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Langat B, Muge EK, Night D, Okoth F, Ochwedo KO, Songok EM. Sero-prevalence of hepatitis B virus and compliance with hepatitis B vaccination schedules among outpatient clinic attendees in Nairobi. PLoS One 2023; 18:e0281256. [PMID: 36730277 PMCID: PMC9894478 DOI: 10.1371/journal.pone.0281256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/18/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Hepatitis B is becoming a growing public health problem in Kenya. To combat the threat, HBV vaccination should be recommended, particularly for individuals who are not covered by the national immunization program. Vaccination provides sero-protection rates approaching 95% among healthy adults after completing the three-dose vaccination course, but decreases to 87% among those who receive only two doses, emphasizing the importance of completing the three-dose vaccination course. However, data on adult adherence to HBV multi-dose vaccines in Sub-Saharan Africa are limited, despite the fact that this information is critical for prevention. As a result, more research on HBV vaccine dose completion is required. The purpose of this study is to estimate the prevalence of hepatitis B virus infection among out-patient clinic attendees in Nairobi, Kenya, as well as to identify beneficiaries of free vaccination and barriers to completing the recommended vaccine doses. METHODS Between July 30th and September 30th, 2015, 2644 outpatient clinic attendees aged ≥ 4 were recruited from three hospitals in Nairobi County, Kenya: Mama Lucy, Riruta, and Loco. Self-administered questionnaires were used to collect socio-demographic information, and blood samples were tested for hepatitis B surface antigen (HBsAg) using the KEMRI HEPCELL Rapid® (Hepatitis B Detection kit) test kit. Individuals who tested negative for HBsAg were given a free course of three doses of HBV vaccine. The vaccination register provided information on the number of doses administered. RESULTS The average age of the study population was 31.4 years (range: 4-66), with females accounting for 59.2%. 1.82% (48/2644) of the participants tested positive for HBsAg. Among the 2596 individuals eligible for vaccination, 66% (1720/2596) received at least one dose, and 51.8% (1345/2596) received all three doses. Vaccination acceptance increased with age, with older patients more likely to return for subsequent dose (OR>1 for second and third dose). Unavailability and failure to contact client were cited as significant (p<0.0001) barrier to vaccination completion by 53.7% (666/1226, 95% CI 0.5-0.6) and 37% (454/1226, 95% CI 0.3-0.4) of respondents respectively. CONCLUSION The prevalence of HBV infection among outpatient clinic attendees highlights the importance of expanding HBV immunization programs in Kenya. However, given the low vaccination completion rate, there is a need for public awareness of the vaccine's importance in preventing HBV and HBV-related complications.
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Affiliation(s)
- Benard Langat
- Department of Medical Biochemistry, University of Nairobi, Nairobi, Kenya
- * E-mail:
| | - Edward K. Muge
- Department of Medical Biochemistry, University of Nairobi, Nairobi, Kenya
| | - Doris Night
- Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Fredrick Okoth
- Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Kevin O. Ochwedo
- Faculty of Science and Technology, Department of Biology, University of Nairobi, Nairobi, Kenya
| | - Elijah M. Songok
- Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya
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Romano’ L, Zanetti AR. Hepatitis B Vaccination: A Historical Overview with a Focus on the Italian Achievements. Viruses 2022; 14:v14071515. [PMID: 35891495 PMCID: PMC9320049 DOI: 10.3390/v14071515] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/08/2022] [Accepted: 07/08/2022] [Indexed: 11/16/2022] Open
Abstract
Vaccination is the most effective way to control and prevent acute and chronic hepatitis B, including cirrhosis and HCC, on a global scale. According to WHO recommendations, 190 countries in the world have introduced hepatitis B vaccination into their national childhood immunization programs with an excellent profile of safety, immunogenicity, and effectiveness. Following vaccination, seroprotection rates are close to 100% in healthy children and over 95% in healthy adults. Persistence of anti-HBs is related to the antibody peak achieved after vaccination. The peak is higher the longer the antibody duration is. Loss of anti-HBs does not necessarily mean loss of immunity since most vaccinated individuals retain immune memory for HBsAg and rapidly develop strong anamnestic responses when boosted. Evidence indicates that the duration of protection can persist for at least 35 years after priming. Hence, booster doses of vaccines are currently not recommended to sustain long-term immunity in healthy vaccinated individuals. In Italy, vaccination against hepatitis B is met with success. In 2020, Italy became one of the first countries in Europe to be validated for achieving the WHO regional hepatitis B control targets.
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Ewe KYH, Blyth CC, McLeod C, Borland ML, Bowen AC, Yeoh DK, Campbell AJ. Re-examining Hepatitis B Postexposure Prophylaxis Following Pediatric Community-acquired Needle-stick Injury in an Era of a National Immunization Registry. Pediatr Infect Dis J 2022; 41:80-84. [PMID: 34862347 DOI: 10.1097/inf.0000000000003350] [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] [Indexed: 11/25/2022]
Abstract
BACKGROUND Long-term hepatitis B immunity has been demonstrated following the completion of the primary vaccination series in childhood. Some guidelines recommend a hepatitis B surface antibody (anti-HBs) directed approach following community-acquired needle-stick injury (CANSI) to inform hepatitis B postexposure prophylaxis (PEP) management. We assessed the utility of anti-HBs testing post-CANSI, as well as the costing of, and adherence to PEP at a pediatric hospital. METHODS Children presenting to an Australian tertiary pediatric hospital post-CANSI (2014-2019) were identified retrospectively using medical and laboratory records. Immunization status was obtained from the Australian Immunisation Registry. RESULTS Fifty-six children with CANSI were identified. Of those with immunization records, all had completed hepatitis B vaccinations (n = 52). At presentation, 44% (n = 23) had anti-HBs <10 IU/L, which was more likely in older (≥6 years, 68%) versus younger children (OR 4.59, P < 0.02). HBIG and hepatitis B vaccine adherence was 65% (15/23) and 78% (18/23), respectively. All children (n = 14) with anti-HBs ≥4 weeks postvaccination ±HBIG, demonstrated an anamnestic response. No hepatitis B infections were detected. Using completed immunizations versus anti-HBs levels as a marker of immunity to direct PEP resulted in a projected cost savings of AUD$ 4234. CONCLUSION Anti-HBs levels <10 IU/L, despite previous vaccinations, were frequent in children post-CANSI, with many demonstrating an anamnestic response. Adherence to postexposure HBIG and hepatitis B vaccine was suboptimal using an anti-HBs directed approach. These data support re-evaluating PEP in an era of the national immunization registry; completion of hepatitis B vaccinations as a marker of immunity provides a practical approach, ensuring optimized care for pediatric CANSI.
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Affiliation(s)
- Krist Y H Ewe
- From the Department of Infectious Diseases, Perth Children's Hospital, Nedlands, Australia
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Australia
| | - Christopher C Blyth
- From the Department of Infectious Diseases, Perth Children's Hospital, Nedlands, Australia
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia
- PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, Western Australia
| | - Charlie McLeod
- From the Department of Infectious Diseases, Perth Children's Hospital, Nedlands, Australia
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia
| | - Meredith L Borland
- School of Medicine, University of Western Australia, Perth, Western Australia
- Department of Emergency Medicine, Perth Children's Hospital, Nedlands, Australia
| | - Asha C Bowen
- From the Department of Infectious Diseases, Perth Children's Hospital, Nedlands, Australia
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia
| | - Daniel K Yeoh
- From the Department of Infectious Diseases, Perth Children's Hospital, Nedlands, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria
| | - Anita J Campbell
- From the Department of Infectious Diseases, Perth Children's Hospital, Nedlands, Australia
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia
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Anutebeh EN, Tatah L, Feteh VF, Aroke D, Assob JCN, Choukem SP. Immune response to hepatitis B vaccine following complete immunization of children attending two regional hospitals in the Southwest region of Cameroon: a cross sectional study. BMC Infect Dis 2021; 21:1205. [PMID: 34856942 PMCID: PMC8641163 DOI: 10.1186/s12879-021-06913-y] [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: 06/09/2021] [Accepted: 11/15/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) infection despite being a vaccine preventable disease remains a global public health problem. In Cameroon, the hepatitis B vaccine was introduced in the expanded program on immunisation in 2005, but there has been limited evaluation of the HBV surface antibody response post vaccination. OBJECTIVE We investigated the immune response to hepatitis B vaccine in infants who received the DPT-Hep B-Hib vaccine, and we assessed HBsAg carriage in non-responders. We also investigated factors associated with non-response or poor response. METHODS Using a hospital based cross sectional design and a structured questionnaire over a four-month period (January to April 2019), we collected data to determine factors associated with hepatitis B surface antibody (anti-HBs) response from infants aged 6 to 9 months attending infant welfare clinics (IWC) at the Buea and Limbe regional hospitals. We collected venous blood and measured anti-HBs titres using a quantitative Foresight® ELISA. We entered and analysed data using EpiData version 3.1 and SPSS version 25 respectively. RESULTS Of the 161 infants enrolled, 159 (98.8%) developed anti-HBs antibodies. Of these 159, 157 (97.5%) and 117 (72.7%) developed ≥ 10.0 mIU/ml (seroprotection) and ≥ 100.0 mIU/ml anti-HBs titres respectively. Being younger (6 months old) was associated with seroprotection (Cramer V = 0.322, p = 0.001). Spearman rho's relational analysis showed that immunity against HBV reduced as the duration since the last dose increased (r = -0.172; P = 0.029). However, a Firth logistic regression showed no significant association of factors with inadequate immunity. All 12 (7.5%) infants exposed to HBV at birth, received the hepatitis B vaccine at birth, including four who received HBIG, and all were protected. Four infants (2.5%) had anti-HBs titres < 10.0 mIU/mL (non-responders) but had no peculiarity. CONCLUSION The seroprotective rate following hepatitis B vaccination of infants is high even in exposed infants. Our study suggests that Cameroon's HBV vaccine in the Expanded Program on Immunisation (EPI) is effective against HBV, although we could not account for the 2.5% non-response rate. Large scale studies are needed to further explore non-response to the vaccine.
