
- Department of Pediatric Hematology-Oncology, Istanbul University School of Medicine, Istanbul, Turkey
| | - Zeynep Karakas
- Department of Pediatric Hematology-Oncology, Istanbul University School of Medicine, Istanbul, Turkey
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Jiang M, Zhu B, Yao Q, Lou H, Zhang X. Anti-HBs levels in children under the age of two years born to HBV carrier mothers after immunoprophylaxis: a multicenter cross-sectional study. BMC Pediatr 2021; 21:492. [PMID: 34736435 PMCID: PMC8567679 DOI: 10.1186/s12887-021-02967-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 10/20/2021] [Indexed: 11/23/2022] Open
Abstract
Background Serological testing for the presence of Hepatitis B Virus (HBV) markers and anti-HBs titers in infants born to HBsAg positive women is critically important for estimation in immunisation programme. Methods This was a multi-center and cross-sectional study conducted in Zhejiang province, China. Children aged 7 to 24 months born to HBsAg positive women during December 2018 to February 2019, completed additional HBV serological markers screening. We indicated distribution of HBV serological markers and anti-HBs titers in children. Multiple logistic regression model with adjusted odds ratio and 95% confidence interval (ORadj and 95% CI) was used to explore the factors associated with inadequate immune response (anti-HBs titers< 100 mIU/ml) among children. Results A total of 1849 children were included. Overall 25 children tested HBsAg positive, giving HBsAg positive rate of 1.35%(95%CI: 0.83-1.88%). 92.00% (23/25) HBsAg positive children were delivered by HBeAg positive mothers. The proportion of protective seroconversion (anti-HBs titers≥10mIU/ml) was 99.29% in all children, and 86.48% children were reported with adequate anti-HBs titers (≥100mIU/ml).We found a significant higher proportions of early antenatal health care (< 13 gestational weeks), and term birth in children with adequate response compared with inadequate response (all P < 0.05). Logistic regression showed preterm birth was a negative factor for inadequate anti-HBs titers (ORadj = 1.868,95%CI 1.132-3.085,P = 0.015). Conclusions Children delivered by HBeAg positive mothers had higher risk of vertical transmission of HBV, despite completion of 3 doses of hepatitis B vaccine and HBIG injection. Inadequate anti-HBs level was significantly associated with preterm birth in HBsAg positive women.
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Affiliation(s)
- Min Jiang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17 Section 3, Renmin South Road, Chengdu, Sichuan, 610041, People's Republic of China
| | - Bo Zhu
- Department of Medical Laboratory Science, Women's Hospital, School of Medicine, Zhejiang University, Xueshi Road 1, Hangzhou, Zhejiang, 310006, People's Republic of China
| | - Qiang Yao
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17 Section 3, Renmin South Road, Chengdu, Sichuan, 610041, People's Republic of China
| | - Haifeng Lou
- Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Xueshi Road 1, Hangzhou, Zhejiang, 310006, People's Republic of China
| | - Xiaohui Zhang
- Department of Women's Health, Women's Hospital, School of Medicine, Zhejiang University, Xueshi Road 1, Hangzhou, Zhejiang, 310006, People's Republic of China.
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Tang J, Luo YQ, Zhou YH. Elimination of hepatitis B virus infection in children: experience and challenge in China. Chin Med J (Engl) 2021; 134:2818-2824. [PMID: 34636773 PMCID: PMC8667976 DOI: 10.1097/cm9.0000000000001791] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT Chronic hepatitis B virus (HBV) infection is a serious health issue because of its severe sequelae. Prevention of mother-to-child transmission (MTCT) of HBV is critical to eliminate chronic HBV infection. Here, we reviewed the progress toward the elimination of HBV infection in children in China in the recent decade. A universal hepatitis B vaccination program started from 2002 has been intensified, with the coverage of timely birth dose >95% of all newborn infants from 2012. Since 2011, China has taken a nationwide program to administer hepatitis B immunoglobulin (HBIG) with free of charge in all neonates of HBV-infected mothers, leading to a significant increment of timely use of HBIG. The prevalence of hepatitis B surface antigen (HBsAg) was declined from around 10% among children in 1980s to <0.5% among children born after 2011. Administration of oral antiviral agents in HBV-infected pregnant women with HBV DNA >2 × 105 U/mL during the third trimester is increasing, which will further reduce MTCT of HBV. However, there are some challenges in the elimination of HBV infection in children, which need to overcome by the concerted efforts. Nevertheless, it is anticipated that China will achieve the goal set by the World Health Organization that the prevalence of HBsAg in children aged <5 years is ≤0.1% by 2030.
