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Fernández Sánchez-Escalonilla S, Gonzalez-Rubio J, Najera A, Cantero Escribano JM, Molina Cabrero FJ, García Guerrero J. Using the AS04C-adjuvanted hepatitis B vaccine in patients classified as non-responders. Trans R Soc Trop Med Hyg 2024; 118:170-177. [PMID: 37897239 DOI: 10.1093/trstmh/trad078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 09/22/2023] [Accepted: 10/11/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Chronic hepatitis B (HB) remains a significant global health concern, despite the widespread availability of the HB vaccine. While the standard vaccine demonstrates an impressive serological response rate exceeding 90%, a subset of individuals exhibit suboptimal immunity. This study aims to elucidate the efficacy of the AS04C-adjuvanted HB vaccine in addressing non-responsiveness. METHODS Conducted at the Preventive Medicine Service of the University Albacete Hospital in Spain from 2017 to 2021, this single-center observational study enrolled 195 patients. Among them, 126 (65%) were classified as non-responders following one or two complete standard vaccination courses. RESULTS After the administration of a complete four-dose regimen of the AS04C-adjuvanted vaccine, 73.81% of non-responder patients exhibited antibody titers indicative of robust immunity (anti-HBs >10). CONCLUSIONS These findings underscore the pivotal role of the AS04C-adjuvanted HB vaccine in addressing non-responsiveness, emphasizing its potential as a crucial tool in augmenting immunization strategies for various populations. This includes non-responders to standard vaccination, individuals with chronic kidney disease, those requiring seroprotection due to factors like immunosuppression or occupational hazards, as well as patients for whom conventional revaccination strategies have proven futile. Additional research is needed to expand on the promising results obtained through our protocol.
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Affiliation(s)
| | - Jesus Gonzalez-Rubio
- Department of Medical Sciences. Faculty of Medicine of Albacete. University of Castilla-La Mancha. Albacete 02008. Spain
- Centre for Biomedical Research (CRIB). University of Castilla-La Mancha. Albacete 02008. Spain
| | - Alberto Najera
- Department of Medical Sciences. Faculty of Medicine of Albacete. University of Castilla-La Mancha. Albacete 02008. Spain
- Centre for Biomedical Research (CRIB). University of Castilla-La Mancha. Albacete 02008. Spain
| | - Jose Miguel Cantero Escribano
- Department of Preventive Medicine and Public Health, Albacete University Teaching Hospital Complex, Albacete 02006, Spain
| | - Francisco Jesús Molina Cabrero
- Department of Preventive Medicine and Public Health, Albacete University Teaching Hospital Complex, Albacete 02006, Spain
| | - Jesús García Guerrero
- Department of Preventive Medicine and Public Health, Albacete University Teaching Hospital Complex, Albacete 02006, Spain
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Qin W, Shao L, Wang J, Zhang H, Wang Y, Zhang X, Xie S, Pan F, Cheng K, Ma L, Chen Y, Song J, Gao D, Chen Z, Yang W, Zhu R, Su H. Persistence of antibodies 5 years after hepatitis B vaccination in preterm birth children: A retrospective cohort study using real-world data. J Viral Hepat 2024; 31:143-150. [PMID: 38235846 DOI: 10.1111/jvh.13908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/21/2023] [Accepted: 12/10/2023] [Indexed: 01/19/2024]
Abstract
Previous studies did not provide substantial evidence for long-term immune persistence after the hepatitis B vaccine (HepB) in preterm birth (PTB) children. Consequently, there is ongoing controversy surrounding the booster immunization strategy for these children. Therefore, we conducted a retrospective cohort study to evaluate the disparities in immune persistence between PTB children and full-term children. A total of 1027 participants were enrolled in this study, including 505 PTB children in the exposure group and 522 full-term children in the control group. The negative rate of hepatitis B surface antibody (HBsAb) in the PTB group was significantly lower than that in the control group (47.9% vs. 41.4%, p = .035). The risk of HBsAb-negative in the exposure group was 1.5 times higher than that in the control group (adjusted odds ratio [aOR] = 1.5, 95% confidence interval [CI]: 1.1-2.0). The geometric mean concentration (GMC) of HBsAb was much lower for participants in the exposure group compared to participants in the control group (9.3 vs. 12.4 mIU/mL, p = .029). Subgroup analysis showed that the very preterm infants (gestational age <32 weeks) and the preterm low birth weight infants (birth weight <2000 g) had relatively low GMC levels of 3.2 mIU/mL (95% CI: 0.9-11.1) and 7.9 mIU/mL (95% CI: 4.2-14.8), respectively. Our findings demonstrated that PTB had a significant impact on the long-term persistence of HBsAb after HepB vaccination. The very preterm infants (gestational age <32 weeks) and the preterm low birth weight infants (birth weight <2000 g) may be special populations that should be given priority for HepB booster vaccination.
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Affiliation(s)
- Wei Qin
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Ling Shao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Blood Purification Center, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jun Wang
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Huan Zhang
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Yao Wang
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Xiaqing Zhang
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
- Department of Health Inspection and Quarantine, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Shaoyu Xie
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Fan Pan
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Kai Cheng
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Liguo Ma
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Yafei Chen
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Dawei Gao
- Microbiology Laboratory, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Zhichao Chen
- Microbiology Laboratory, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Wei Yang
- Microbiology Laboratory, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Rui Zhu
- Microbiology Laboratory, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
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Liang Q, Li N, Song S, Wei Q, Ma C, Li K, Wang S, Feng S, Wang Y. Impact of timing on protection of combined immunoprophylaxis in preventing mother-to-child transmission of hepatitis B virus: a retrospective study. J Matern Fetal Neonatal Med 2023; 36:2257837. [PMID: 37699774 DOI: 10.1080/14767058.2023.2257837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/16/2023] [Accepted: 09/06/2023] [Indexed: 09/14/2023]
Abstract
Objective: To evaluate the impact of timing combined immunoprophylaxis on mother-to-child transmission (MTCT) of the hepatitis B virus (HBV) in pregnant women living with hepatitis B. Methods: A retrospective cohort study was included HBsAg-positive pregnant women who delivered full-term at Tianjin Third Central Hospital from January 2019 to December 2021. The objective of this study is to determine whether early administration of hepatitis B immune globulin (HBIG) and the first dose of hepatitis B vaccination after birth can further improve protection. Result: A total of 694 pregnant women living with hepatitis B were included; 93 infants from these mothers were lost to follow-up [including moving (n = 21), emigrating (n = 26), changing contact information (n = 27), and other reasons (n = 19)], leaving 601 infants for analysis. The incidence in babies born to mothers with hepatitis B was 1.50% (9/601). Based on the different timing of combined immunoprophylaxis administration after birth, 601 infants were divided into two groups (within 2 h and within 2-12 h). The incidence in babies born to mothers with hepatitis B were 0.32% (1/308) and 2.73% (8/293) for infants who received combined immunoprophylaxis within 2 h and between 2 and 12 h of birth, respectively (p = 0.037). The infection incidence of infants born to HBeAg-positive mothers and HBeAg-positive mothers who did not receive antiviral treatment during pregnancy was lower in the 2-h group compared to the 2-12 h group (0.72% vs. 5.84%, p = 0.04 and 1.20% vs. 9.46%, p = 0.047). Conclusion: Using combined immunoprophylaxis as soon as possible (within two hours of birth) may protect against MTCT of HBV more.
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Affiliation(s)
- Qian Liang
- The Third Central Clinical College of Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
- Artificial Cell Engineering Technology Research Center, Tianjin, China
- Tianjin Institute of Hepatobiliary Disease, Tianjin, China
- The Third Central Hospital of Tianjin, Tianjin, China
| | - Nan Li
- Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
- Artificial Cell Engineering Technology Research Center, Tianjin, China
- Tianjin Institute of Hepatobiliary Disease, Tianjin, China
- The Third Central Hospital of Tianjin, Tianjin, China
| | - Shurong Song
- Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
- Artificial Cell Engineering Technology Research Center, Tianjin, China
- Tianjin Institute of Hepatobiliary Disease, Tianjin, China
- The Third Central Hospital of Tianjin, Tianjin, China
| | - Qing Wei
- Tianjin Institute of Hepatobiliary Disease, Tianjin, China
- The Third Central Hospital of Tianjin, Tianjin, China
| | - Chunlei Ma
- Tianjin Institute of Hepatobiliary Disease, Tianjin, China
- The Third Central Hospital of Tianjin, Tianjin, China
| | - Ke Li
- Tianjin Institute of Hepatobiliary Disease, Tianjin, China
- The Third Central Hospital of Tianjin, Tianjin, China
| | - Shaohua Wang
- Tianjin Institute of Hepatobiliary Disease, Tianjin, China
- The Third Central Hospital of Tianjin, Tianjin, China
| | - Shuo Feng
- Tianjin Institute of Hepatobiliary Disease, Tianjin, China
- The Third Central Hospital of Tianjin, Tianjin, China
| | - Yingmei Wang
- Tianjin Medical University General Hospital, Tianjin, China
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Kim JC, Choi JA, Park H, Yang E, Noh S, Kim JS, Kim MJ, Song M, Park JH. Pharmaceutical and Immunological Evaluation of Cholera Toxin A1 Subunit as an Adjuvant of Hepatitis B Vaccine Microneedles. Pharm Res 2023; 40:3059-3071. [PMID: 37914841 DOI: 10.1007/s11095-023-03623-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/11/2023] [Indexed: 11/03/2023]
Abstract
PURPOSE For successful delivery of a solid vaccine formulation into the skin using microneedles, the solubility of an adjuvant should be considered because the decrease in the dissolution rate by the addition of adjuvant decreases the delivery efficiency of the vaccine. METHODS In this study, cholera toxin A subunit 1 (CTA1) was examined as an adjuvant to Hepatitis B vaccine (HBV) microneedles because of its good water solubility, improved safety, and positive effect as shown in intramuscular administration of a liquid vaccine. RESULTS All solid formulations with CTA 1 dissolved in in vivo mouse skin within 30 min, and they were successfully delivered into the skin. In experiments with mice, the addition of CTA1 led to improved IgG immune response compared to the use of an aluminum hydroxide-based formulation and intramuscular administration of HBV. In addition, CTA1 induced CD8 + T cell response as much as in which the aluminum hydroxide-based formulation induced. CONCLUSIONS CTA1 is an adjuvant that satisfies both the delivery efficiency and the immunological characteristics required for vaccine microneedles. CTA1 will be used as a potential adjuvant through vaccine microneedles.