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Affiliation(s)
- Ephesians N Anutebeh
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
- Health and Human Development (2HD) Research Network, Douala, Cameroon
| | - Lambed Tatah
- Health and Human Development (2HD) Research Network, Douala, Cameroon
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Vitalis F Feteh
- Health and Human Development (2HD) Research Network, Douala, Cameroon
- Nuffield Department of Medicine, Big Data Institute, University of Oxford, Oxford, UK
| | - Desmond Aroke
- Health and Human Development (2HD) Research Network, Douala, Cameroon
- Newark Beth Israel Medical Centre, Newark, NJ, USA
- African Journal of Integrated Health, Buea, Cameroon
| | - Jules C N Assob
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
- African Journal of Integrated Health, Buea, Cameroon
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Simeon Pierre Choukem
- Faculty of Health Sciences, University of Buea, Buea, Cameroon.
- Health and Human Development (2HD) Research Network, Douala, Cameroon.
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon.
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van den Ende C, Marano C, van Ahee A, Bunge EM, De Moerlooze L. The immunogenicity of GSK’s recombinant hepatitis B vaccine in children: a systematic review of 30 years of experience. Expert Rev Vaccines 2017; 16:789-809. [DOI: 10.1080/14760584.2017.1338569] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
| | | | - Ayla van Ahee
- Pallas Health Research and Consultancy, Rotterdam, The Netherlands
| | - Eveline M. Bunge
- Pallas Health Research and Consultancy, Rotterdam, The Netherlands
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Catherine FX, Piroth L. Hepatitis B virus vaccination in HIV-infected people: A review. Hum Vaccin Immunother 2017; 13:1-10. [PMID: 28267387 PMCID: PMC5489285 DOI: 10.1080/21645515.2016.1277844] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 12/16/2016] [Accepted: 12/24/2016] [Indexed: 12/21/2022] Open
Abstract
HBV immunization is highly recommended in people infected with HIV. However, the classical schedule used in the general population has been shown to be insufficient in people living with HIV. This review summarizes the main studies dealing with HBV vaccination in people living with HIV, depending on their baseline status (in particular, never vaccinated, already vaccinated, or with an isolated anti-HBc serological profile). It shows that reinforced 40µg intramuscular HBV vaccination schedules are now frequently recommended, either initially in people never vaccinated, or in the lack of an anamnestic response in other situations. Adjuvants cannot be currently recommended. Anti-HBs titers have to be checked 1 to 2 months following the last vaccine dose, and annually thereafter a booster is necessary if antiHBs titers decrease below 10 mIU/mL. In patients with a CD4 cell count <200/µL, guidelines recommend starting the vaccination regimen as soon as possible after HAART has been started.
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Chang MS, Nguyen MH. Epidemiology of hepatitis B and the role of vaccination. Best Pract Res Clin Gastroenterol 2017; 31:239-247. [PMID: 28774405 DOI: 10.1016/j.bpg.2017.05.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 05/16/2017] [Accepted: 05/31/2017] [Indexed: 02/06/2023]
Abstract
Hepatitis B virus (HBV) is a major cause of morbidity and mortality with a disproportionate impact on Asia and Africa. Current guidelines recommend screening at-risk populations for chronic HBV infection so that diagnosed individuals can be linked to appropriate hepatitis care. The vast majority of infected individuals are undiagnosed and untreated, and are at risk of developing cirrhosis, liver failure, and hepatocellular carcinoma. In individuals who are not yet infected, the HBV vaccine is safe and highly effective at preventing disease transmission. Countries with successful vaccination programs have been able to dramatically reduce their HBV prevalence. A concerted effort to screen, treat, and vaccinate at-risk individuals has the potential to eliminate HBV as a public health threat by 2030.
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Affiliation(s)
- Matthew S Chang
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, 300 Pasteur Drive, Palo Alto, CA 94304, USA.
| | - Mindie H Nguyen
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, 300 Pasteur Drive, Palo Alto, CA 94304, USA.
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Lankester FJ, Wouters PAWM, Czupryna A, Palmer GH, Mzimbiri I, Cleaveland S, Francis MJ, Sutton DJ, Sonnemans DGP. Thermotolerance of an inactivated rabies vaccine for dogs. Vaccine 2016; 34:5504-5511. [PMID: 27729174 DOI: 10.1016/j.vaccine.2016.10.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 09/28/2016] [Accepted: 10/03/2016] [Indexed: 12/24/2022]
Abstract
This study provides the first robust data that the antibody response of dogs vaccinated with Nobivac® Rabies vaccine stored for several months at high temperatures (up to 30°C) is not inferior to that of dogs vaccinated with vaccine stored under recommended cold-chain conditions (2-8°C). A controlled and randomized non-inferiority study was carried out comparing the four-week post vaccination serological responses of Tanzanian village dogs inoculated with vaccine which had been stored at elevated temperatures for different periods of time with those of dogs vaccinated with the same product stored according to label recommendations. Specifically, the neutralizing antibody response following the use of vaccine which had been stored for up to six months at 25°C or for three months at 30°C was not inferior to that following the use of cold-chain stored vaccine. These findings provide reassurance that the vaccine is likely to remain efficacious even if exposed to elevated temperatures for limited periods of time and, under these circumstances, it can safely be used and not necessarily destroyed or discarded. The availability of thermotolerant vaccines has been an important factor in the success of several disease control and elimination programs and could greatly increase the capacity of rabies vaccination campaigns to access hard to reach communities in Africa and Asia. We have not confirmed a 3-year duration of immunity for the high temperature stored vaccine, however because annual re-vaccination is usually practiced for dogs presented for vaccination during campaigns in Africa and Asia this should not be a cause for concern. These findings will provide confidence that, for rabies control and elimination programs using this vaccine in low-income settings, more flexible delivery models could be explored, including those that involve limited periods of transportation and storage at temperatures higher than that currently recommended.
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Affiliation(s)
- Felix J Lankester
- Paul G. Allen School for Global Animal Health, Washington State University, 240 SE Ott Road, Pullman, WA 99164-7090, USA; Serengeti Health Initiative, Serengeti, Tanzania.
| | | | - Anna Czupryna
- Serengeti Health Initiative, Serengeti, Tanzania; Lincoln Park Zoo, 2001 N. Clark St., Chicago, IL 60614, USA
| | - Guy H Palmer
- Paul G. Allen School for Global Animal Health, Washington State University, 240 SE Ott Road, Pullman, WA 99164-7090, USA
| | | | - Sarah Cleaveland
- Boyd Orr Centre for Population and Ecosystem Health, Institute for Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Mike J Francis
- MSD Animal Health, Walton Manor, Walton, Milton Keynes MK7 7AJ, UK
| | - David J Sutton
- MSD Animal Health, Walton Manor, Walton, Milton Keynes MK7 7AJ, UK
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Abstract
PURPOSE OF REVIEW Hepatitis B virus (HBV) infection contributes significantly to vaccine-preventable disease related deaths, and insufficient HBV immunity may have unique implications for the pediatric liver transplant population. This article reviews the significance of HBV infection and the vaccination and screening measures needed to achieve adequate HBV immunity in these children. RECENT FINDINGS HBV non-immunity among transplant candidates is higher than expected, even after appropriate completion of the vaccine series. Annual measurement of quantifiable HBV surface antibody in this vulnerable group should guide administration of booster and/or re-vaccination, improving immunoprotection from this potentially deadly hepatotropic virus. The liver plays a vital role in immune regulation; it induces immune tolerance and competence and both clears antigens from the circulation and generates liver-primed memory cells through antigen presentation via hepatic scavenger cells. Lymphocyte populations are depleted in patients with liver disease. SUMMARY Immunity provided during early childhood against HBV infection is important to both pediatric liver transplant candidates and aging recipients. Appropriate vaccination and achievement of adequate immunity pre-transplant and post-transplant is critical. The field of pediatric transplantation is ripe for functional cellular and humoral immunity studies that examine factors which predict poor immune response to childhood vaccines, particularly HBV.
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Quantification of Transfusion Recipients at Risk of Receiving Hepatitis B Virus-Contaminated Blood Components: A Korean Study. Indian J Hematol Blood Transfus 2016; 32:312-9. [PMID: 27429524 DOI: 10.1007/s12288-015-0564-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 06/18/2015] [Indexed: 10/23/2022] Open
Abstract
Although there are lots of studies about the risk for the hepatitis B virus infection such as the residual risk for donated blood, there is no research on the risk of HBV infection, from the viewpoint of recipients in Korea. Using the data about HBsAg status of donated blood in 2008 and 2009, the distribution of blood components from the claim data of health insurance in 2009, the distribution of HBsAg and HBsAb of recipients, and some assumptions, we quantified the number of recipients in Korea that might be expected to receive HBV-contaminated blood components, as a proxy index for HBV infection by transfusion in 2009. Of the 376,211 recipients, the number who might be expected to receive blood components with HBV in 2009 was 23.2 (95 % CI 13.6, 36.8) in the basic model, 43.2 (95 % CI 25.4, 68.7) in extended model I, 55.2 (95 % CI 32.5, 87.7) in extended model II and 101.6 (95 % CI 59.8, 161.4) in extended model III. The number of HBV-positive samples per 100,000 transfused units was 0.6 in the basic model (95 % CI 0.3, 0.9), 1.1 in extended model I (95 % CI 0.6, 1.8), 1.4 in extended model II (95 % CI 0.8, 2.2), and 2.6 in extended model III (95 % CI 1.5, 4.1). This study showed that a few recipients might receive HBV-contaminated blood component by transfusion. These results could be used as a scientific evidence for health policy on HBV transfusion infection.