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Affiliation(s)
- Jie Tang
- Department of Obstetrics and Gynecology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu 213017, China
- Department of Obstetrics and Gynecology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu 213017, China
| | - Yu-Qian Luo
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu 210008, China
| | - Yi-Hua Zhou
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu 210008, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu 210008, China
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Xu Y, Liu Y, Wang J, Che X, Zhang X, Jiang W, Du J, Zhang X, Gu W. Hepatitis B virus infection seromarkers among college freshmen and their immune responses to different vaccination policies of hepatitis B vaccine. Hum Vaccin Immunother 2021; 17:4587-4594. [PMID: 34407383 DOI: 10.1080/21645515.2021.1959829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND College students are one of the susceptible population of Hepatitis B virus (HBV) infection. We aim to delineate HBV infection seromarkers among college freshmen and to evaluate immunological response of vaccination immunization for hepatitis B vaccine (HepB). METHODS A simple random sampling method was adopted to select subjects and who met the "inclusion and exclusion criteria" and who with history of vaccination were selected as the observation objects. HBsAg and anti-HBs levels were detected before revaccination. Subjects with negative anti-HBs before immunization were inoculated with 20 ug HepB according to the 0-1-6 procedure and those with weak positive anti-HBs before immunization were inoculated with 1-dose 20 ug HepB. Anti-HBs levels were detected after HepB booster. Combined with the results of anti-HBs, their immune response to HepB and influencing factors in freshmen were investigated. Anti-HBs before immunization was negative and ≥10 m IU/ml after immunization was considered positive conversion; anti-HBs before immunization was weak positive and anti-HBs≥100 m IU/ml after immunization was also considered positive conversion. RESULTS A total of 10645 freshmen were included. The total rate of HBsAg carriers was 0.6% (63/10645), and the strong positive rate of anti-HBs was 16.1% (1706/10645), the weak positive rate was 14.4% (1526/10645).1286 freshmen were vaccinated with HepB and completed the questionnaire survey. About 79.0% (154/195) of freshmen's anti-HBs turned strong positive after receiving 1-dose HepB and 100.0% (1091/1091) turned positive after receiving 3-doses HepB. The Geometrical Mean Titer (GMT) of anti-HBs was significantly influenced by gender, registration and the immunization doses of HepB. CONCLUSION The HBsAg carrying rate and anti-HBs positive rate of college freshmen were low, and the HepB has a good effect on the immunity of college freshmen. Increasing the immunization rate of HepB is very important for the prevention and control of hepatitis B.
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Affiliation(s)
- Yuyang Xu
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yan Liu
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Jun Wang
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xinren Che
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xuechao Zhang
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Wei Jiang
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Jian Du
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xiaoping Zhang
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Wenwen Gu
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
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Kumar D, Srivastava S, Tevatia MS, Kaur K, Sood A, Manrai M, Mukerjee R. Hepatitis B vaccination in Indian children: Seroprotection and age-related change in antibody titres. Med J Armed Forces India 2020; 77:200-204. [PMID: 33867638 DOI: 10.1016/j.mjafi.2020.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 08/29/2020] [Indexed: 11/28/2022] Open
Abstract
Background Childhood immunization against hepatitis B is one of the most effective strategies for reducing the global burden of chronic hepatitis B infection and its sequelae. There are limited data from India on both the anti-Hep B antibody titres in children after vaccination and the age-related decline in the titres. This study was planned to estimate the proportion of children in the age group of 1-10 years who develop protective levels of anti-hepatitis B antibodies after childhood vaccination and to examine the change in antibody titres with age in these children. Methods A hospital-based cross-sectional study was carried out in children admitted to the hospital for various ailments. Basic demographic data, vaccination history and HBsAg status of the mother were recorded. All the enrolled children were evaluated for HBsAg and anti hepatitis B surface antibody (anti-HBS) titres. Institutional ethical clearance was obtained, and informed consent from the parents of the children was taken before drawing samples. Results We found that 68.86% Confidence Interval ((CI): 59.8-76.8%) of the children showed protective antibody titres after vaccination, while 31.14% (CI: 23.1-40.2%) of the children had titres less than 10 IU/L. Although 100% of children in the age group from birth to three years had titres more than 10 IU/L, this percentage showed a decline across the age groups, and 60% of children aged 9-10 years had titres less than 10 IU/L. Conclusion Childhood vaccination against hepatitis B is effective in 68% children, and the antibody levels showed a steady decline with increasing age.