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Affiliation(s)
- Jong-Chan Kim
- Department of BioNano Technology, Gachon BioNano Research Institute, Gachon University, Seongnam, South Korea
| | - Jung-Ah Choi
- Science Unit, International Vaccine Institute, Seoul, South Korea
| | - Hayan Park
- Science Unit, International Vaccine Institute, Seoul, South Korea
| | - Eunji Yang
- Science Unit, International Vaccine Institute, Seoul, South Korea
| | - Shinyoung Noh
- Science Unit, International Vaccine Institute, Seoul, South Korea
| | - Ji-Seok Kim
- Department of BioNano Technology, Gachon BioNano Research Institute, Gachon University, Seongnam, South Korea
| | - Moon-Jin Kim
- Department of BioNano Technology, Gachon BioNano Research Institute, Gachon University, Seongnam, South Korea
| | - Manki Song
- Science Unit, International Vaccine Institute, Seoul, South Korea.
| | - Jung-Hwan Park
- Department of BioNano Technology, Gachon BioNano Research Institute, Gachon University, Seongnam, South Korea.
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Walsh C, McDaniel K, Lindsey L, Johnson S, Walton T. Seroconversion following Heplisav-B, hepatitis B vaccine (recombinant), adjuvanted, in patients with end-stage renal disease at an urban safety net hospital. Am J Health Syst Pharm 2023; 80:S130-S134. [PMID: 36681904 DOI: 10.1093/ajhp/zxad022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Indexed: 01/23/2023] Open
Abstract
PURPOSE Heplisav-B is a novel recombinant adjuvanted vaccine for hepatitis B virus (HBV) that has been approved as a 2-dose regimen and shown to have similar seroconversion rates in healthy adults as single-antigen HBV vaccines. More data are needed to determine whether similarly high rates of seroconversion and immunity are observed in immunocompromised patient populations such as in patients with end-stage renal disease (ESRD) on hemodialysis. METHODS Patients with ESRD who presented for emergency-only hemodialysis and either were HBV vaccine naive or had a hepatitis B surface antibody (anti-HBs) titer of less than 10 IU/mL received 3 standard 20-μg doses of Heplisav-B at week 0, week 4 (±2 weeks), and week 24 (±2 weeks), with anti-HBs titer measured at week 28 (±2 weeks). RESULTS Thirty-two patients received at least one dose in the study timeframe, with 24 patients completing the vaccine series and measurement of anti-HBs titer. The mean age of the patients was 46 years, and 58% of patients were male. Of the 24 patients who completed the vaccine series, 20 (83%) seroconverted after the third dose. Three of the 4 patients who did not seroconvert after 3 doses were revaccinated with an additional 20-μg dose, and 2 of the 3 patients had an anti-HBs titer of greater than 10 IU/mL 4 weeks after this dose. CONCLUSION Patients with ESRD who received three 20-μg doses of recombinant HBV vaccine had a seroconversion rate of 83%, representing a similar seroconversion rate and fewer doses of vaccine as compared to the standard HBV vaccine regimen for patients with ESRD.
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Affiliation(s)
- Connor Walsh
- Department of Pharmacy, Grady Memorial Hospital, Atlanta, GA, USA
| | - Kathryn McDaniel
- Department of Pharmacy, Grady Memorial Hospital, Atlanta, GA, USA
| | - Lindsey Lindsey
- Department of Pharmacy, Grady Memorial Hospital, Atlanta, GA, USA
| | - Sarah Johnson
- Division of Renal Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Ted Walton
- Department of Pharmacy, Grady Memorial Hospital, Atlanta, GA, USA
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McPherson C. Bad Liver and a Broken Heart: Hepatitis B in the Newborn. Neonatal Netw 2023; 42:348-355. [PMID: 38000801 DOI: 10.1891/nn-2023-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 11/26/2023]
Abstract
Hepatitis B viral infection is a significant source of morbidity and mortality worldwide. The United States has experienced a precipitous drop in acute hepatitis B infection after the introduction and widespread adoption of recombinant vaccines. Neonates experience significant risk from both vertical and horizontal hepatitis B exposure during a period of immaturity of the innate and adaptive immune systems. Acquisition of hepatitis B virus at or near birth confers the highest lifetime risk of chronic infection and subsequent complications including liver cirrhosis and hepatocellular carcinoma. Pregnant women should be screened for the presence of hepatitis B surface antigen, indicating acute or chronic infection, and, if positive, hepatitis B viral deoxyribonucleic acid, allowing for quantification of viral load. The development of highly effective and safe recombinant vaccines allows partial protection of late preterm and term neonates immediately after birth. Additionally, administration of hepatitis B immune globulin in the setting of suspected or confirmed exposure supplements the immune response and decreases the risk of chronic infection. The optimal timing of vaccination is later in low-birth-weight neonates due to the aforementioned immune system immaturity. Health care providers serving neonates must familiarize themselves with national guidelines regarding hepatitis B vaccination and hepatitis B immune globulin therapy. Understanding the risks of infection and the evidence basis supporting vaccination and immunotherapy will allow providers to educate families and support decision-making, with the potential to eradicate this vaccine-preventable illness in our lifetime.
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Chai Y, Tang J, Su Y, Xuan K, Xu L, Hao J, Lu Z, Wang B, Chen X, Luo X, He J, Zhu L. Hepatitis B antibody levels after different doses of hepatitis B vaccination: a retrospective study based on hospitalized children. Epidemiol Infect 2023; 151:e186. [PMID: 37881897 PMCID: PMC10644064 DOI: 10.1017/s0950268823001747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/24/2023] [Accepted: 10/19/2023] [Indexed: 10/27/2023] Open
Abstract
Many studies have investigated the positivity rate of hepatitis B surface antibody (HBsAb) after hepatitis B vaccine (HepB) immunization. However, the antibody level, assessed monthly or at more frequent intervals after each of the three doses, particularly within the first year after birth, has not been previously reported. To elucidate the level of antibody formation at various times after vaccination, the current study used the available detection data of HBsAb in hospitalized children to analyze the HBsAb level after immunization combined with their vaccination history. Both the positivity rate and geometric mean concentration (GMC) increased sequentially with immunization doses, reaching their peaks earlier after the third dose than after the first two doses, and the rate of HBsAb positivity was able to reach 100% between 11 and 90 days after completing the three doses of HepB. Within one year after receiving the three doses, the antibody positivity rate and GMC were maintained above 90% and 100 mIU/mL, respectively, and subsequently steadily declined, reaching the lowest value in the 9th and 10th years. The current findings reveal, in more detail, the level of antibody formation at different times following each dose of HepB in hospitalized children, particularly in the age group up to one year after vaccination. For the subjects of this study, we prefer to believe that the proportion of HBsAb non-response should be less than 5% after full immunization with HepB, provided that the appropriate time for blood collection is chosen.