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Sami SM, Salama II, Abdel-Latif GA, El Etreby LA, Metwally AI, Abd El Haliem NF. Hepatitis B Seroprotection and the Response to a Challenging Dose among Vaccinated Children in Red Sea Governorate. Open Access Maced J Med Sci 2016; 4:219-25. [PMID: 27335590 PMCID: PMC4908735 DOI: 10.3889/oamjms.2016.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 03/25/2016] [Accepted: 03/26/2016] [Indexed: 01/05/2023] Open
Abstract
AIM: To assess the long-term effectiveness of hepatitis B virus vaccine and the need for a booster dose among children who received three doses of vaccine during infancy in Red Sea Governorate. METHODS: A cross-sectional study was performed. Interviews with children (9 months to 16 years) and parents were done. Blood samples to assess Hepatitis B markers were tested. Children showing no seroprotection received a booster dose to assess their anamnestic response after four weeks and one year later. RESULTS: None of the participants had evidence of chronic Hepatitis B. The seroprotection rate was 23.3% and it significantly decreased with age. Multivariate logistic analysis revealed that older age was the significant predicting variable for having no seroprotective level, while baseline anti-HBs level < 3.3 IU/L was the predicting variable for not developing early anamnestic response or loss of late anamnestic response. CONCLUSION: Long-term immunity persists among children who received complete series of hepatitis B vaccination during infancy even in absence or reduction of anti-HBs over time. Therefore, a booster dose is not necessary to maintain immunity till the age of sixteen.
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Affiliation(s)
- Samia M Sami
- National Research Center, Child Health, Cairo, Egypt
| | - Iman I Salama
- National Research Center, Community Medicine Research, Cairo, Egypt
| | | | | | - Ahmed I Metwally
- National Research Center, Community Medicine Research, Cairo, Egypt
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12
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Immunity to hepatitis B persists in adolescents 15-16 years of age vaccinated in infancy with three doses of hepatitis B vaccine. Vaccine 2016; 34:2745-9. [PMID: 27095043 DOI: 10.1016/j.vaccine.2016.04.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 04/06/2016] [Accepted: 04/06/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Vaccination of infants against hepatitis B virus (HBV) using hepatitis B vaccine is effective in preventing the infection during early childhood and there is a growing evidence of long-term protection. So far, no need for a booster dose has been identified in healthy subjects; however further follow-up continues to determine the exact duration of protection. We evaluated antibody persistence and immune response to a hepatitis B vaccine challenge dose in children aged 15-16 years, previously vaccinated with 3-doses of the same vaccine in infancy (third dose received before 18 months of age). METHODS A single hepatitis B vaccine challenge dose containing 10μg hepatitis B surface (HBs) antigen was administered to adolescents aged 15-16 years. Blood samples were taken before and one month after the challenge dose to measure anti-HBs antibodies using a chemiluminescence immunoassay. Solicited local and general symptoms, as well as unsolicited and serious adverse events were recorded after the challenge dose. RESULTS 303 subjects were enrolled, of whom 302 and 293 subjects formed the total vaccinated and according-to-protocol cohorts, respectively. Pre-challenge, 65.4% (95% CI: 59.6-70.9) subjects were seroprotected (anti-HBs antibody concentration ≥10mIU/mL). One month post-challenge, 97.9% (95% CI: 95.6-99.2) were seroprotected, while 90.8% (95% CI: 86.8-93.8) had anti-HBs antibody concentrations ≥100mIU/mL. The post-challenge geometric mean concentration (GMC; 4134.9 [95% CI: 3114.2-5490.1]) was 150-fold higher than the pre-challenge GMC. Overall, 96.9% (95% CI: 94.2-98.6) subjects mounted an anamnestic response. The safety and reactogenicity profile of the hepatitis B vaccine challenge dose was consistent with previous experience. CONCLUSIONS Immunity to hepatitis B persists in 15-16 year old adolescents following primary vaccination in infancy. TRIAL REGISTRATION http://www.clinicaltrials.govNCT01847430.
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Dumaidi K, Al-Jawabreh A. Persistence of Anti-HBs Among Palestinian Medical Students After 18 - 22 Years of Vaccination: A Cross-Sectional Study. HEPATITIS MONTHLY 2015; 15:e29325. [PMID: 26834785 PMCID: PMC4717190 DOI: 10.5812/hepatmon.29325] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 08/15/2015] [Accepted: 08/29/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Hepatitis B infection is a global public health problem affecting various sectors in the society. Vaccination is the first line measure to prevent the disease. OBJECTIVES To assess the persistence of anti-HBs marker among medical students after 18 - 22 of vaccination as an indicator for Hepatitis B virus vaccine efficacy. PATIENTS AND METHODS In this study, 249 Palestinian medical students vaccinated at birth, 1, and 6 months of age using Engerix™-B starting from 1992 were studied. About 58% (144/249) of the students were Palestinians holding Israeli citizenship, while 42% (105/249) were Palestinians from the West Bank. Students were tested serologically for anti-HBs, as a marker for vaccine-induced immunity. RESULTS Over 75% (188/248) of students had levels of anti-HBs greater than 10 mIU/mL indicating immunity and protection. Five cases had positive results for anti-HBc indicating exposure to HBV infection; however, none of these cases showed any sign of HBV-DNA indicating effective clearance of the virus by the vaccine. Around 57% of the study group had anti-HBs level of 100 - 1000 mIU/mL. No significant association was found between anti-HBs level and age, sex, locality and level of anti-HBc (P > 0.05). The students were aware of different aspects of hepatitis B infection regarding the virus, symptoms, prevention and mode of transmission. CONCLUSIONS The Palestinian and Israeli official policies to give a booster dose for risk groups like medical students at anti-HBs level below 10 mIU/mL should continue to ensure absolute protection. The currently-used vaccine and its time program cleared virus from students believed to have been exposed to the virus during their lifetime.
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Affiliation(s)
- Kamal Dumaidi
- Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Arab American University, Jenin, Palestine
| | - Amer Al-Jawabreh
- Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Arab American University, Jenin, Palestine
- Al-Quds Public Health Society, Jerusalem, Palestine
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Ganczak M, Dmytrzyk-Daniłów G, Korzeń M, Szych Z. A cross-sectional serosurvey on hepatitis B vaccination uptake among adult patients from GP practices in a region of South-West Poland. BMC Public Health 2015; 15:1060. [PMID: 26475167 PMCID: PMC4609044 DOI: 10.1186/s12889-015-2388-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 10/06/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hepatitis B is a significant health burden in Poland with nosocomial transmission being the main source of infection. Therefore, HBV vaccination is widely recommended for those not covered by the national immunisation program. OBJECTIVE To assess the coverage and influencing determinants of HBV vaccination among adult patients attending GP clinics as well as to establish serological status in terms of HBV infection. METHODS Patients who were seen consecutively in March 2013 at four randomly selected GP practices located in Zgorzelec county, in south-western part of Poland, were invited to participate and complete questionnaires on socio-demographic data and other factors related to vaccination. A pilot study was done in one urban GP practice in the city of Gryfino (Gryfino county), the results have been included in the study. Patients' immunisation status was assessed basing on vaccination cards and anti-HBs titer with the use of third-generation testing methods. In addition, serum samples were assayed for anti-HBc total. RESULTS Response rate: 99.3 %. Of 410 participants (66.1 % females, median age 56 years), 55.4 % (95%CI:50.5-60.1 %) were previously vaccinated; in those 11.5 % took 2 doses, 66.1 % - 3 doses,18.1 % - 4 doses. Elective surgery was the main reason (57.7 %) for HBV immunization, 4.8 % - were vaccinated due to recommendations by GPs. The multivariable logistic regression model revealed that living in a city (OR 2.11), and having a surgery in the past (OR 2.73) were each associated with greater odds of being vaccinated. Anti-HBc total prevalence among those unvaccinated was 13.6 % (95%CI:9.3 %-19,5 %), and 7.2 % (95%CI:4.4-11.8 %) among those vaccinated. CONCLUSIONS Low HBV immunization coverage among adult patients from GP clinics and the presence of serological markers of HBV infection among both - those unvaccinated and vaccinated call for comprehensive preventative measures against infection, including greater involvement of family doctors. Although interventions should cover the whole population, inhabitants living in the rural areas should be a group of special interest. Preoperative immunization for HBV seems to be an efficient public health tool to increase the vaccination uptake.
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Affiliation(s)
- Maria Ganczak
- Department of Public Health, Pomeranian Medical University, Zolnierska 48, 71-210, Szczecin, Poland.
| | | | - Marcin Korzeń
- Faculty of Computer Science and Information Technology, West Pomeranian University of Technology, Zolnierska 49, 71-210, Szczecin, Poland.
| | - Zbigniew Szych
- Department of Computer Science and Education Quality Research, Pomeranian Medical University, Zolnierska 53, 71-210, Szczecin, Poland.