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Affiliation(s)
- Dharmendra Kumar
- Senior Advisor (Medicine) & Gastroenterologist, Medical Division, Command Hospital (SC), Pune, India
| | - Sharad Srivastava
- Senior Advisor (Medicine) & Gastroenterologist, Medical Division, Command Hospital (SC), Pune, India
| | - M S Tevatia
- Consultant (Pathology), Command Hospital (SC), Pune, India
| | - Kanwaljit Kaur
- Classified Specialist (Pathology), Base Hospital Barrackpore, Kolkata, India
| | - Amit Sood
- Classified Specialist (Pediatrics), Command Hospital (WC), Chandimandir, India
| | - Manish Manrai
- Associate Professor, Dept of Internal Medicine, Armed Forces Medical College, Pune, India
| | - Reema Mukerjee
- Professor, Dept of Community Medicine, Armed Forces Medical College, Pune, India
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11
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Effect of hepatitis B surface antibody in patients with core antibody-positive liver transplantation: a systematic review and meta-analysis. Hepatol Int 2020; 14:202-211. [PMID: 32100260 DOI: 10.1007/s12072-020-10021-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 01/28/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIM There is an increased awareness of de novo hepatitis B virus (HBV) infection (DNH) in hepatitis B surface antigen (HBsAg)-negative recipients receiving hepatitis B core antibody (HBcAb)-positive liver organ. Whether hepatitis B surface antibody (HBsAb) has positive result on preventing the occurrence of DNH in HBcAb-positive liver graft recipients remains unknown. A meta-analysis was conducted to evaluate the effect of HBsAb on DNH in these patients. METHODS We sought published studies through August 29, 2019, in Medline and other sources that examined DNH in liver transplantation receptors with HBcAb-positive grafts. The rate of DNH was established in random-effects model meta-analyses. RESULTS In 36 studies involving 950 patients, the pooled incidence rate of DNH was 5% in patients with HBsAb positive versus 28.0% HBsAb negative. Prophylactic treatment has a significant impact on the occurrence of DNH in HBsAb-negative patients, no difference in hepatitis B immunoglobulin-combined and nucleos(t)ide analogues (NAs)-alone immunoprophylaxis. Unprotected HBV-naïve patients had the highest risk with DNH. CONCLUSION Immunoprophylaxis may need more consideration for HBsAb-positive patients receiving HBcAb-positive liver grafts. Active vaccination and mono-prophylaxis with NAs could be recommended in HBsAb-negative recipients against DNH. Further studies should examine the higher genetic barrier drugs for preventing DNH, and the association between DNH and HBV DNA-positive liver graft in this patient population.