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Affiliation(s)
- Yu Chai
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Jihai Tang
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Yin Su
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Kun Xuan
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Lili Xu
- Children’s Hospital of Fudan University Anhui Hospital, Heifei, China
| | - Jiayan Hao
- Children’s Hospital of Fudan University Anhui Hospital, Heifei, China
| | - Zhijian Lu
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - BinBing Wang
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Xia Chen
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Xianwei Luo
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Jiali He
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Lijuan Zhu
- Children’s Hospital of Fudan University Anhui Hospital, Heifei, China
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Zhao M, Wang C, Li P, Sun T, Wang J, Zhang S, Ma Q, Ma F, Shi W, Shi M, Ma Y, Pan Y, Zhang H, Xie X. Single-cell RNA sequencing reveals the transcriptomic characteristics of peripheral blood mononuclear cells in hepatitis B vaccine non-responders. Front Immunol 2023; 14:1091237. [PMID: 37593735 PMCID: PMC10431960 DOI: 10.3389/fimmu.2023.1091237] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 04/12/2023] [Indexed: 08/19/2023] Open
Abstract
The emergence of a vaccine against hepatitis B has proven to be an important milestone in the prevention of this disease; however, 5%-10% of vaccinated individuals do not generate an immune response to the vaccine, and its molecular mechanism has not been clarified. In this study, single-cell RNA sequencing was performed on peripheral blood mononuclear cells (PBMCs) from three volunteers with a high immune response (HR) and three with no immune response (NR) to the hepatitis B vaccine. We found that the antigen-presenting activity scores of various antigen-presenting cells, the mitogen-activated protein kinase (MAPK) pathway activity scores of naive B cells, and the cell activity scores of three types of effector T cells were significantly decreased, whereas the cytotoxicity scores of CD3highCD16lowKLRG1high natural killer T (NKT) cells were significantly increased in the NR group compared with those in the HR group. Additionally, the expression levels of some classical molecules associated with distinct signaling pathways-including HLA-B, HLA-DRB5, BLNK, BLK, IL4R, SCIMP, JUN, CEBPB, NDFIP1, and TXNIP-were significantly reduced in corresponding subsets of PBMCs from the NR group relative to those of the HR group. Furthermore, the expression of several cytotoxicity-related effector molecules, such as GNLY, NKG7, GZMB, GZMM, KLRC1, KLRD1, PRF1, CST7, and CTSW, was significantly higher in CD3highCD16lowKLRG1high NKT cells derived from non-responders. Our study provides a molecular basis for the lack of response to the hepatitis B vaccine, including defective antigen presentation, decreased T cell activity, and reduced IL-4 secretion, as well as novel insight into the role of NKT cells in the immune response to the hepatitis B vaccine.
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Affiliation(s)
- Meie Zhao
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
- Department of Laboratory Medicine, The First People’s Hospital of Lanzhou, Lanzhou, Gansu, China
| | - Chunxia Wang
- Department of Laboratory Medicine, The First People’s Hospital of Lanzhou, Lanzhou, Gansu, China
| | - Peiqiang Li
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Tao Sun
- Clinical Laboratory, Huzhou Central Hospital, Huzhou Hospital Affiliated with Zhejiang University, Huzhou, Zhejiang, China
| | - Jing Wang
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Shasha Zhang
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Qinglong Ma
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Fengdie Ma
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Wenjing Shi
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Maoning Shi
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Yapeng Ma
- Department of Laboratory Medicine, The First People’s Hospital of Tianshui, Tian Shui, Gansu, China
| | - Yunyan Pan
- Department of Laboratory Medicine, The Second Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Hui Zhang
- Virus Laboratory, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China
| | - Xiaodong Xie
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
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9
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Zhang S, Zhao T, Chen L, Xie M, Lu QB, Du J, Zeng J, Huang N, Liu Y, Wang C, Cui F. Analysis of deaths following yeast-derived hepatitis B vaccination of infants, China, January 2013 to December 2020. Front Public Health 2023; 11:1170483. [PMID: 37397780 PMCID: PMC10313061 DOI: 10.3389/fpubh.2023.1170483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
In China, adverse events following immunization (AEFI) are reported by the China AEFI Surveillance System (CNAEFIS). Serious AEFI, including deaths, are mandatorily reported and are evaluated for causality by province-or prefecture-level panels of experts. Yeast-derived HepB is the most widely used HepB in China for infants. However, the information about the death of infants caused by HepB is unclear. The CNAEFIS data on deaths following HepB from 2013 to 2020 were used for analyses. Descriptive analysis of epidemiologic characteristics was used to report death cases following HepB. We used administered doses to calculate denominators to estimate the risk of death after vaccination. During 2013-2020, there were 161 deaths following the administration of 173 million doses of HepB, for an overall incidence of 0.9 deaths per million doses. One hundred fifty-seven deaths were categorized as coincidental, and four deaths were accompanied by an abnormal reaction determined to be unrelated to the cause of death. The most common causes of death were neonatal pneumonia and foreign body asphyxia. These data provide reliable evidence on the safety of HepB among infants in China and can enhance public confidence in HepB immunization. To ensure public confidence in infants' HepB vaccination, monitoring and scientifically evaluating AEFI-related deaths of HepB is necessary.
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Affiliation(s)
- Sihui Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Tianshuo Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Linyi Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Mingzhu Xie
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Qing-Bin Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Juan Du
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Jing Zeng
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Ninghua Huang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Yaqiong Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Chao Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Fuqiang Cui
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
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10
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Nie L, Hua W, Liu X, Pang X, Guo C, Zhang W, Tian Y, Qiu Q. Associated Factors and Immune Response to the Hepatitis B Vaccine with a Standard Schedule: A Prospective Study of People with HIV in China. Vaccines (Basel) 2023; 11:vaccines11050921. [PMID: 37243025 DOI: 10.3390/vaccines11050921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/25/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023] Open
Abstract
Hepatitis B (HB) vaccination is recommended for people with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). We aimed to assess the immune response to the HB vaccine and associated factors using the standard vaccination schedule among people with HIV (PWH) in China. A prospective study was carried out from 2016 to 2020 in Beijing, China. PWH were given three 20 μg doses of recombinant HB vaccine at 0, 1, and 6 months. Blood samples were taken within 4-6 weeks after each dose to evaluate the anti-HBs levels. A total of 312 participants completed vaccination and serologic testing. The seroconversion (anti-HBs ≥ 10 IU/L) rates following the first, second, and third doses of the vaccine were 35.6% (95% CI: 30.3-40.9%), 55.1% (95% CI: 49.6-60.7%), and 86.5% (95% CI: 82.8-90.3%), respectively, and the geometric means of the anti-HBs titers were 0.8 IU/L (95% CI: 0.5-1.6 IU/L), 15.7 IU/L (95% CI: 9.4-26.3 IU/L), and 241.0 IU/L (95% CI: 170.3-341.1 IU/L), respectively. In multivariate analysis, after three doses of vaccination, age, CD4 cell count, and HIV-RNA viral load were significantly associated with strong, moderate, and weak response, respectively. These findings confirm that these personal health conditions are related to the HB response. HB vaccination in PWH using the standard schedule was still highly effective in the context of early treatment initiation, especially among participants aged 30 years and younger.
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Affiliation(s)
- Li Nie
- Beijing Center for Disease Prevention and Control, Beijing 100013, China
| | - Wei Hua
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Xiuying Liu
- Beijing Center for Disease Prevention and Control, Beijing 100013, China
| | - Xinghuo Pang
- Beijing Center for Disease Prevention and Control, Beijing 100013, China
| | - Caiping Guo
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Wei Zhang
- Beijing Center for Disease Prevention and Control, Beijing 100013, China
| | - Yakun Tian
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Qian Qiu
- Beijing Center for Disease Prevention and Control, Beijing 100013, China
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11
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Abstract
OBJECTIVE The main objective of this article is to review the immunogenicity and safety of the 3-antigen recombinant hepatitis B vaccine (3A-HepB) in adults. DATA SOURCES A literature search was performed using PubMed and Google Scholar (2000 to June 2022) with the search terms hepatitis B vaccine and 3-antigen. Other resources included the Centers for Disease Control and Prevention, conference abstracts of liver meetings, the prescribing information, and the manufacturer's website. STUDY SELECTION AND DATA EXTRACTION All English-language articles of studies assessing the immunogenicity and safety of 3A-HepB in humans were included. DATA SYNTHESIS The 3A-HepB is licensed to prevent infection caused by all known subtypes of the hepatitis B virus in adults. It contains 3 hepatitis B surface antigens. The 3A-HepB has been shown to be noninferior to a single-antigen hepatitis B vaccine (1A-HepB). It is administered intramuscularly as a 3-dose series at 0, 1, and 6 months. The most commonly reported local reactions were injection site pain and tenderness, and the most commonly reported systemic reactions were headache, fatigue, and myalgia. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE The introduction of 3A-HepB represents another step toward reducing the rates of new hepatitis B infections. However, clinical trials are needed to assess the immunogenicity of 3A-HepB in individuals at high-risk of nonresponse or low response to 1A-HepB, such as those with renal or hepatic impairment and those with altered immunocompetence. CONCLUSIONS The 3A-HepB represents another vaccine to prevent hepatitis B in adults. It is safe and immunogenic but is associated with more adverse reactions than 1A-HepB.
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Affiliation(s)
| | | | - Elias B Chahine
- Palm Beach Atlantic University, Gregory School of Pharmacy, West Palm Beach, FL, USA
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12
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Seida I, Seida R, Elsalti A, Mahroum N. Vaccines and Autoimmunity-From Side Effects to ASIA Syndrome. Medicina (Kaunas) 2023; 59. [PMID: 36837564 DOI: 10.3390/medicina59020364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/20/2022] [Accepted: 01/05/2023] [Indexed: 02/17/2023]
Abstract
Since vaccines are in fact manufactured chemical compounds such as drugs, the appearance of side effects following their use is not surprising. Similarly, as the main goal of vaccines is to stimulate the immune system bringing out the production of protective antibodies, autoimmune-related side effects as a consequence of increased immune activity do not seem irrational. Fortunately, the rate of such side effects is low; however, the importance of reporting adverse events following vaccinations, understanding the mechanisms behind their appearance, making early diagnosis, and appropriate treatment cannot be overemphasized. In fact, autoimmune-related side effects of vaccines, particularly those based on adjuvants, were reported long before the introduction of the autoimmune/inflammatory syndrome induced by adjuvants (ASIA). Nevertheless, ASIA gathered and united the side effects of vaccines under one title, a step which helped organize the research and call for better immune stimulators than adjuvants. New technologies and methods of making vaccines were clearly noticed during the pandemic of COVID-19 after the introduction of mRNA-based vaccines. In our current paper, we introduce the notion of side effects to vaccines, particularly those of autoimmune nature, the mechanisms of ASIA, and the main vaccines linked with the syndrome including the recent COVID-19 vaccines. The transition from side effects to ASIA is the main idea behind our work.