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15
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Arias-Moliz MT, Rojas L, Liébana-Cabanillas F, Bernal C, Castillo F, Rodríguez-Archilla A, Castillo A, Liébana J. Serologic control against hepatitis B virus among dental students of the University of Granada, Spain. Med Oral Patol Oral Cir Bucal 2015; 20:e566-71. [PMID: 26241457 PMCID: PMC4598925 DOI: 10.4317/medoral.20579] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 04/04/2015] [Indexed: 12/12/2022] Open
Abstract
Background To evaluate the immunological situation against hepatitis B virus (HBV) of a cohort of dentistry students, to analyze the behavior of the levels of hepatitis B surface antigen (anti-HBs) after the administration of one or three vaccine doses, and to determine the influence of age and sex on the immune response. Material and Methods This retrospective cohort study included students attending the School of Dentistry of the institution where the study was performed from 2005 to 2012 who had completed the public health vaccination calendar for HBV at the age of 12-13. Data on age, sex, basal anti-HBs levels, post-vaccination anti-HBs results and final anti-HBs levels were collected. Comparisons of the basal and final levels, as well as associations regarding age and sex, were performed by means of the Student t and Chi-square tests. Results Of the 359 students, 97 (27.02%) had basal antibody concentrations <10 mIU/ml, whereas in 262 the levels of anti-HBs were ≥10 mIU/ml (72.98%). Of the 288 participating students who completed the School´s protocol for immunization, 287 (99.65%) attained a level of protection ≥10 mIU/ml. Globally, there were statistically significant differences between the basal antibody levels and those achieved after administration of the vaccine and booster, but no association with age or sex was observed. Conclusions About 70% of dental students vaccinated as preadolescents had serologic evidence of protection against HBV. Administering a booster is associated with the presence of an excellent immune memory. There is clearly a need to reinforce control of the antibody levels in groups at risk, such as Dentistry students. Key words:Dental students, hepatitis B virus, serologic control.
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Affiliation(s)
- M-T Arias-Moliz
- Department of Microbiology, School of Dentistry, Campus de Cartuja, Colegio Máximo s/n, E-18071 Granada, Spain,
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Hartal M, Yavnai N, Galor I, Avramovich E, Sela T, Kayouf R, Tzurel-Ferber A, Greenberg LJ, Halperin T, Levine H. Seroprevalence of anti-HBs antibodies at young adulthood, before and after a booster vaccine dose, among medical personnel vaccinated in infancy. Vaccine 2015; 33:4878-85. [DOI: 10.1016/j.vaccine.2015.07.058] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 06/20/2015] [Accepted: 07/20/2015] [Indexed: 11/30/2022]
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Leung DH, Ton-That M, Economides JM, Healy CM. High prevalence of hepatitis B nonimmunity in vaccinated pediatric liver transplant recipients. Am J Transplant 2015; 15:535-40. [PMID: 25611886 DOI: 10.1111/ajt.12987] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 08/11/2014] [Accepted: 08/12/2014] [Indexed: 01/25/2023]
Abstract
Durable protection from hepatitis B virus (HBV) and other vaccine-preventable diseases assumes great importance due to improved long-term patient and graft survival rates in pediatric liver transplantation. Vaccine immunogenicity data in transplanted children is limited. This was a cross-sectional, single-center, point-prevalence study evaluating HBV immunity in 160 pediatric liver transplant recipients. Patients with hepatitis B surface antibody levels <10 IU/L were considered nonimmune. Predictor variables for nonimmunity identified in univariate analyses were later analyzed within a logistic regression model. All subjects received the full HBV vaccination series prior to transplant. The majority (67%) of previously immunized pediatric liver transplant patients were nonimmune. Older children (p < 0.001) and children who were further out from transplant (p < 0.001) were more likely to be nonimmune in univariate analyses, but only time from transplant was a significant predictor of nonimmunity in a logistic regression model (odds ratio 1.3, p < 0.001 at 1 year). The mean time since transplant was 5.6 years ± 4.6. Markers of nutrition, immunosuppression, white blood cell parameters and type/severity of disease did not correlate with HBV immunity. Information on the anamnestic response to boosting or revaccination is needed to adequately address this vulnerable group.
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Affiliation(s)
- D H Leung
- Department of Pediatrics, Baylor College of Medicine, Houston, TX; Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Texas Children's Hospital, Houston, TX
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18
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Avdicova M, Crasta PD, Hardt K, Kovac M. Lasting immune memory against hepatitis B following challenge 10-11 years after primary vaccination with either three doses of hexavalent DTPa-HBV-IPV/Hib or monovalent hepatitis B vaccine at 3, 5 and 11-12 months of age. Vaccine 2014; 33:2727-33. [PMID: 24962750 DOI: 10.1016/j.vaccine.2014.06.070] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 05/21/2014] [Accepted: 06/13/2014] [Indexed: 01/05/2023]
Abstract
BACKGROUND The combined hexavalent diphtheria-tetanus-pertussis-hepatitis B-inactivated poliomyelitis - Haemophilus influenzae type b conjugate vaccine (Infanrix hexa™; DTPa-HBV-IPV/Hib: GlaxoSmithKline Vaccines) induces robust responses to the HBV component when administered at 3, 5 and 11-12 months of age. We assessed long term HBV antibody persistence 10-11 years after primary vaccination in infancy. METHODS Antibody persistence and immune memory were assessed post-primary vaccination at 3, 5, 11-12 months with DTPa-HBV-IPV/Hib, or monovalent HBV vaccine (Engerix™ B, GlaxoSmithKline Vaccines) co-administered with DTPa-IPV/Hib (Infanrix™-IPV/Hib, GlaxoSmithKline Vaccines) in 185 children aged 11-12 years. Blood samples were collected before and 1 month after a challenge dose of Engerix™ B (10μg dose). RESULTS 10-11 years after primary vaccination the percentage of subjects with persisting anti-HBs antibody concentrations ≥10mIU/ml was 48.4% in the DTPa-HBV-IPV/Hib group and 58.4% in the DTPa-IPV/Hib+HBV group. After the HBV challenge dose, the percentage with anti-HBs ≥100mIU/ml increased from 14.7% to 93.6% in the DTPa-HBV-IPV/Hib group and 19.1% to 94.4% in the DTPa-IPV/Hib+HBV group. Anti-HBs GMCs increased by at least 187-fold in each group. An anamnestic response (≥4-fold increase in initially seropositive or anti-HBs concentration ≥10mIU/ml in initially seronegative subjects) was observed in 96.8% and 96.6% of subjects in the DTPa-HBV-IPV/Hib and DTPa-IPV/Hib+HBV groups, respectively. No serious adverse events occurred that were considered related to challenge vaccination. CONCLUSION Administration of HBV as part of a combination vaccine or as a monovalent vaccine induced long lasting immune memory against HBV in children primed at 3, 5 and 11 months of age. Antibody persistence and immune memory were similar, suggesting that protection afforded by DTPa-HBV-IPV/Hib and monovalent HBV vaccines, is likely to be of similar duration. The administration of HBV challenge dose 10-11 years after the 3, 5, 11-12 months primary schedule induced strong anamnestic responses and was well tolerated. This study is registered at www.clinicaltrials.govNCT01138098.
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Affiliation(s)
- Mária Avdicova
- Cesta Knemocnici 1, RÚVZ Banská Bystrica (úvz), Slovakia.
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19
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Middleman AB, Baker CJ, Kozinetz CA, Kamili S, Nguyen C, Hu DJ, Spradling PR. Duration of protection after infant hepatitis B vaccination series. Pediatrics 2014; 133:e1500-7. [PMID: 24843060 DOI: 10.1542/peds.2013-2940] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Little is known about duration of protection after the infant primary series of hepatitis B (HB) vaccine in settings of low HB endemicity. This study sought to determine the proportion of adolescents immunized as infants who had protective titers of antibody to hepatitis B surface antigen (anti-HBs) before and after a challenge dose of vaccine. METHODS US-born 16- through 19-year-olds who received a recombinant HB vaccine 3-dose series initiated within 7 days of birth (group 1) or at ≥4 weeks of age (group 2) and completed by 12 months of age were enrolled. Participants had serologic testing before and 2 weeks after randomization to receive a challenge dose of 10 µg or 20 µg of Engerix-B. Baseline and postchallenge levels of anti-HBs were compared by group, challenge dosage, and demographic and behavioral characteristics. RESULTS At baseline, 24% had protective anti-HBs levels of ≥10 IU/mL; 92% achieved protective levels after challenge dose. Although group 1 had a lower proportion of seroprotection at baseline, group and challenge dosage were not associated with postchallenge proportion of seroprotection. Being in group 2, higher test dosage, higher baseline geometric mean titer, and nonwhite race were associated with significantly higher geometric mean titer after challenge dose. CONCLUSIONS More than 90% of study participants immunized against HB as infants exhibited a seroprotective response to a challenge dose of vaccine. Duration of protection from the primary infant HB vaccine series extended through the adolescent years in the setting of low HB endemicity.