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12
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Ng Y, Chua LAV, Cui L, Ang LW, Tee NWS, Lin RTP, Ma S, Lee VJM. Seroprevalence of vaccine-preventable diseases among children and adolescents in Singapore: Results from the National Paediatric Seroprevalence Survey 2018. Int J Infect Dis 2019; 92:234-240. [PMID: 31843668 DOI: 10.1016/j.ijid.2019.12.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 12/09/2019] [Accepted: 12/10/2019] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES The Ministry of Health (MOH), Singapore, conducted the National Paediatric Seroprevalence Survey 2018 (NPSS 2018) to estimate the latest immunity levels against measles, rubella, varicella, diphtheria, tetanus and hepatitis B, and the seroprevalence of chronic hepatitis B virus (HBV) carriage in children and adolescents in Singapore. METHODS The survey involved prospective collection of residual sera from 1,200 children and adolescents aged 1-17 years in two public acute hospitals. Enzyme-linked immunosorbent assays (EIA) or plague reduction neutralisation tests (PRNT) were used to determine the seroprevalence of the vaccine-preventable diseases. RESULTS Overall prevalence of measles and rubella antibodies among Singaporean children and adolescents aged 1-17 years were 98.2% (95% CI: 91.2-98.8%) and 94.8% (95% CI: 93.4-95.9%) respectively. 97.1% (95% CI: 96.0-97.9%) of subjects had at least basic protection against diphtheria, while 89.3% (95% CI: 87.5-91.0%) were protected against tetanus. The prevalence of chronic HBV carriage was 0.4% (95% CI: 0.2-1.0%), while 45.7% (95% CI: 42.9-48.5%) were immune against HBV. The seroprevalence for varicella antibodies was 52.9% (95% CI: 50.1-55.7%). Concordance between vaccination status and seroprevalence was observed for measles, rubella, diphtheria and tetanus. CONCLUSION Singapore's children and adolescents are well-protected against measles, rubella, diphtheria and tetanus. Continual efforts in ensuring high vaccination coverage should be sustained.
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Affiliation(s)
- Yixiang Ng
- Epidemiology and Disease Control Division, Ministry of Health, Singapore
| | - Lily Ai Vee Chua
- Epidemiology and Disease Control Division, Ministry of Health, Singapore.
| | - Lin Cui
- National Public Health Laboratory, National Centre for Infectious Diseases, Singapore
| | - Li Wei Ang
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, Singapore
| | - Nancy Wen Sim Tee
- National Public Health Laboratory, National Centre for Infectious Diseases, Singapore
| | - Raymond Tzer Pin Lin
- National Public Health Laboratory, National Centre for Infectious Diseases, Singapore
| | - Stefan Ma
- Epidemiology and Disease Control Division, Ministry of Health, Singapore
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13
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Chung S, Roh EY, Park B, Lee Y, Shin S, Yoon JH, Song EY. GWAS identifying HLA-DPB1 gene variants associated with responsiveness to hepatitis B virus vaccination in Koreans: Independent association of HLA-DPB1*04:02 possessing rs1042169 G - rs9277355 C - rs9277356 A. J Viral Hepat 2019; 26:1318-1329. [PMID: 31243853 DOI: 10.1111/jvh.13168] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 05/07/2019] [Accepted: 05/15/2019] [Indexed: 02/06/2023]
Abstract
Recently, HLA class II loci, including HLA-DPB1, have been reported to be associated with interindividual variance in the hepatitis B (HB) vaccine response. In this study, we investigated significant single nucleotide polymorphisms (SNPs) for anti-HBs antibody levels in 6867 healthy Koreans using a genome-wide association study (GWAS). In GWAS, the top 20 SNPs that showed significant association with anti-HBs levels (P < 1.0 × 10-29 ) all resided in HLA-DPB1. Utilizing PCR sequencing, we verified the relationship of the top 3 most significant SNPs (rs1042169, rs9277355 and rs9277356) from the GWAS and genotypes of HLA-DPB1 with the HB vaccine response in Korean infants who received a scheduled vaccination. The DPB1*04:02 allele has G, C and A nucleotides for the 3SNP sites, and was significantly more frequent in responders than in nonresponders (10.9% vs 1.0%, Pc = 0.018). DPB1*05:01 was significantly more frequent in nonresponders than in responders (49.0% vs 31.1%, Pc = 0.018). In multivariate logistic regression, DPB1*04:02 showed a significant association with both vaccine response (P = 0.037, OR = 8.465) and high-titre response (P = 0.027, OR = 9.860). The haplotypes rs1042169 G - rs9277355 C - rs9277356 A showed a significant association with a high-titre response only (P = 0.002, OR = 2.941). In conclusion, DPB1*04:02 possessing rs1042169 G - rs9277355 C - rs9277356 A is an independent predictor of the HB vaccine response in Koreans.