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Demissie M, Weldekidan HA, Yosef Y, Sori SA, Tsega D, Jiru HD, Derribow AB, Tetema MD, Jima GB, Zeleke FT, Endeshew F, Abeje S. Timing of Hepatitis B Vaccine Birth Dose in Exposed Newborns, Southwest Ethiopia: A Cross-Sectional Study. SAGE Open Nurs 2023; 9:23779608231187258. [PMID: 37457619 PMCID: PMC10345928 DOI: 10.1177/23779608231187258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/19/2023] [Accepted: 06/24/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Hepatitis B virus disease is a global acute and chronic communicable disease. Mother-to-child transmission is the reason for high carrier rates. Unvaccinated newborns infected through mother-to-child transmission are at >95% risk of developing chronic hepatitis B virus disease. Vaccination is the most effective measure to reduce the global incidence of hepatitis B virus disease. Despite the World Health Organization's target to achieve 90% of the hepatitis B vaccine birth dose by 2030, little is known about the vaccination status of exposed newborns. Objective The present study aimed to determine the timing of the hepatitis B vaccine birth dose in exposed newborns in Southwest Ethiopia. Methods An institution-based cross-sectional study was employed on 422 systematically selected exposed newborns from April 2, 2022, to August 28, 2022. A pretested, interviewer-administered questionnaire was used for data collection. Data were entered into Epi data 3.1 and exported into SPSS version 23 software for analysis. Both bivariable and multivariable binary logistic regressions were performed. Variables with a p-value <.05 at a 95% confidence interval (CI) were considered statistically significant. Results The proportion of neonates who received their first dose of the hepatitis B vaccine on time was 57 (42.5%) (95% CI: 38.3-46.1%). A higher likelihood of vaccinating their exposed newborns on time was associated with formal education (adjusted odds ratio [AOR] = 3.01, 95% CI: 2.21-7.09), four or more ANC visits (AOR = 2.33, 95% CI: 2.05-6.21), and husband engagement (AOR = 4.31, 95% CI: 2.03-6.34). Conclusion The proportion of timely initiation of the hepatitis B vaccine birth dose in Southwest Ethiopia was low. Thus, strengthening health education on the hepatitis B vaccine, encouraging women to have at least four ANC visits, and encouraging male involvement help improve the timely administration of the hepatitis B vaccine.
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Affiliation(s)
- Mebratu Demissie
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Haregwa Asnake Weldekidan
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Yirgalem Yosef
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Seboka Abebe Sori
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Daniel Tsega
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Hirut Dinku Jiru
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Aberash Beyene Derribow
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Mesfin Difer Tetema
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Gudeta Beriso Jima
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Fentahun Temene Zeleke
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Fikremariam Endeshew
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Seblework Abeje
- Department of Biochemistry, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
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14
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Li Y, Chen W, Jin C, Wang T, Yao T, Feng S, Wang B, Feng Y, Wang S. Infant immune response to hepatitis B vaccine after fetal exposure to telbivudine. Hum Vaccin Immunother 2022; 18:2029259. [PMID: 35296227 PMCID: PMC8993090 DOI: 10.1080/21645515.2022.2029259] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Whether telbivudine (LdT) treatment to pregnant women with hepatitis B surface antigen (HBsAg) affects infant immune response to hepatitis B vaccine (HepB) has not been investigated. A total of 127 HBsAg positive mothers and their neonates were enrolled and followed up at 11–13 months. Mothers took LdT (LdT group) or did not receive antiviral therapy (control group). Infant anti-HBs, immune cells and cytokines were measured after HepB was administered according to 0-1-6 procedure. We performed a 1:3 propensity score matching (PSM). Immune indexes in the two groups were compared. Baseline characteristics of mother-baby pairs were comparable in LdT group and control group. Infant anti-HBs geometric mean concentration (GMC) did not differ significantly between the two groups [767.70 (745.35) vs. 711.90 (819.60), P = .599]. There was no difference between the two groups in infant positive rate of anti-HBs [97.8% (91/93) vs. 97.1% (33/34), P = .999] and strong positive rate of anti-HBs [40.9% (38/93) vs. 44.1% (15/34), P = .742]. Infants with negative, low, medium, and high anti-HBs levels were similarly distributed between the two groups (P = .511). No differences in proportion of helper T cells, cytotoxic T cells, B cells, myeloid dendritic cells, and plasmacytoid dendritic cells of infants (P > .05) were detected between the two groups. Children in the LdT and control group had comparable levels of interleukin-2, interleukin-4, interleukin-6, interleukin-10, interleukin-12, interferon-α, interferon-γ and tumor necrosis factor-α (P > .05). Intrauterine exposure to LdT was safe to infant immune response to HepB after birth.
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Affiliation(s)
- Yandi Li
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China.,Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Wenxin Chen
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Cong Jin
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Ting Wang
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Tian Yao
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Shuying Feng
- Department of Obstetrics and Gynaecology, The Third People's Hospital of Taiyuan, Taiyuan, Shanxi, China
| | - Bo Wang
- Department of Obstetrics and Gynaecology, The Third People's Hospital of Taiyuan, Taiyuan, Shanxi, China
| | - Yongliang Feng
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China.,Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Suping Wang
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China.,Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, Shanxi, China
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15
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Öztürk S, Özel AS, Ergen P, Şenbayrak S, Ağalar C. Hepatitis B immunization data of patients living with HIV/AIDS: a multi-centre study. Cent Eur J Public Health 2022; 30:213-218. [PMID: 36718922 DOI: 10.21101/cejph.a7300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 12/06/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Human immunodeficiency virus (HIV) and hepatitis B virus (HBV) are the two leading viruses that cause the greatest number of virus-related morbidities in the world. HIV/HBV coinfection is correlated with high morbidity and mortality. For this particular reason hepatitis B vaccination is crucial for people living with HIV. METHODS Patients who are being followed-up for HIV/AIDS and who have received a hepatitis B vaccine in 4 HIV clinics over a 5-year time period have been studied. Our multi-centered, retrospective, cross-sectional and observational study investigates factors that affect hepatitis B vaccination immune response of individuals living with HIV. The patients have been studied for the parameters such as age, sex, CD4 count at the time of diagnosis or vaccination, HIV-RNA levels, comorbidities, vaccine dosage, success of immunization after vaccination, and the demographics of the patients who have and have not developed immunity. RESULTS Of 645 patients that are being followed-up in our clinics, 158 received hepatitis B vaccine; 39 of these 158 patients have been excluded from the study because they did not fulfil the inclusion criteria. Finally, 119 patients were evaluated in the study, 17 of the patients (14.3%) were females and 102 (85.7%) were males. The median age was 41.11 ± 10.09 (min-max: 18-75). Twenty-three of the patients (19.3%) were at the stage of AIDS during diagnosis while 80.7% were at the stage of HIV infection. Ninety-one of the patients (76.5%) have been administered a single dose hepatitis B vaccine on the standard 0, 1st, 6th month vaccination schedule, whereas 23.5% were administered a double dose on the same vaccination schedule. When further evaluated to find whether the patient was able to develop sufficient immunity (anti-HBs ≥ 10), it was found that the immune response was statistically significantly higher in the patients whose CD4 count was greater than 200 at the time of the first diagnosis and vaccination (p = 0.05 and p = 0.001, respectively). The patients have also been evaluated according to the number of doses they received (1 vs. 2). The immune response of the patients who received two doses was statistically significantly higher (p = 0.041). CONCLUSION We can conclude that in the patients with CD4 count less than 200 at the time of their diagnosis and vaccination a high dose recombinant hepatitis B vaccine should definitely be administered as the normal dose and higher dose have similar side effect profiles and the higher dose provides greater immunity.