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Affiliation(s)
- Amy B Middleman
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma;
| | - Carol J Baker
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas; and
| | - Claudia A Kozinetz
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas; and
| | - Saleem Kamili
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Chi Nguyen
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas; and
| | - Dale J Hu
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Background paper to the revised recommendation for hepatitis B vaccination of persons at particular risk and for hepatitis B postexposure prophylaxis in Germany. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2014; 56:1565-76. [PMID: 24170086 DOI: 10.1007/s00103-013-1845-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The German Standing Committee on Vaccination (Ständige Impfkommission, STIKO) recommends vaccinating risk groups against hepatitis B and gives advice for postexposure prophylaxis. STIKO has recently revised this recommendation, focusing on: (i) classification of risk groups, (ii) duration of protection after primary immunization, and (iii) anti-HBs threshold that defines successful hepatitis B vaccination. Orientating literature reviews were performed for the first objective. Examples of population subgroups at increased risk were identified and classified into three indication groups. Systematic reviews on the duration of vaccine-induced protection identified one randomized controlled trial (RCT) and nine cohort studies. When applying the grading of recommendation, assessment, development, and evaluation (GRADE) methodology, evidence from RCTs was considered of very low quality regarding the question of whether hepatitis B can be prevented for 15 years after successful primary vaccination (anti-HBs ≥ 10 IU/l) with a vaccine efficacy of 96 % against chronic hepatitis, 89 % against HBsAg positivity, and 73 % against isolated anti-HBc positivity. However, seven cohort studies showed that no cases of clinical hepatitis B or HBsAg positivity occurred during a maximum follow-up period of 10 years in settings comparable to the situation in Germany when anti-HBs ≥ 10 IU/l was used to indicate vaccination success. Less than 1 % of vaccinated study participants had isolated anti-HBc positivity. GRADE assessment of two cohort studies revealed that evidence of very low quality exists that the use of anti-HBs ≥ 100 IU/l to measure vaccination success leads to a lower frequency of anti-HBc positivity during follow-up than the use of anti-HBs ≥ 10 IU/l. The recommendation was revised according to this evidence.
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Van Der Meeren O, Bleckmann G, Crasta PD. Immune memory to hepatitis B persists in children aged 7-8 years, who were vaccinated in infancy with 4 doses of hexavalent DTPa-HBV-IPV/Hib (Infanrix™ hexa) vaccine. Hum Vaccin Immunother 2014; 10:1682-7. [PMID: 24637296 DOI: 10.4161/hv.28480] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Protection against hepatitis B disease relies on either protective serum antibodies or on the ability of the immune system to mount an anamnestic response when confronted with the hepatitis B virus (HBV). This open multicenter study (EUDRACT: 2010-022538-10) measured antibodies to HBV surface antigen (anti-HBs) in 7-8-year-old children who had received 4 doses of hexavalent diphtheria-tetanus-acellular pertussis-HBV-inactivated poliovirus-Hemophilus influenzae type b conjugate vaccine (DTPa-HBV-IPV/Hib: Infanrix™ hexa; GlaxoSmithKline Vaccines) in the first 2 years of life through routine vaccine services in Germany. The ability of these children to mount an anamnestic response to a challenge dose of monovalent HBV vaccine (Engerix™ B Kinder; GlaxoSmithKline Vaccines) was also assessed. Before the challenge dose, 78.5% of children had anti-HBs levels ≥6.2 mIU/mL (seropositive) and 72.2% had anti-HBs levels ≥10 mIU/mL (seroprotected). Post-challenge, 98.9% had anti-HBs levels ≥10 mIU/mL and 95.8% had anti-HBs ≥100 mIU/mL. An anamnestic response to the challenge was observed in 96.6% of all subjects. The challenge dose was well tolerated, with a reactogenicity and safety profile consistent with published data. DTPa-HBV-IPV/Hib induces long-lasting immune memory to HBV that appears very similar to that induced by monovalent HBV vaccines. Protection against hepatitis B may be conferred through immune memory in subjects who responded to primary vaccination, even when they subsequently lose detectable levels of circulating anti-HBs antibodies.
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22
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Spada E, Romanò L, Tosti ME, Zuccaro O, Paladini S, Chironna M, Coppola RC, Cuccia M, Mangione R, Marrone F, Negrone FS, Parlato A, Zamparo E, Zotti CM, Mele A, Zanetti AR. Hepatitis B immunity in teenagers vaccinated as infants: an Italian 17-year follow-up study. Clin Microbiol Infect 2014; 20:O680-6. [PMID: 24528380 DOI: 10.1111/1469-0691.12591] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 01/30/2014] [Accepted: 02/09/2014] [Indexed: 01/05/2023]
Abstract
We assessed the persistence of hepatitis B surface antigen antibody (anti-HBs) and immune memory in a cohort of 571 teenagers vaccinated against hepatitis B as infants, 17 years earlier. Vaccinees were followed-up in 2003 and in 2010 (i.e. 10 years and 17 years after primary vaccination, respectively). When tested in 2003, 199 vaccinees (group A) had anti-HBs <10 mIU/mL and were boosted, 372 (group B) were not boosted because they had anti-HBs ≥10 mIU/mL (n = 344) or refused booster (n = 28) despite anti-HBs <10 mIU/mL. In 2010, 72.9% (416/571) of participants had anti-HBs ≥10 mIU/mL (67.3% in group A vs. 75.8% in group B; p 0.03). The geometric mean concentrations (GMCs) were similar in both groups. Between 2003 and 2010, anti-HBs concentrations in previously boosted individuals markedly declined with GMC dropping from 486 to 27.7 mIU/mL (p <0.001). Fifteen vaccinees showed a marked increase of antibody, possibly due to natural booster. In 2010, 96 individuals (37 of group A and 59 of group B) with anti-HBs <10 mIU/mL were boosted; all vaccinees of the former group and all but two of the latter had an anamnestic response. Post-booster GMC was higher in group B (895.6 vs. 492.2 mIU/mL; p 0.039). This finding shows that the immune memory for HBsAg persists beyond the time at which anti-HBs disappears, conferring long-term protection.
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Affiliation(s)
- E Spada
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanitá, Rome; Dipartimento di Malattie Infettive, Parassitarie e Immunomediate, Istituto Superiore di Sanità, Rome
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23
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Bagheri-Jamebozorgi M, Keshavarz J, Nemati M, Mohammadi-Hossainabad S, Rezayati MT, Nejad-Ghaderi M, Jamalizadeh A, Shokri F, Jafarzadeh A. The persistence of anti-HBs antibody and anamnestic response 20 years after primary vaccination with recombinant hepatitis B vaccine at infancy. Hum Vaccin Immunother 2014; 10:3731-6. [PMID: 25483689 PMCID: PMC4514033 DOI: 10.4161/hv.34393] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 07/25/2014] [Accepted: 08/08/2014] [Indexed: 01/16/2023] Open
Abstract
Hepatitis B (HB) vaccine induces protective levels of antibody response (anti-HBs≥10 mIU/mL) in 90-99% of vaccinees. The levels of anti-HBs antibody decline after vaccination. The aim of this study was to evaluate the persistence of anti-HBs antibodies and immunologic memory in healthy adults at 20 years after primary vaccination with recombinant HB vaccine. Blood samples were collected from 300 adults at 20 years after primary HB vaccination and their sera were tested for anti-HBs antibody by ELISA technique. A single booster dose of HB vaccine was administered to a total of 138 subjects, whose anti-HBs antibody titer was <10 mIU/mL. The sera of subjects were re-tested for the anti-HBs antibody levels at 4 weeks after booster vaccination. At 20 years after primary vaccination 37.0% of participants had protective levels of antibody with geometric mean titer (GMT) of 55.44±77.01 mIU/mL. After booster vaccination, 97.1% of vaccinees developed protective levels of antibody and the GMT rose from 2.35±6.49 mIU/mL to 176.28±161.78 mIU/mL. 125/138 (90.6%) of re-vaccinated subjects also showed an anamnestic response to booster vaccination. At 20 years after primary vaccination with HB vaccine, low proportion of the subjects had protective levels of antibody. However, the majority of the re-vaccinated subjects developed protective levels of anti-HBs and showed an anamnestic response after booster vaccination. Additional follow-up studies are necessary to determine the duration of immunological memory.