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Affiliation(s)
- Soie Chung
- Department of Laboratory Medicine and Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eun Youn Roh
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Laboratory Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.,Seoul Metropolitan Public Cord Blood Bank-ALLCORD, Seoul, Republic of Korea
| | - Boram Park
- Department of Public Health Sciences, Seoul National University, Seoul, Republic of Korea
| | - Yunhwan Lee
- Department of Public Health Sciences, Seoul National University, Seoul, Republic of Korea
| | - Sue Shin
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Laboratory Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.,Seoul Metropolitan Public Cord Blood Bank-ALLCORD, Seoul, Republic of Korea
| | - Jong Hyun Yoon
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Laboratory Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.,Seoul Metropolitan Public Cord Blood Bank-ALLCORD, Seoul, Republic of Korea
| | - Eun Young Song
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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14
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Differences in Antibodies Against Blood Group, HBV, and Salmonella Regarding Protein Content, Activity, and Affinity in Black and Yellow Healthy Individuals. Jundishapur J Microbiol 2019. [DOI: 10.5812/jjm.94687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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15
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Yang YT, Huang AL, Zhao Y. The prevalence of hepatitis B core antibody in vaccinated Chinese children: A hospital-based study. Vaccine 2018; 37:458-463. [PMID: 30527659 DOI: 10.1016/j.vaccine.2018.11.067] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 11/20/2018] [Accepted: 11/21/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND & AIMS After nearly 30 years of immunization, there is little known about the prevalence of hepatitis B core antibody (anti-HBc) in Chinese children. The clinical significance of anti-HBc would be more and more important. In this study, we had tried to analyse the prevalence of anti-HBc in vaccinated Chinese children, exploring the post-immunization status based on a large sample sized investigation. METHODS Proportions of anti-HBc were analysed among 215,627 hospitalized Chinese children immunized with HBV vaccination in this study. RESULTS The proportions of anti-HBc were divided into 3 stages: 36.6% in 0-year-old group, followed by 1- to 10-year-old which stayed relatively stable (5.69 ± 0.40%, [4.86-6.28%]), and significant increasing within 11- to 16-year-old (7.80 ± 1.24%, [6.62-9.74%]), meanwhile, similar changes of HBsAg were showed in the corresponding ages, and significantly increased in children older than 9-year (1.40%, [1.00-2.04%]), comparing with 0.30% in 0-year-old, 0.55 ± 0.13% (0.30-0.64%) in 1- to 9-year-old. The average level of anti-HBc maintains 5.99% in children aged 1- to 16-year with 0.63% for HBsAg. CONCLUSION This is the first study of the prevalence of anti-HBc in vaccinated Chinese children: 36.6% of anti-HBc-positivity was found in 0-year-old group, which could be maternal in origin. Relatively high prevalence of anti-HBc may not be ignored in children aged 1- to 16-year-old. Strangely, our data also showed that HBV breakthrough infection would occur in immunized Chinese children older than 9-year-old, and more attention is needed on those children.
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Affiliation(s)
- Yu-Ting Yang
- Research Center for Immunologic and Infectious Diseases, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - Ai-Long Huang
- Institute for Viral Hepatitis, Ministry of Education Key Laboratory of Molecular Biology on Infectious Diseases, Chongqing Medical University, Chongqing, China
| | - Yao Zhao
- Research Center for Immunologic and Infectious Diseases, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
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16
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Zhou Y, Zhou YH. Is revaccination required in children who received a full primary vaccination against hepatitis B in infancy? A letter in response to Changes and analysis of anti-HBs titres after primary immunization in 1-to 16-year-old Chinese children: A hospital-based study. J Viral Hepat 2018; 25:1220. [PMID: 29851210 DOI: 10.1111/jvh.12941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- Y Zhou
- Department of Infectious Diseases, Yixing People's Hospital, Yixing, Jiangsu, China
| | - Y-H Zhou
- Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital and Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, Jiangsu, China
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