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Affiliation(s)
- Servet Öztürk
- Clinic of Infectious Diseases and Clinical Microbiology, Okan University Hospital, Istanbul, Turkey
| | - Ayşe Serra Özel
- Clinic of Infectious Diseases and Clinical Microbiology, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Pinar Ergen
- Clinic of Infectious Diseases and Clinical Microbiology, Prof. Dr. Suleyman Yalcin Hospital, Medeniyet University, Istanbul, Turkey
| | - Seniha Şenbayrak
- Clinic of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Canan Ağalar
- Clinic of Infectious Diseases and Clinical Microbiology, Medicana Atasehir Hospital, Fenerbahce University, Istanbul, Turkey
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16
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Lian J, Kuang W, Jia H, Lu Y, Zhang X, Ye C, Gu J, Lv Y, Yu J, Zhang Y, Lu X, Zhao Y, Yang D, Wang K, Zhao P, Yu Y, Bai L, Zhang J, Zhang X, Yang Y. Pegylated interferon-α-2b combined with tenofovir disoproxil fumarate, granulocyte-macrophage colony-stimulating factor, and hepatitis B vaccine treatment for naïve HBeAg-positive chronic hepatitis B patients: A prospective, multicenter, randomized controlled study. J Med Virol 2022; 94:5475-5483. [PMID: 35836102 DOI: 10.1002/jmv.28003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 02/05/2023]
Abstract
Hepatitis B surface antigen (HBsAg) loss or seroconversion is an ideal treatment endpoint for patients with chronic hepatitis B but is rarely achievable in hepatitis B e-antigen (HBeAg)-positive patients using existing treatment strategies. In this study, the effect of pegylated interferon (peg-IFN) alfa-2b plus tenofovir disoproxil fumarate (TDF), granulocyte-macrophage colony-stimulating factor (GM-CSF), and hepatitis B vaccine was evaluated. This randomized controlled trial was conducted at nine liver centers in Chinese university hospitals from May 2018 to July 2020. Patients (n = 303) enrolled were randomly administered peg-IFN-α-2b combined with TDF, GM-CSF, and hepatitis B vaccine (experimental group); peg-IFN-α-2b plus TDF (control group 2); or interferon-α-2b alone (control group 1). The primary efficacy endpoint was HBsAg seroconversion at 48 weeks and the secondary endpoint included safety. No differences in baseline HBsAg levels were observed among the groups. The primary endpoint was achieved in three (3.0%), one (1.03%), and one (1.19%) patient in the experimental group, control group 2, and control group 1, respectively. The incidence of HBsAg seroconversion at week 48 was not significantly different among the three groups (p = 0.629). However, the decrease in serum levels of HBsAg at week 48 was significantly higher in the experimental and control group 2 compared with that in control group 1 (p = 0.008 and 0.006, respectively). No significant difference between the experimental and control group 2 was observed (p = 0.619). Adverse events were not significantly different among the groups except for the lower incidence of neutropenia in the experimental group. Peg-IFN-α-2b combined with TDF, GM-CSF, and hepatitis B vaccine is not superior to peg-IFN-α-2b combined with TDF in HBeAg-positive naïve patients. Clinical Trials Registration: ChiCTR1800016173.
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Affiliation(s)
- Jiangshan Lian
- Department of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Kuang
- Department of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hongyu Jia
- Department of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yingfeng Lu
- Department of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoli Zhang
- Department of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chanyuan Ye
- Department of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jueqing Gu
- Department of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yan Lv
- Department of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiong Yu
- Department of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yimin Zhang
- Department of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoqing Lu
- Department of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yingren Zhao
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Dongliang Yang
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kai Wang
- Department of Hepatology, Qilu Hospital of Shandong University, Jinan, China
| | - Ping Zhao
- International Center for Liver Disease Treatment, 302 Hospital, Beijing, China
| | - Yanyan Yu
- Department of Infectious Diseases, Peking University First Hospital, Beijing, China
| | - Lang Bai
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, China
| | - Jiming Zhang
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Xinxin Zhang
- Department of Infectious Disease, Research Laboratory of Clinical Virology, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yida Yang
- Department of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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17
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Deng X, Guo X, Gu H, Wang D, Laperche S, Allain J, Zang L, Candotti D. Anti-HBc-nonreactive occult hepatitis B infections with HBV genotypes B and C in vaccinated immunocompetent adults. J Viral Hepat 2022; 29:958-967. [PMID: 35876456 PMCID: PMC9804389 DOI: 10.1111/jvh.13733] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/01/2022] [Indexed: 01/05/2023]
Abstract
Absence of anti-HBc reactivity with detectable anti-HBs was observed in blood donors with occult hepatitis B virus (HBV) infection (OBI). The prevalence and mechanisms underlying this uncommon condition were investigated over time in Chinese blood donors with OBI. Isolated anti-HBs OBI status was identified from 466,911 donors from Dalian, China, and monitored in follow-up (range: 2.6-84.3 months). HBV vaccination status was documented, and infecting viral strains were characterized. Of 451 confirmed OBIs (1:1035), 43 (9.5%; 1:10,858) had isolated anti-HBs as only serological marker. Isolated anti-HBs OBIs differed from anti-HBc-reactive OBIs by significantly younger age (median 24 years), higher HBV DNA (median: 20 IU/ml) and anti-HBs (median 60.5 IU/L) levels, paucity of mutations in HBV Core and S proteins, and high vaccination rate (72%). Vaccinated isolated anti-HBs OBIs (n = 31) differed from unvaccinated (n = 11) by significantly younger age (22 vs 38 years), higher anti-HBs level at index (48% vs 9% with anti-HBs >100 IU/L) and higher frequency of anti-HBs immune response (44% vs 20%). Of 15 vaccinated and 5 unvaccinated OBIs follow-up, 65% (8 vaccinated and 5 unvaccinated) became HBV DNA negative suggesting aborted recent infection, while 35% (7 vaccinated) had low persistent viraemia 2 to 65 months post index. In conclusion, isolated anti-HBs OBI in Chinese blood donors appears associated with young, vaccinated, adults exposed to HBV who predominantly develop low level aborted infection revealed by transient HBV DNA and immune anti-HBs response. However, a subset of individuals still experienced low but persistent viral replication whose clinical outcome remains uncertain.
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Affiliation(s)
| | | | - Hongfang Gu
- Dalian Public Health Clinical CenterDalianChina
| | | | - Syria Laperche
- Department of Blood Transmitted AgentsNational Institute of Blood TransfusionParisFrance
| | | | | | - Daniel Candotti
- Department of Blood Transmitted AgentsNational Institute of Blood TransfusionParisFrance,Department of VirologyHenri Mondor Hospital, AP‐HPCréteilFrance,University of Paris‐Est, INSERM U955, IMRBCréteilFrance
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18
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Nacasch N, Cohen-Hagai K, Tayar N, Levian A, Rashid G, Benchetrit S, Neumark E, Wand O, Hod T, Rosman Y, Shashar M, Grupper A, Shitrit P. Humoral Response to Hepatitis B and COVID-19 Vaccine among Maintenance Hemodialysis Patients. Vaccines (Basel) 2022; 10:1670. [PMID: 36298535 DOI: 10.3390/vaccines10101670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 09/28/2022] [Accepted: 10/03/2022] [Indexed: 11/05/2022] Open
Abstract
Maintenance hemodialysis (MHD) patients have impaired immunological responses to pathogens and vaccines. In this study, we compared the humoral response to HBV and COVID-19 vaccines in a cohort of MHD patients. Demographic and clinical characteristics of vaccine responders and non-responders were also compared, and the association between the humoral responses to both vaccines was evaluated. The cohort included 94 MHD patients who were vaccinated at least once for HBV and twice for COVID-19. Among the 94 patients, 28 (29.8%) did not develop protective titers to HBV. Hypertension, coronary heart disease, and heart failure were more common in non-responders. Among MHD patients, 85% had positive IgG anti-spike SARS-CoV-2 levels 6 months after two doses of BNT162b2 (Pfizer/Biotech) vaccine. Age and immunosuppressive therapy were the main predictors of humoral response to COVID-19 vaccine. We did not find any association between non-responders to HBV and non-responders to COVID-19 vaccine. There was no difference in IgG anti-spike titers between HBV responders and non-responders (505 ± 644 vs. 504 ± 781, p = 0.9) Our results suggest that reduced humoral response to hepatitis B is not associated with reduced response to COVID-19 vaccine. Different risk-factors were associated with poor immune response to HBV and to COVID-19 vaccines.
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Aoun M, Kahwaji RM, Sleilaty G, Boueri C, Hawi J, Khalil CB, Hage V. Factors predictive of anti-spike antibody titers after COVID-19 vaccination in hemodialysis patients. ADV CLIN EXP MED 2022; 31:855-861. [PMID: 35438849 DOI: 10.17219/acem/147360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Hemodialysis (HD) patients have a high prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and mortality, but they may have a weak response to coronavirus disease 2019 (COVID-19) vaccines. OBJECTIVES This study aimed to evaluate factors predictive of humoral response in HD patients vaccinated against SARS-CoV-2 infection. MATERIAL AND METHODS This is a 2-center observational study including HD patients who received the BNT162b2 mRNA vaccine followed by serological measurements 20 days and 4 weeks after the 1st and 2nd dose, respectively. Healthy controls were included. Anti-spike antibody was measured using the chemiluminescent immunoassay (CLIA) method. The quantile regression analysis was performed to assess factors associated with anti-spike antibody titers. RESULTS Seventy-two HD patients and 22 healthy controls were included. Mean age of dialysis patients and controls was 72.5 ±11.5 years and 45.7 ±17.4 years, respectively. In the HD group, median levels of anti-spike antibody were 3 (interquartile range (IQR): 0.5-26) UI/mL and 391 (IQR: 55-1642) UI/mL after the 1st and 2nd dose, respectively, with response rates of 62.5% and 96.7%. The median level of the anti-spike antibody after the 1st dose in previously infected patients was 8571 (IQR: 2586-19147) UI/mL. There was a significant correlation between anti-spike antibody levels after the 2nd dose and age and anti-hepatitis B surface (HBs) antibody and serum albumin levels (Spearman's rho: r = -0.289, p < 0.001; r = 0.357, p = 0.027; r = 0.317; p = 0.026, respectively). The regression analysis showed a significant association of previous infection and anti-Hbs antibody level with anti-spike antibody level after the 1st dose of vaccine (p < 0.001). After a 5-month follow-up, 2 vaccinated patients contracted COVID-19. CONCLUSIONS This study showed a response rate of 96.7% to 2 doses of BNT162b2 mRNA vaccine in HD patients and 100% to a single dose in previously infected patients. The level of anti-spike antibody can be predicted by age, anti-Hbs antibodies, serum albumin, and previous infection. Despite the immunization of patients, preventive measures should be maintained in all dialysis units.