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Key Words
- Anti-HBc antibody, antibody to HBcAg
- Anti-HBs antibody, antibody to HBsAg
- ELISA, Enzyme-linked immunosorbent assay
- EPI, Expanded Program on Immunization
- GMT, Geometric mean titer
- HB, Hepatitis B
- HBV, Hepatitis B virus
- HBcAg, Hepatitis B core antigen
- HBsAg, Hepatitis B surface antigen
- WHO, World Health Organization
- anamnestic response
- anti-HBs antibody
- hepatitis B vaccine
- mIU/mL, milli-international units per milliliter
- persistence
- protection
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Affiliation(s)
- Masoomeh Bagheri-Jamebozorgi
- Molecular Medicine Research Center; Rafsanjan University of Medical Sciences; Rafsanjan, Iran
- Department of Immunology; School of Medicine; Rafsanjan University of Medical Sciences; Rafsanjan, Iran
| | - Jila Keshavarz
- Molecular Medicine Research Center; Rafsanjan University of Medical Sciences; Rafsanjan, Iran
- Department of Immunology; School of Medicine; Rafsanjan University of Medical Sciences; Rafsanjan, Iran
| | - Maryam Nemati
- Department of Immunology; School of Medicine; Kerman University of Medical Sciences; Kerman, Iran
| | | | - Mohammad-Taghi Rezayati
- Department of Immunology; School of Medicine; Rafsanjan University of Medical Sciences; Rafsanjan, Iran
| | - Mohsen Nejad-Ghaderi
- Health Vice-Chancellor; Rafsanjan University of Medical Sciences; Rafsanjan, Iran
| | - Ahmad Jamalizadeh
- Health Vice-Chancellor; Rafsanjan University of Medical Sciences; Rafsanjan, Iran
| | - Fazel Shokri
- Department of Immunology; School of Public Health; Tehran University of Medical Sciences; Tehran, Iran
| | - Abdollah Jafarzadeh
- Molecular Medicine Research Center; Rafsanjan University of Medical Sciences; Rafsanjan, Iran
- Department of Immunology; School of Medicine; Rafsanjan University of Medical Sciences; Rafsanjan, Iran
- Department of Immunology; School of Medicine; Kerman University of Medical Sciences; Kerman, Iran
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Gilca V, De Serres G, Boulianne N, Murphy D, Ouakki M, De Wals P, Trudeau G, Massé R, Dionne M. Long-term persistence of immunity after vaccination of pre-adolescents with low doses of a recombinant hepatitis B vaccine. Hum Vaccin Immunother 2013; 9:1685-90. [PMID: 23744506 DOI: 10.4161/hv.25015] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND AND AIMS Recent studies have shown no detectable antibodies and no response to a challenge dose of vaccine 10-20 y after receiving low doses (2.5-5 µg) of recombinant hepatitis B vaccine during first months of life. Little information is available on long-term persistence of immunity after vaccinating pre-adolescents with low doses of hepatitis B vaccine. RESULTS The results of 560 subjects were included in this analysis. All subjects had a seroprotective antibody titer (≥10 IU/L) one month post-primary vaccination; 5, 10 and 15 y post-vaccination 95%, 95% and 87% had detectable antibodies, and 82%, 86%, and 68% had a seroprotective antibody titer; GMTs were 73 IU/L, 89 IU/L, and 28 IU/L, respectively. More than 99.4% of subjects had an anamnestic response to a challenge dose of vaccine given 5, 10, or 15 y post-vaccination. Five and ten years post-booster dose 97% and 95% of subjects still have a seroprotective anti-HBs titer with GMTs 16-18-fold higher when compared with those observed 5-10 y post-primary vaccination. MATERIALS AND METHODS This randomized trial was initiated in 1996 with the main objective to assess the persistence of antibodies and immune memory 5, 10 and 15 y after vaccinating 8-10 y-old children with three doses of Recombivax 2.5 µg, as well as the short and long-term effect of a booster dose given at different intervals. CONCLUSIONS Virtually all children vaccinated at the age of 8-10 y with low doses of hepatitis B vaccine still have an excellent immune memory up to age of 25 y. The results of this study do not support the use of booster doses.
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Affiliation(s)
- Vladimir Gilca
- Institut National de Santé Publique du Québec; Laval University; Québec, QC Canada
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25
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26
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Gilca V, De Serres G, Boulianne N, Murphy D, De Wals P, Ouakki M, Trudeau G, Massé R, Dionne M. Antibody persistence and the effect of a booster dose given 5, 10 or 15 years after vaccinating preadolescents with a recombinant hepatitis B vaccine. Vaccine 2012. [PMID: 23206974 DOI: 10.1016/j.vaccine.2012.11.037] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The persistence of antibody obtained post-vaccination of preadolescents with three doses of Engerix-B and the effect of a booster administered 5, 10 or 15 years later were monitored in 663 vaccinees. Five, 10 and 15 years post-vaccination >94% of subjects had detectable antibodies and 88.2%, 86.4% and 76.7% had a titre ≥10 IU/L; GMTs were 269 IU/L, 169 IU/L and 51 IU/L, respectively; 99.1-100% vaccinees reached a titre ≥10 IU/l post-booster. GMTs were 118012 IU/L, 32477 IU/L, and 13946 IU/L when the booster was administered 5, 10 or 15 years post-vaccination, respectively. We conclude that vaccination induces immunity in the great majority of vaccinees for at least 15 years. The response to a booster dose suggests persistence of immune memory in almost all vaccinees. Although a booster dose increases substantially anti-HBs titres, the clinical relevance of such an increase remains unknown. These results do not support the need of a booster for at least 15 years when vaccinating preadolescents with Engerix-B.
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Affiliation(s)
- Vladimir Gilca
- Institut National de Santé Publique du Québec, Université Laval, Québec, Canada.
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27
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Van Damme P, Leroux-Roels G, Crasta P, Messier M, Jacquet JM, Van Herck K. Antibody persistence and immune memory in adults, 15 years after a three-dose schedule of a combined hepatitis A and B vaccine. J Med Virol 2011; 84:11-7. [PMID: 22052690 DOI: 10.1002/jmv.22264] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2011] [Indexed: 12/29/2022]
Abstract
A combined hepatitis A and B vaccine is available since 1996. Two separate open-label primary studies evaluated the immunogenicity and safety of this hepatitis A and B vaccine (720 EI.U of HAV and 20 µg of HBsAg) in 306 healthy subjects aged 17-43 years who received three doses of the vaccine following a 0, 1, and 6 months schedule. These subjects were followed up annually for the next 15 years to evaluate long-term persistence of anti-HAV and anti-HBs antibodies. The subjects whose antibody concentrations fell below the cut-offs between Year 11 and Year 15 (anti-HAV: <15 mIU/ml; anti-HBs: <10 mIU/ml) were offered an additional dose of the appropriate monovalent hepatitis A and/or B vaccine. In subjects who received the additional vaccine dose, a blood sample was collected 1 month after vaccination. At the Year 15 time point, all subjects in Study A and Study B were seropositive for anti-HAV antibodies and 89.3% and 92.9% of subjects in the respective studies had anti-HBs antibody concentrations ≥10 mIU/ml. Four subjects (two in each study) received an additional dose of monovalent hepatitis B vaccine and mounted anamnestic responses to vaccination. No vaccine-related serious adverse events were reported. This study confirms the long-term immunogenicity of the three-dose regimen of the combined hepatitis A and B vaccine, as eliciting long-term persistence of antibodies and immune memory against hepatitis A and B for up to at least 15 years after a primary vaccination.
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Affiliation(s)
- P Van Damme
- Vaccine & Infectious Disease Institute, Centre for the Evaluation of Vaccination (WHO Collaborating Centre) Campus Drie Eiken, Universiteitsplein 1, Antwerpen, Belgium.
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Junqueira ALN, Tavares VR, Martins RMB, Frauzino KV, Costa e Silva AMD, Rodrigues IMX, Minamisava R, Teles SA. Presence of maternal anti-HBs antibodies does not influence hepatitis B vaccine response in Brazilian neonates. Mem Inst Oswaldo Cruz 2011; 106:113-6. [DOI: 10.1590/s0074-02762011000100018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2010] [Accepted: 08/12/2010] [Indexed: 01/05/2023] Open
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Van Damme P, Moiseeva A, Marichev I, Kervyn AD, Booy R, Kuriyakose S, Brockway A, Ng SP, Leyssen M, Jacquet JM. Five years follow-up following two or three doses of a hepatitis B vaccine in adolescents aged 11-15 years: a randomised controlled study. BMC Infect Dis 2010; 10:357. [PMID: 21171982 PMCID: PMC3016379 DOI: 10.1186/1471-2334-10-357] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Accepted: 12/20/2010] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The standard three-dose schedule of hepatitis B vaccines is frequently not completed, especially in adolescents. A primary study has confirmed the equivalence of a two-dose schedule of an Adult formulation of hepatitis B vaccine [Group HBV_2D] to a three-dose schedule of a Paediatric formulation in adolescents (11-15 years) [Group HBV_3D]. This follow-up study evaluated the five year persistence of antibody response and immune memory against the hepatitis B surface (anti-HBs) antigens five years after completion of primary vaccination. METHODS A total of 234 subjects returned at the Year 5 time point, of which 144 subjects received a challenge dose of hepatitis B vaccine. Blood samples were collected yearly and pre- and post-challenge dose to assess anti-HBs antibody concentrations. RESULTS At the end of five years, 79.5% (95% confidence interval [CI]: 71.7 - 86.1) and 91.4% (95% CI: 82.3 - 96.8) of subjects who received the two-dose and three-dose schedules, respectively had anti-HBs antibody concentrations ≥ 10 mIU/mL. Post-challenge dose, all subjects had anti-HBs antibody concentration ≥ 10 mIU/mL and >94% subjects had anti-HBs antibody concentration ≥ 100 mIU/mL. All subjects mounted a rapid anamnestic response to the challenge dose. Overall, the challenge dose was well-tolerated. CONCLUSION The two-dose schedule of hepatitis B vaccine confers long-term immunogenicity and shows evidence of immune memory for at least five years following vaccination. TRIAL REGISTRATION Clinical Trials NCT00343915, NCT00524576.
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Affiliation(s)
- Pierre Van Damme
- Faculty of Medicine, Vaccine & Infectious Disease Institute (WHO Collaborating Centre), Centre for Evaluation of Vaccination, Antwerpen, Belgium.
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Poorolajal J, Mahmoodi M, Haghdoost A, Majdzadeh R, Nasseri-Moghaddam S, Ghalichi L, Fotouhi A. Booster dose vaccination for preventing hepatitis B. Cochrane Database Syst Rev 2010:CD008256. [PMID: 21069704 DOI: 10.1002/14651858.cd008256.pub2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Antibodies against hepatitis B surface antigen (HBs) wane over time after vaccination for hepatitis B (HB); hence, the duration of protection provided by the vaccine is still unknown but may be evaluated indirectly by measuring the anamnestic immune response to booster doses of vaccine. OBJECTIVES To assess the benefits and harms of booster dose hepatitis B vaccination for preventing HB infection. SEARCH STRATEGY We searched The Cochrane Hepato-biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 4, 2010) in The Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded, conference databases, and reference lists of articles to May 2010. We also contacted authors of articles and manufacturers. SELECTION CRITERIA Randomised clinical trials addressing anamnestic immune response to booster of HB vaccine five years or more after primary vaccination in apparently healthy participants, vaccinated in a 3-dose or 4-dose schedules of HB vaccine without receiving additional dose or immunoglobulin. DATA COLLECTION AND ANALYSIS Two authors made the decisions if the identified publications on studies met the inclusion criteria or not. Primary outcome measures included the proportion with anamnestic immune response in non-protected participants and signs of hepatitis B virus infection. Secondary outcomes were the proportion with local and systemic adverse event events developed following booster dose injection. Weighted proportion were planned to be reported with 95% confidence intervals. MAIN RESULTS There were no eligible randomised clinical trials fulfilling the inclusion criteria of this review. AUTHORS' CONCLUSIONS We were unable to identify randomised clinical trials on the topic. We need randomised clinical trials to formulate future booster policies for preventing hepatitis B infection.
