A survey on the vaccination practice for perinatal hepatitis B virus infection at a clinic in Okinawa, Japan

Comparison of Two Hepatitis B Vaccination Strategies Targeting Vertical Transmission: A 10-Year Japanese Multicenter Prospective Cohort Study

In 1985, a hepatitis B (HB) vaccination strategy against vertical HB virus transmission was introduced in Japan that recommended vaccination of infants at two, three, and five months of age (delayed strategy). This schedule was revised in 2013, recommending to vaccinate at birth and at 1 and 6 months of age (non-delayed strategy). We aimed to compare the vertical HB virus transmission rates and immunogenic responses between these two vaccination strategies. This Japanese multicenter prospective cohort study included 222 infants born between 2008 and 2017 to serum hepatitis B surface (HBs) antigen (HBsAg)-positive mothers. During the study period, 136 and 86 infants received delayed and non-delayed strategies, respectively. A positive vertical HB virus transmission was defined as a positive serum HBsAg status. Seropositive immunogenic response was defined as a serum anti-HBs titer of ≥10 mIU/mL. Post-vaccination serum HBsAg positivity rates did not differ significantly between the delayed (0/136 [0.0%, 95% confidence interval, 0.0–2.7%]) and non-delayed (2/86 [2.3%, 95% confidence interval, 0.3–8.1%]) strategy groups. Seropositive immunogenic response rates were 100.0% (136/136) and 97.7% (84/86), respectively. Although this study was under-powered to detect a statistically significant result, no vertical HB virus transmission was observed in the delayed strategy.

Japanese original delayed hepatitis B vaccination provides adequate immunogenicity against mother-to-child hepatitis B virus infection in preterm infants: A nationwide survey in Japan

OBJECTIVE

We aimed to evaluate immunogenicity following Japanese original delayed hepatitis B (HB) vaccinations for prevention of mother-to-child HB infection in preterm infants.

METHODS

A nationwide survey in Japan was conducted at certified neonatology facilities in 2014. Eighty-four preterm infants born from a serum hepatitis B surface (HBs) antigen-positive mother were included. We collected data on the following parameters: gestational age, birth weight (BW), age at HB vaccination, age at examination of serum anti-HBs titer, and serum anti-HBs titer. The delayed HB vaccination schedule was 3 doses of HB vaccines at 2, 3 and 5 months of age. A seropositive immunogenic response to HB vaccination was defined as an anti-HBs titer ≥10 mIU/mL. Seropositive rates were calculated in all participants. Four subgroups based on BW were as follows: <1000 g (n = 13), 1000-1499 g (n = 16), 1500-1999 g (n = 26), and ≥2000 g (n = 29).

RESULTS

Among 84 preterm infants who completed the delayed vaccination schedule, 82 (98%) achieved seropositive anti-HBs titer at a median age of 6 months. Seropositive rates of infants <1000 g, 1000-1499 g, 1500-1999 g, and ≥2000 g were 92%, 94%, 100%, and 100%, respectively.

CONCLUSION

The Japanese original delayed HB vaccinations achieved sufficient seropositive rates in preterm infants and provide immunogenicity against mother-to-child HB infection.

Epidemiology and prophylaxis of viral hepatitis: a global perspective

BACKGROUND

Viral hepatitis with various forms of acute and chronic liver disease as potential and ultimately fatal sequelae presents a public health problem worldwide.

METHODS

Recent published reports on the global epidemiology and prophylaxis of viral hepatitis were reviewed.

RESULTS

With the advances in novel technologies, eight distinct types of hepatitis virus have been described: Hepatitis A, B, C, D, E, G, TT and SEN viruses. Hepatitis A and E viruses are transmitted by the fecal-oral route and do not induce a chronic carrier state. Due to major changes in epidemiology of hepatitis A virus their significance is more pronounced in areas of intermediate endemicity. Since the available hepatitis A vaccine is rather expensive, cost-benefit studies should be performed with emphasis on the area under consideration or specialized vulnerable groups. Parenterally transmitted hepatitis B and C viruses are major causes of chronic liver disease, including cirrhosis, hepatocellular carcinoma and end-stage liver failure. Hepatitis D virus is unable to replicate on its own, it requires an established hepatitis B virus infection to be able to replicate. Since its introduction, hepatitis B vaccine has been widely used leading to a significant decrease in HBV infection in countries with universal vaccination. Hepatitis G and TT viruses have been characterized within the latter part of the past decade but their significance as to the causation of human liver disease has yet to be elucidated. Likewise, the precise impact of the most recently described SEN virus isolated from patients with post-transfusion hepatitis awaits further studies.

CONCLUSIONS

In the course of this review, we present the situation and focus on research activities emphasizing epidemiology and prevention of the various forms of viral hepatitis.