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Affiliation(s)
- Mabel Aoun
- Department of Nephrology, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Department of Nephrology, Saint-George Hospital Ajaltoun, Lebanon
| | | | - Ghassan Sleilaty
- Department of Biostatistics and Clinical Research Center, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Celine Boueri
- Department of Nephrology, Saint-George Hospital Ajaltoun, Lebanon
| | - Jenny Hawi
- Department of Nephrology, Saint-George Hospital Ajaltoun, Lebanon
| | | | - Valerie Hage
- Department of Nephrology, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Department of Nephrology, Centre Hospitalier de Bhannes, Lebanon
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20
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Peng J, Yao X, Yuan C, Liu X, Xia R, He J, Li R, Yao Y. The Investigation of Hepatitis B Vaccine Immune Responses in Occult Hepatitis B Virus-Infected Patients. Front Immunol 2022; 13:903685. [PMID: 35747142 PMCID: PMC9211749 DOI: 10.3389/fimmu.2022.903685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/03/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives There is no effective treatment for occult hepatitis B virus infection (OBI) patients, and immunotherapy may be one of the most promising options. We aim to investigate the underlying mechanism and therapeutic potential of hepatitis B vaccine immunotherapy for OBI patients. Methods Outpatient OBI patients were screened and randomly divided into treatment (Group A) and control (Group B) groups. At weeks 0, 4, and 24, patients in Group A received a subcutaneous/intramuscular injection of hepatitis B vaccine (Engerix-B, 20 μg/time) according to the standard vaccination schedule; patients in Group B served as blank control. The patients were followed for 36 weeks, with clinical, biochemical, virological, immunological, and imaging data collected and analyzed at weeks 0, 12, 24, and 36, respectively, and the relation between the virology and immunology results was analyzed. Results Of the 228 OBI patients, 28 were excluded, and 200 were enrolled for observation. In the end, 44 patients were included in Group A and 39 in Group B after excluding lost cases. At week 0 (baseline), some patients in two groups had liver disease symptoms, HBV-related liver function damage, and liver fibrosis. 86.36% (38/44) and 82.05% (32/39) patients were positive for serum hepatitis B surface antibodies (anti-HBs) in Group A and Group B, respectively, with the median (quartile) of 42.47 (16.85, 109.1) and 39.27 (16.06, 117.4) mIU/ml, respectively. Reduced peripheral blood CD4+T, CD8+T, and B lymphocytes were found in some patients in two groups. These results were not statistically different between Group A and Group B (P>0.05). At week 36, all patients were serum anti-HBs (+) in Group A, with a median (quartile) of 1000 (483.9, 1000) mIU/ml, which was significantly higher than that at week 0 (P<0.05) and that in Group B (P<0.05). Compared to week 0, the number of CD8+ T and B lymphocytes increased significantly and were significantly higher than Group B at the same point. Two patients in Group B were found to have hepatitis B virus reactivation from week 12 to week 36. Correlation Analysis Anti-HBs in Group A patients were positively correlated with B lymphocytes (r=0.3431, 0.3087, and 0.3041, respectively) and positively correlated with CD8+ T lymphocytes (r=0.4954, 0.3054, and 0.3455, respectively) at weeks 12, 24, and 36. Conclusion Virological reactivation is a risk for OBI patients. Serum hepatitis B surface antibodies were significantly increased after hepatitis B vaccine treatment, the same as the numbers of peripheral blood B and CD8+ T lymphocytes; changes in hepatitis B surface antibody levels were positively correlated with the changes in peripheral blood B and CD8+ T lymphocytes.
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Affiliation(s)
- Jing Peng
- The Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xueying Yao
- The Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chunyan Yuan
- The Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoli Liu
- The Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Renxiang Xia
- The Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jian He
- The Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Rui Li
- The Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yunqing Yao
- The Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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21
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Hettenbaugh J, Mullane R, Gillispie G, Shostrom V, Flores L, Fillaus JA, Florescu MC, Murcek D, Tendulkar KK. Hepatitis B Vaccination in Advanced Chronic Kidney Disease: A Quality Improvement Project at a Veteran Affairs Chronic Kidney Disease Clinic. Infect Dis Rep 2021; 13:1036-1042. [PMID: 34940404 PMCID: PMC8701395 DOI: 10.3390/idr13040094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/29/2021] [Accepted: 11/29/2021] [Indexed: 11/19/2022] Open
Abstract
Hepatitis B vaccination is recommended in all patients with end-stage kidney disease (ESKD). However, only 50–60% of these patients achieve protective antibody levels if immunized after starting dialysis. Strategies to overcome this low seroconversion rate include a 6-month vaccination schedule starting earlier [chronic kidney disease (CKD) stage 4 and 5] to ensure immunity when patients progress to ESKD. We conducted a quality improvement program to immunize pre-dialysis patients. Patients who were found to have a negative baseline serology with a negative hepatitis B surface antibody level (HBsAb) were offered vaccination on a 6-month schedule (0, 1 and 6 months) with one of two available vaccines within the VA system (Recombivax™ or Engerix™). HBsAb titers were checked 3–4 months later, and titers ≥ 12 mIU/mL were indicative of immunity at VA. Patients who did not seroconvert were offered a repeat schedule of three more doses. We screened 198 patients (187 males and 11 females) with CKD 4 and 5 [glomerular filtration rate (GFR) < 29 mL/min/1.73 m2]. The median age of this cohort was 72 years (range 38–92 years). During the study period of 5 years (2015–2020), 10 patients were excluded since their GFR had improved to more than 30 mL/min/1.73 m2, 24 others had baseline immunity and 2 refused vaccination. The hepatitis B vaccination series was not started on 106 patients. Of the remaining 56, 12 patients progressed to ESKD and started dialysis before completion of the vaccination schedule, 6 expired and 1 did not come to clinic in 2020 due to the pandemic. Of the 37 patients who completed the vaccination schedule, 16 achieved seroconversion with adequate HBsAb titers, 10 did not develop immunity despite a second hepatitis B vaccination series, while 11 did not get a second series. Given the low seroconversion rate, albeit in a small cohort, vaccination should be considered in patients with earlier stages of CKD. Other options include studies on FDA approved vaccines of shorter duration. We plan to increase awareness among nephrologists, patients and nursing staff about the importance of achieving immunity against hepatitis B.
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Affiliation(s)
- Jacob Hettenbaugh
- Department of Internal Medicine, Division of Nephrology, University of Nebraska Medical Center, Omaha, NE 68138, USA; (J.H.); (R.M.); (G.G.); (V.S.); (L.F.); (J.A.F.); (M.C.F.); (D.M.)
- VA Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA
| | - Ryan Mullane
- Department of Internal Medicine, Division of Nephrology, University of Nebraska Medical Center, Omaha, NE 68138, USA; (J.H.); (R.M.); (G.G.); (V.S.); (L.F.); (J.A.F.); (M.C.F.); (D.M.)
- VA Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA
| | - Gayle Gillispie
- Department of Internal Medicine, Division of Nephrology, University of Nebraska Medical Center, Omaha, NE 68138, USA; (J.H.); (R.M.); (G.G.); (V.S.); (L.F.); (J.A.F.); (M.C.F.); (D.M.)
- VA Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA
| | - Valerie Shostrom
- Department of Internal Medicine, Division of Nephrology, University of Nebraska Medical Center, Omaha, NE 68138, USA; (J.H.); (R.M.); (G.G.); (V.S.); (L.F.); (J.A.F.); (M.C.F.); (D.M.)
- VA Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA
| | - Linda Flores
- Department of Internal Medicine, Division of Nephrology, University of Nebraska Medical Center, Omaha, NE 68138, USA; (J.H.); (R.M.); (G.G.); (V.S.); (L.F.); (J.A.F.); (M.C.F.); (D.M.)
- VA Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA
| | - Jennifer A. Fillaus
- Department of Internal Medicine, Division of Nephrology, University of Nebraska Medical Center, Omaha, NE 68138, USA; (J.H.); (R.M.); (G.G.); (V.S.); (L.F.); (J.A.F.); (M.C.F.); (D.M.)
- VA Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA
| | - Marius C. Florescu
- Department of Internal Medicine, Division of Nephrology, University of Nebraska Medical Center, Omaha, NE 68138, USA; (J.H.); (R.M.); (G.G.); (V.S.); (L.F.); (J.A.F.); (M.C.F.); (D.M.)
- VA Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA
| | - Denise Murcek
- Department of Internal Medicine, Division of Nephrology, University of Nebraska Medical Center, Omaha, NE 68138, USA; (J.H.); (R.M.); (G.G.); (V.S.); (L.F.); (J.A.F.); (M.C.F.); (D.M.)