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Affiliation(s)
- Jalal Poorolajal
- Department of Epidemiology and Biostatistics, Research Centre for Health Sciences, Faculty of Health, Hamadan University of Medical Sciences (UMSHA), Shahid Fahmideh Avenue, Hamadan, Hamadan, Iran, 6517838695
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Marshall H, Nolan T, Díez Domingo J, Rombo L, Sokal EM, Marès J, Casanovas JM, Kuriyakose S, Leyssen M, Jacquet JM. Long-term (5-year) antibody persistence following two- and three-dose regimens of a combined hepatitis A and B vaccine in children aged 1–11 years. Vaccine 2010; 28:4411-5. [DOI: 10.1016/j.vaccine.2010.04.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Revised: 04/07/2010] [Accepted: 04/14/2010] [Indexed: 10/19/2022]
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Impaired generation of hepatitis B virus-specific memory B cells in HIV infected individuals following vaccination. Vaccine 2010; 28:3672-8. [PMID: 20356567 DOI: 10.1016/j.vaccine.2010.03.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Revised: 02/25/2010] [Accepted: 03/10/2010] [Indexed: 02/09/2023]
Abstract
Hepatitis B-specific memory B cell (HSMBC) frequencies were measured following hepatitis B vaccination in 15 HIV uninfected and 12 HIV infected adolescents. HSMBC were detected at significantly lower frequencies in HIV infected than in HIV uninfected individuals. The detection of HBsAb >10mIU/ml at study week 28 was strongly associated with the detection of HSMBC and a direct correlation between HBsAb titers and HSMBC frequencies was observed. In HIV uninfected individuals, antibody titers >1000mIU/ml were associated with higher HSMC frequencies. Lower HSMBC frequencies, reduced memory B cell (MBC) proliferation, and altered B cell phenotypes were measured in viremic HIV infected individuals compared with aviremic HIV infected or HIV uninfected individuals.
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Van Damme P, von Sonnenburg F, Hatz C, Hoet B, Lefevre I, Leyssen M. Long-term immunogenicity of preservative-free hepatitis B vaccine formulations in adults. J Med Virol 2009; 81:1710-5. [PMID: 19697416 DOI: 10.1002/jmv.21568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Vaccination with recombinant hepatitis B vaccines is highly effective in preventing hepatitis B infection. Recently, a preservative-free (PF) formulation of hepatitis B vaccine [GlaxoSmithKline (GSK) Biologicals, Rixensart, Belgium] has been licensed. The immunogenicity of the PF hepatitis B vaccine and antibody persistence 6 years later was assessed in this study. This formulation was compared with the preservative- containing (PC) formulation of the vaccine and a low-preservative (LP) content formulation. Five hundred forty-one healthy adult subjects were evaluated in the primary study. Over 94% of the subjects in the three study groups had seroprotective anti-HBs antibody concentrations (>or=10 mIU/ml) 1 month after completing primary vaccination. Antibody measurements in 242 healthy adults who returned for the follow-up study and who had received primary vaccination 6 years earlier showed that over 81% of subjects in the three study groups still had anti-HBs antibody concentrations >or=10 mIU/ml. No apparent differences in antibody decline or distribution between the study groups were observed. These results indicate that the removal of preservatives from the hepatitis B vaccine does not affect adversely its immunogenicity both in the short and in the longer term.
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Affiliation(s)
- Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Wilrijk, Belgium
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Abzug MJ, Warshaw M, Rosenblatt HM, Levin MJ, Nachman SA, Pelton SI, Borkowsky W, Fenton T. Immunogenicity and immunologic memory after hepatitis B virus booster vaccination in HIV-infected children receiving highly active antiretroviral therapy. J Infect Dis 2009; 200:935-46. [PMID: 19663708 DOI: 10.1086/605448] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) is an important cause of comorbidity in human immunodeficiency virus (HIV)-infected individuals. The immunogenicity of HBV vaccination in children receiving highly active antiretroviral therapy (HAART) was investigated. METHODS HIV-infected children receiving HAART who had low to moderate HIV loads and who had previously received 3 doses of HBV vaccine were given an HBV vaccine booster. Concentrations of antibody to hepatitis B surface antigen (anti-HBs) were determined before vaccination and at weeks 8, 48, and 96. A subset of subjects was administered a subsequent dose, and anti-HBs was measured before and 1 and 4 weeks later. RESULTS At entry, 24% of 204 subjects were seropositive. Vaccine response occurred in 46% on the basis of seropositivity 8 weeks after vaccination and in 37% on the basis of a 4-fold rise in antibody concentration. Of 69 subjects given another vaccination 4-5 years later, immunologic memory was exhibited by 45% on the basis of seropositivity 1 week after vaccination and by 29% on the basis of a 4-fold rise in antibody concentration at 1 week. Predictors of response and memory included higher nadir and current CD4 cell percentage, higher CD19 cell percentage, and undetectable HIV load. CONCLUSIONS HIV-infected children frequently lack protective levels of anti-HBs after previous HBV vaccination, and a significant proportion of them do not respond to booster vaccination or demonstrate memory despite receiving HAART, leaving this population insufficiently protected from infection with HBV.
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Affiliation(s)
- Mark J Abzug
- University of Colorado Denver School of Medicine and The Children's Hospital, 13123 E. 16th Avenue, Aurora, CO 80045, USA.
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Long-term immunogenicity of two pediatric doses of combined hepatitis A and B or monovalent hepatitis B vaccine in 8 to 10-year-old children and the effect of a challenge dose given seven years later. Pediatr Infect Dis J 2009; 28:916-8. [PMID: 19672212 DOI: 10.1097/inf.0b013e3181a3ad28] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A total of 465 children aged 8 to 10 years were vaccinated with 2 doses of Recombivax-HB 2.5 microg (RB) or Twinrix-Junior 10 microg/360 EL.U (TX), according to a 0 and 6 months schedule. Seven years postsecond dose, a challenge dose of vaccine was given. All vaccinees in the TX and 98% in the RB group showed an anamnestic response. Vaccination at the age of 8 to 10 years with two-pediatric doses of TX or RB given with a 6 months interval induces a long-lasting immunity in most vaccinees.
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Gilca V, De Serres G, Boulianne N, De Wals P, Murphy D, Trudeau G, Massé R, Duval B. Antibody kinetics among 8-10 years old respondents to hepatitis B vaccination in a low endemic country and the effect of a booster dose given 5 or 10 years later. Vaccine 2009; 27:6048-53. [PMID: 19683086 DOI: 10.1016/j.vaccine.2009.07.100] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Revised: 06/04/2009] [Accepted: 07/22/2009] [Indexed: 01/01/2023]
Abstract
Few data are available concerning the persistence of anti-HBs and the effect of booster doses given several years post-vaccination against hepatitis B during preadolescence. The objective of this open-labelled clinical trial was to evaluate the persistence of antibodies after vaccination with three paediatric doses of Engerix-B at the age of 8-10 years and the effect of a booster dose given 5 (Group Y5) or 10 (Group Y10) years later. Anti-HBs were measured before and one month post-primary vaccination, then 5 and 10 years later, before the booster dose, as well as one month and 1 year post-booster. The anamnestic response was defined as a >or=fourfold increase of anti-HBs post-booster (>or=10 IU/L) when compared to pre-booster. Ten years post-primary vaccination, 559 of the 652 initially randomized subjects (86%) were eligible for analysis. Group Y5, 5 years post-booster results: 99% of subjects had detectable levels of antibodies and 96% a titer >or=10 IU/L. The anti-HBs GMTs decreased from 114,489 IU/L one month post-booster to 3354 IU/L 5 years later. Group Y10 results: 10 years post-primary vaccination 96% of subjects had a detectable level of anti-HBs and 85% were above the threshold of 10 IU/L. The GMTs one month post-booster were 31,030 IU/L. The challenge with a booster demonstrated an anamnestic response in 99% of subjects in group Y5 and 100% of subjects in group Y10. All subjects were anti-HBc negative. The booster doses were well tolerated. The excellent anamnestic response observed after the booster dose demonstrates the persistence of immunity in virtually all young adults vaccinated at the age of 8-10 with three paediatric doses of Engerix-B.
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Affiliation(s)
- Vladimir Gilca
- Institut national de santé publique du Québec, Laval University, Quebec, Canada.