- VA Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA
| | - Ketki K. Tendulkar
- Department of Internal Medicine, Division of Nephrology, University of Nebraska Medical Center, Omaha, NE 68138, USA; (J.H.); (R.M.); (G.G.); (V.S.); (L.F.); (J.A.F.); (M.C.F.); (D.M.)
- VA Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA
- Correspondence: ; Tel.: +1-402-559-9227
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22
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Zhou Y, Lu Z, He H, Yan R, Deng X, Tang X, Zhu Y, Xu X. Influencing factors and necessity of post-vaccination serologic testing follow-up for HBsAg-positive mothers and their infants: A 5-year prospective study in Zhejiang Province, China (2016-2020). J Viral Hepat 2021; 28:1413-1421. [PMID: 34310810 DOI: 10.1111/jvh.13581] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 07/02/2021] [Accepted: 07/21/2021] [Indexed: 12/09/2022]
Abstract
In 2016, China officially proposed for the first time that infants born to HBsAg-positive mothers should be tested for HBsAg and anti-HBs 1-2 months after their third dose of HepB, also known as the post-vaccination serological testing programme. This study aimed to systematically evaluate the implementation and influencing factors of PVST to further reduce HBV infection risk in infants and improve the protective effect of HepB to the greatest extent. A prospective observational study was conducted to investigate the interruption of MTCT of hepatitis B. Univariate and multivariate analyses were applied to explore factors associated with the PVST follow-up rate among HBsAg-positive mothers and their infants. Additionally, bivariate analysis was performed on HBsAg and anti-HBs results in infants born to HBsAg-positive mothers. Here, the participation rate of PVST was 67.08% among 2120 pairs of positive mothers and infants. The HBsAg-positive rate among participants was 0.77%, whereas the anti-HBs positive rate was 96.84%, and both negative rates were 2.39%. Among infants with double negative results (34), only 15 completed three doses of HepB and PVST again, and 14 (93.33%) of which the antibody test results turned positive. Older mothers with high educational levels who reside in the local area were the most likely to PVST follow-up. The PVST programme is necessary to evaluate the HepB response status of newborns after vaccination. Moreover, revaccination for susceptible infants can effectively improve the MTCT-blocking rate of hepatitis B. Therefore, the scope of PVST projects in Zhejiang and China should be expanded.
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Affiliation(s)
- Yang Zhou
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Zhaojun Lu
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Hanqing He
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Rui Yan
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xuan Deng
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xuewen Tang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yao Zhu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xiaoping Xu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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23
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Koc ÖM, de Smedt P, Kremer C, Robaeys G, van Damme P, Hens N, Almeida J, Falkenberg F, Savelkoul P, Oude Lashof A. Immunogenicity and safety of HBAI20 Hepatitis B vaccine in non-responders: Double-blinded, randomised, controlled phase 2 trial. Liver Int 2021; 41:2318-2327. [PMID: 33966331 PMCID: PMC8518051 DOI: 10.1111/liv.14939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 03/28/2021] [Accepted: 04/29/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND & AIMS Approximately 5%-10% of the general population respond inadequately to licensed recombinant hepatitis B vaccines. We assessed the immunogenicity and safety of a new HBAI20 vaccine, consisting of a new AI20 adjuvant (20-µg recombinant human IL-2 attached to 20-µg aluminium hydroxide) in combination with HBVaxPro®-10 µg. METHODS In a double-blinded, randomised, controlled phase 2 trial, 18- to 59-year-old healthy non-responders (titre <10 mIU/ml after three or more doses of hepatitis B vaccine) were assigned (3:1 ratio) to receive either HBAI20 vaccine or HBVaxPro®-10 µg in a 0, 1 and 2-month schedule. The primary outcome was seroprotection (titre ≥ 10 mIU/ml) measured 1-3 months following the third vaccination. RESULTS A total of 133 participants were randomised to receive either HBAI20 vaccine (n = 101) or HBVaxPro®-10 µg (n = 32). In the modified intention-to-treat analysis, the seroprotection rate after the third vaccination was 92.0% (80/87) in the HBAI20 group and 79.3% (23/29) in the HBVaxPro®-10-µg group, P = .068. Using a generalised linear mixed model to adjust for stratification factors, a higher odds of seroprotection with HBAI20 vaccine was shown (adjusted odds ratio = 3.48, P = .028). Frequency of mild and moderate local adverse events was greater in the HBAI20 group than in the HBVaxPro®-10 µg. Rates of severe local adverse events and systemic adverse events were low and similar in both groups. CONCLUSIONS In this group of hepatitis B vaccine non-responders, the HBAI20 vaccine demonstrated a higher seroprotection rate when adjusting for stratification factors and a similar safety profile compared to the licensed recombinant HBVaxPro®-10 µg.
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Affiliation(s)
- Özgür M Koc
- Department of Medical Microbiology, School of NUTRIM, Maastricht UMC+, Maastricht, The Netherlands.,Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium.,Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Philippe de Smedt
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, Antwerp University, Antwerp, Belgium
| | - Cécile Kremer
- Data Science Institute, I-BioStat, Hasselt University, Hasselt, Belgium
| | - Geert Robaeys
- Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium.,Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Department of Gastroenterology and Hepatology, KU Leuven, Leuven, Belgium
| | - Pierre van Damme
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, Antwerp University, Antwerp, Belgium
| | - Niel Hens
- Data Science Institute, I-BioStat, Hasselt University, Hasselt, Belgium.,Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, Antwerp University, Antwerp, Belgium
| | | | - Frank Falkenberg
- CyTuVax B.V, Maastricht, The Netherlands.,CIRES GmbH, Dortmund, Germany
| | - Paul Savelkoul
- Department of Medical Microbiology, School of NUTRIM, Maastricht UMC+, Maastricht, The Netherlands.,Department of Medical Microbiology & Infection Control, Amsterdam University Medical Centers, VUMC, Amsterdam, The Netherlands
| | - Astrid Oude Lashof
- Department of Medical Microbiology, School of NUTRIM, Maastricht UMC+, Maastricht, The Netherlands
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Wang WC, Lin YS, Chang YF, Yeh CC, Su CT, Wu JS, Su FH. Association of HLA-DPA1, HLA-DPB1, and HLA-DQB1 Alleles With the Long-Term and Booster Immune Responses of Young Adults Vaccinated Against the Hepatitis B Virus as Neonates. Front Immunol 2021; 12:710414. [PMID: 34484213 PMCID: PMC8416438 DOI: 10.3389/fimmu.2021.710414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 07/19/2021] [Indexed: 01/02/2023] Open
Abstract
The neonatal hepatitis B vaccination (HBVac) was implemented 35 years ago in Taiwan, but many vaccinees exhibit inadequate long-term vaccine-induced seroprotective hepatitis B surface antibody (anti-HBs) levels. We investigated the association of the human leukocyte antigen (HLA) alleles (DPA1, DPB1, DQA1, and DQB1) with the long-term immunological response to the neonatal HBVac and adolescent booster HBVac in a Taiwanese cohort. We divided 281 Han students (median age 22, age range 17–29 years) into the following groups: (1) Group A (n = 61): anti-HBs titer ≥ 10 mIU/mL at the beginning of the study; (2) Group B (n = 75): anti-HBs level > 1000 mIU/mL after the first booster; (3) Group C (n = 37): anti-HBs level < 10 mIU/mL after the first booster; and (4) Group D (n = 5): anti-HBs level < 10 mIU/mL after three boosters. DQA1, DQB1, DPA1, and DPB1 typing of the participants was performed using sequence-specific oligonucleotides. Associations of HLA alleles and haplotypes with effects on neonatal HBVac and booster HBVac were examined through logistic regression analysis and Fisher’s exact test. A false discovery rate-based measure of significance, the q-value, was used for multiple comparisons, and an association was considered significant if the corresponding q-value was < 0.1. DPA1 alleles were associated with the long-term immunological response to the neonatal HBVac. The estimated odds ratio (OR) of the lack of HBV protective immunity when carrying an additional DPA1*01 and DPA1*02 was 0.36 [95% confidence interval (CI) = 0.17–0.76, p = 0.0076] and 2.39 (95% CI = 1.17–4.87, p = 0.016), respectively. DPB1 and DQB1 alleles were associated with a response to the adolescent booster vaccination. The estimated ORs of being nonresponsive to the first booster when carrying an additional DPB1*05 and DQB1*02 were 2.11 (95% CI = 1.13–3.93, p = 0.019) and 3.73 (95% CI = 1.43–9.71, p = 0.0070), respectively. All DPB1*03 carriers responded to the first booster (p of Fisher’s exact test = 0.0045). In our study, we discovered that HLA-DPA1 was primarily associated with the long-term response of primary infantile HBVac, and HLA-DPB1 and HLA-DQB1 exhibited associations with the HBV booster vaccination.