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Vázquez L, Garcia F, Rüttimann R, Coconier G, Jacquet JM, Schuerman L. Immunogenicity and reactogenicity of DTPa-HBV-IPV/Hib vaccine as primary and booster vaccination in low-birth-weight premature infants. Acta Paediatr 2008; 97:1243-9. [PMID: 18489623 DOI: 10.1111/j.1651-2227.2008.00884.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To assess suitability of a combined DTPa-HBV-IPV/Hib vaccine (Infanrix hexa) for immunization of low-birth-weight (<2.0 kg) preterm infants, with particular focus on the hepatitis B response. METHODS Open-label study in 170 preterm infants receiving primary vaccination at 2, 4 and 6 months of age and booster vaccination at 18-24 months. Enrollment and analysis were stratified in two groups: infants with birth weight between 1.5 kg and 2.0 kg (low birth weight: LBW), infants with BW <1.5 kg (very low birth weight: VLBW). RESULTS One month after the three dose primary vaccination, 93.7% and 94.9% of infants in VLBW and LBW groups, respectively, had anti-HBs antibody concentrations > or = 10 mIU/mL. High seroprotection and response rates (92.4-100%) to all vaccine antigens were observed. Those were reinforced (>98%) by booster vaccination for all antigens except for HBs in VLBW children: only 88.7% of those had anti-HBs antibody concentrations > or = 10 mIU/mL, compared with 96.5% of LBW children (difference statistically not significant). The vaccine was well tolerated in both groups of infants. CONCLUSION Preterm infants will benefit by the administration of a primary and booster vaccination with DTPa-HBV-IPV/Hib vaccine.
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Affiliation(s)
- Liliana Vázquez
- Fundación Centro de Estudios Infectológicos, Buenos Aires, Argentina
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Giambi C, Bella A, Barale A, Montù D, Marchisio M, Oddone M, Zito S, Rapicetta M, Chionne P, Madonna E, Ciofi degli Atti ML. A cohort study to evaluate persistence of hepatitis B immunogenicity after administration of hexavalent vaccines. BMC Infect Dis 2008; 8:100. [PMID: 18662386 PMCID: PMC2527316 DOI: 10.1186/1471-2334-8-100] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2008] [Accepted: 07/28/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In 2001, two hexavalent vaccines were licensed in Italy (Hexavac, Infanrix Hexa), and since 2002 were extensively used for primary immunization in the first year of life (at 3, 5, 11/12 months of age). In 2005, the market authorization of Hexavac was precautionary suspended by EMEA, because of doubts on long-term protection against hepatitis B virus. The objectives of this study were to evaluate the persistence of antibodies to anti-HBs, in children in the third year of life, and to investigate the response to a booster dose of hepatitis B vaccine. METHODS Participant children were enrolled concomitantly with the offering of anti-polio booster dose, in the third year of life. Anti-HBs titers were determined on capillary blood samples. A booster dose of hepatitis B vaccine was administered to children with anti-HBs titers < 10 mIU/ml, with the monovalent precursor product of the previously received hexavalent vaccine. HBsAb titers were tested again one month after the booster. RESULTS Sera from 113 children previously vaccinated with Hexavac, and from 124 vaccinated with Infanrix Hexa were tested for anti-HBs. Titers were > or = 10 mIU/ml in 69% and 96% (p < 0,0001) respectively. The proportion of children with titers > or = 100 mIU/ml did also significantly differ among groups (27% and 78%; p < 0,0001).Post-booster, 93% of children achieved titers > or = 10 mIU/ml, with no significant difference by vaccine group. DISCUSSION Fifteen months after third dose administration, a significant difference in anti-HBs titers was noted in the two vaccine groups considered. Monovalent hepatitis B vaccine administration in 3-year old children induced a proper booster response, confirming that immunologic memory persists in children with anti-HBs titers < 10 mIU/ml. However, long-term persistence of HBV protection after hexavalent vaccines administration should be further evaluated over time.
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Affiliation(s)
- Cristina Giambi
- Communicable Disease Epidemiology Unit, National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
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A non-randomized vaccine effectiveness trial of accelerated infant hepatitis B immunization schedules with a first dose at birth or age 6 weeks in Côte d'Ivoire. Vaccine 2008; 26:2753-61. [PMID: 18436354 DOI: 10.1016/j.vaccine.2008.03.018] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2007] [Revised: 03/08/2008] [Accepted: 03/12/2008] [Indexed: 11/22/2022]
Abstract
Most African countries do not initiate hepatitis B vaccination at birth. We conducted a non-randomized controlled trial comparing hepatitis B vaccination given at age 0, 6, and 14 weeks versus the current Côte d'Ivoire schedule of 6, 10, and 14 weeks. Pregnant women were enrolled at four health centers in Abidjan. At age 9 months, 0.5% of infants in both the birth and 6-week cohorts were positive for HBsAg and all were born to HBeAg-positive women. Among infants of HBeAg-positive mothers, 9 of 24 (37.5%) in the birth cohort and 10 of 17 (58.8%) in the 6-week cohort were HBsAg positive (adjusted OR, 2.7; 95% CI: 0.7-11.0). While both vaccine schedules prevented most cases of infant HBV transmission, both also had high failure rates among infants of HBeAg-positive mothers. African infants may benefit from a birth dose but additional studies are needed to verify this hypothesis.
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Reinert P, Dejos V, Clyti N, Abitbol V. Immunogénicité et réactogénicité des vaccins DTCa-P-HepB/Hib et DTCa-P/Hib coadministrés avec le vaccin pneumococcique osidique conjugué, adsorbé, chez des nourrissons en primovaccination et en rappel selon le calendrier vaccinal français. Arch Pediatr 2008; 15:263-70. [DOI: 10.1016/j.arcped.2007.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Wang LY, Lin HH. Short-term response to a booster dose of hepatitis B vaccine in anti-HBs negative adolescents who had received primary vaccination 16 years ago. Vaccine 2007; 25:7160-7. [PMID: 17707557 DOI: 10.1016/j.vaccine.2007.07.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2006] [Revised: 05/31/2007] [Accepted: 07/16/2007] [Indexed: 12/19/2022]
Abstract
We conducted a revaccination study to investigate the short-term response to booster hepatitis B (HB) vaccination in seronegative adolescents who had received primary infantile HB vaccination. A booster dose of recombinant HB vaccine was administered to 395 adolescents 15-18 years of age whose serum titers of antibody against hepatitis B surface antigen (HBsAg) (anti-HBs) were <10 mIU/mL. Seventy-seven percent of the booster recipients converted to anti-HBs seropositivity (postbooster titers> or =10 mIU/mL). As compared with adolescents who had undetectable prebooster anti-HBs titers (<0.1 mIU/mL), the seropositive rates and geometric mean titers (GMTs) of 2-month and 1-year postbooster were significantly higher for those of prebooster titers of 0.1-0.9 and 1.0-9.9 mIU/mL (all p<0.0001). Postbooster titers declined significantly more rapidly for those with undetectable prebooster anti-HBs titers than for those with prebooster titers of 0.1-0.9 and 1.0-9.9 mIU/mL. Our observations indicate that a booster dose of HB vaccine maybe unable to induce sufficient immunological response in adolescents who had undetectable residual anti-HBs titers.
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Affiliation(s)
- Li-Yu Wang
- Graduate Institute of Aboriginal Health, Tzu Chi University, Hualien, Taiwan
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Monteiro MBCL, Fragoso R, Foletto S, Lemos EM, Pereira FEL. Intestinal helminthes and/or Toxocara infection are unrelated to anti-HBs titers in seven-year-old children vaccinated at birth with recombinant hepatitis B vaccine. Rev Soc Bras Med Trop 2007; 40:147-51. [PMID: 17568879 DOI: 10.1590/s0037-86822007000200001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2006] [Accepted: 03/20/2007] [Indexed: 11/22/2022] Open
Abstract
The aim of this investigation was to evaluate the possible effect of nematode infection on anti-HBs antibody levels in the serum of seven-year-old schoolchildren vaccinated at birth with the recombinant hepatitis B vaccine. Anti-HBs and anti HBc antibodies were evaluated in the sera of 100 schoolchildren with at least one intestinal nematode and/or a positive serological reaction for anti-Toxocara antibodies and in 95 schoolchildren without intestinal helminthiasis or serum anti-Toxocara antibodies. Both groups were from public elementary schools located on the urban periphery of Vitória, ES, Brazil. Among these 195 children, the median anti-HBs antibody titer was 31.3 IU/ml and the frequency of titers less than 10 IU/ml was 33.8% (95% CI: 27.1-40.4%). There were no significant differences between the medians of anti-HBs titers or the frequency of titers less than 10 IU/ml between the groups with or without helminthes (29.5 and 32.9 IU/ml and 33 and 34.7%, respectively; p>0.05). Even when the children with intestinal nematodes and/or anti-Toxocara antibodies and with blood eosinophil counts over 600/mm(3) were compared with children without infection from intestinal nematodes and without anti-Toxocara antibodies, with blood eosinophil counts less than 400 eosinophils/mm(3), these differences were not significant. None of the children presented anti-HBc antibodies. In conclusion, infections with intestinal nematodes and/or the presence of anti-Toxocara antibodies did not interfere with the anti-HBs antibody titers in seven-year-old children vaccinated at birth with the recombinant hepatitis B vaccine.
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Affiliation(s)
- Marisa B C L Monteiro
- Núcleo de Doenças Infecciosas, Centro de Ciências da Saúde, Universidade Federal do Espirito Santo, Vitória, ES
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An YW, Chung EH, Rheem I. A study of the current(2003-2005) prevalence of anti-HBs and immunologic memory of hepatitis B vaccine in children from the central area of Korea. KOREAN JOURNAL OF PEDIATRICS 2006. [DOI: 10.3345/kjp.2006.49.6.630] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Young Won An
- Department of Pediatrics, College of Medicine, Dankook University, Cheonan, Korea
| | - Eun Hee Chung
- Department of Pediatrics, College of Medicine, Dankook University, Cheonan, Korea
| | - Insoo Rheem
- Department of Laboratory Medicine, College of Medicine, Dankook University, Cheonan, Korea
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