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Affiliation(s)
- Wen-Chang Wang
- The Ph.D. Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,Cancer Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yu-Shiang Lin
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.,Department of Clinical Laboratory, the First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Yin-Fan Chang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Ching Yeh
- Cancer Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.,Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.,Master Program in Applied Epidemiology, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Chien-Tien Su
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.,Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Jin-Shang Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Family Medicine, National Cheng Kung University Hospital, Douliou Branch, College of Medicine, National Cheng Kung University, Yunlin, Taiwan.,Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Fu-Hsiung Su
- Department of Family Medicine, Cardinal Tien Hospital, Fu Jen Catholic University, New Taipei City, Taiwan.,School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
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25
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Benarji KA, Anitha A, Suresh B, Aparna V, Praveena A, Penumatsa LA. Knowledge and attitude of dental students toward hepatitis B virus and its vaccination - A cross-sectional study. J Oral Maxillofac Pathol 2021; 25:553. [PMID: 35281163 PMCID: PMC8859610 DOI: 10.4103/jomfp.jomfp_387_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/02/2021] [Indexed: 12/02/2022] Open
Abstract
Objectives: To estimate the awareness of hepatitis B virus (HBV) and coverage of hepatitis B vaccination among dental students enrolled in dental colleges located in Andhra Pradesh. Materials and Methods: A cross-sectional study was conducted using a prestructured questionnaire to find out the awareness of HBV and coverage of hepatitis B vaccine among dental students. Results: A total of 2780 dental students were approached to participate in the study but only 2701 (97.1%) students (M = 900, F = 1801) gave response. Out of the total 2701 students, 79.45% were aware of HBV infection and only 51.50% of the participants received hepatitis B vaccine. 20.5% have come across HBV infected patients and 59.5% are unaware of postexposure protocol. Of all, 63.9%, 21.5% and 42% felt the mode of transmission is blood, sexual contact and oral fluids, respectively. 49.12% recommended for awareness programs on risks in HBV; 56.46% suggested mandatory Hepatitis B vaccination programs in dental colleges. Conclusions: Despite the availability and accessibility of a cost-effective hepatitis B vaccine, the vaccination coverage among dental students was low. Health education needs to be improved for all health care students especially for dental students.
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Affiliation(s)
- Kotti Ajay Benarji
- Department of Oral Pathology and Microbiology, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Gannvaram, Andhra Pradesh, India
| | - Akkaloori Anitha
- Assistant Professor, Department of Public Health Dentistry, Govt Dental College and Hospital, Hyderabad, Telangana, India
| | - Babburi Suresh
- Department of Oral Pathology and Microbiology, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Gannvaram, Andhra Pradesh, India
| | - V Aparna
- Department of Oral Pathology and Microbiology, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Gannvaram, Andhra Pradesh, India
| | - A Praveena
- Department of Oral Pathology and Microbiology, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Gannvaram, Andhra Pradesh, India
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Wong K, Bruxvoort K, Slezak J, Hsu JWY, Reynolds K, Sy LS, Jacobsen SJ. Hepatitis B vaccine and risk of acute myocardial infarction among individuals with diabetes mellitus. Pharmacoepidemiol Drug Saf 2021; 30:1441-1446. [PMID: 34245081 DOI: 10.1002/pds.5327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 05/10/2021] [Accepted: 07/07/2021] [Indexed: 11/05/2022]
Abstract
PURPOSE A pre-licensure clinical trial of a two-dose cytosine phosphoguanine adjuvanted hepatitis B vaccine (HEPLISAV-B® [Dynavax, USA]; HepB-CpG vaccine) found an unanticipated numerical imbalance in acute myocardial infarction (AMI) compared to recipients of a three-dose aluminum adjuvanted hepatitis B vaccine (ENGERIX-B® [GlaxoSmithKline, Belgium]; HepB-alum vaccine). A post-licensure study was required to compare AMI rates among recipients of HepB-CpG vaccine and HepB-alum vaccine. Individuals with diabetes mellitus (DM), who are at higher risk of AMI, comprise more than half of the post-licensure study cohort. To inform the ongoing post-licensure study, we examined the association between AMI and receipt of HepB-alum vaccine in individuals with DM. METHODS We conducted a case-control study nested in a cohort of individuals with DM ages ≥40 years at Kaiser Permanente Southern California using electronic health records. AMI cases from 2012 to 2017 were identified by principal discharge diagnosis and matched 1:1 with randomly selected controls. The adjusted odds ratio (aOR) for receipt of ≥1 HepB-alum vaccine dose was compared for AMI cases and controls using conditional logistic regression. We subsequently performed the same matched case-control analysis stratified by year. RESULTS Of 8138 matched case-control pairs, 17.4% of cases and 15.0% of controls received HepB-alum vaccine. The aOR of HepB-alum vaccination comparing cases and controls was 0.97 (95% confidence interval 0.87-1.08). Similarly, there was no significant association between HepB-alum vaccine and AMI in any of the study years. CONCLUSIONS HepB-alum vaccination was not associated with AMI in individuals with DM. This finding will provide contextual insight for the ongoing post-licensure study of HepB-CpG vaccine.
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Affiliation(s)
- Katherine Wong
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Katia Bruxvoort
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Jeff Slezak
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Jin-Wen Y Hsu
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Kristi Reynolds
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Lina S Sy
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Steven J Jacobsen
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
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Yan D, Yang J, Ji Z, Wang J, Lu X, Huang Y, Zhong C, Li L. Profiling T cell receptor β-chain in responders after immunization with recombinant hepatitis B vaccine. J Gene Med 2021; 23:e3367. [PMID: 34048625 DOI: 10.1002/jgm.3367] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/22/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND T cells with edited T cell receptor β-chain variable (TRBV) are involved in the immune response to recombinant hepatitis B surface antigen (rHBsAg) vaccine and the production of hepatitis B surface antibody (HBsAb). The immune repertoire (IR) profile and mechanism of vaccination positive responders (VPR) with rHBsAg are not fully understood. METHODS The IR of six VPRs (HBsAb+, HbsAg-) with rHBsAg vaccination was established by the high throughput sequencing technique and bioinformatics analysis and compared with those in five vaccination negative responders (VNRs) (HbsAb-, HbsAg-) who were also inoculated with rHBsAg. The repertoire features of the BV, BJ and V (CDR3) J genes and immune diversity in peripheral blood mononuclear cells, respectively, were analyzed for each subject. RESULTS There was no significant difference in sequencing amplification indices of each sample. However, TRBV15/BJ2-3 demonstrated significantly high expression levels in VPR compared to those in the VNR group (both p < 0.05). Further results showed that the BV15/BJ2-5 level was significantly increased for VPR compared to that of VNR group. Interestingly, the motif of CDR3 in TRBV15/BJ2-5 was mostly expressed as "GGETQ" or "GETQ". Additionally, there was no remarkable difference between the two groups of distribution with respect to the different clone expression levels of V (CDR3) J. CONCLUSIONS The features of IR in the VPR and VNR will contribute to the exploration of the mechanism of the positive response to rHBsAg, and also contribute to development of optimized hepatitis B vaccine, in addition to providing a partial interpretation of the VNR who has a relatively low infection with HBV.
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Affiliation(s)
- Dong Yan
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases; National Clinical Research Center for Infectious Diseases; the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiezuan Yang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases; National Clinical Research Center for Infectious Diseases; the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhongkang Ji
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases; National Clinical Research Center for Infectious Diseases; the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ju Wang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases; National Clinical Research Center for Infectious Diseases; the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoqing Lu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases; National Clinical Research Center for Infectious Diseases; the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yandi Huang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases; National Clinical Research Center for Infectious Diseases; the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chengli Zhong
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases; National Clinical Research Center for Infectious Diseases; the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lanjuan Li
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases; National Clinical Research Center for Infectious Diseases; the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Tall H, Adam P, Tiendrebeogo ASE, Vincent JP, Schaeffer L, von Platen C, Fernandes-Pellerin S, Sawadogo F, Bokoum A, Bouda G, Ouattara S, Ouédraogo I, Herrant M, Boucheron P, Sawadogo A, Betsem E, Essoh A, Kabore L, Ouattara A, Méda N, Hien H, Gosset A, Giles-Vernick T, Boyer S, Kania D, Vray M, Shimakawa Y. Impact of Introducing Hepatitis B Birth Dose Vaccines into the Infant Immunization Program in Burkina Faso: Study Protocol for a Stepped Wedge Cluster Randomized Trial (NéoVac Study). Vaccines (Basel) 2021; 9:583. [PMID: 34206058 DOI: 10.3390/vaccines9060583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/19/2021] [Accepted: 05/21/2021] [Indexed: 12/17/2022] Open
Abstract
To achieve global hepatitis elimination by 2030, it is critical to prevent the mother-to-child transmission (MTCT) of hepatitis B virus (HBV). Since 2009, the WHO has recommended administering hepatitis B vaccine to all neonates within 24 h of birth to prevent MTCT. However, many countries in sub-Saharan Africa only provide hepatitis B immunization at the age of 6, 10, and 14 weeks or 8, 12, and 16 weeks using a combined vaccine. To accelerate the introduction of the hepatitis B birth dose vaccine (HepB-BD) into sub-Saharan Africa, it is critical to establish to what extent the addition of HepB-BD can further reduce HBV transmission in areas where three-dose infant vaccination has been implemented. We therefore designed a study to evaluate the impact, acceptability, and cost-effectiveness of incorporating the HepB-BD into the routine immunization program in a real-life field condition in Burkina Faso, where the hepatitis B vaccination is currently scheduled at 8-12-16 weeks. Through a multidisciplinary approach combining epidemiology, anthropology, and health economics, the Neonatal Vaccination against Hepatitis B in Africa (NéoVac) study conducts a pragmatic stepped wedge cluster randomized controlled trial in rural areas of the Hauts-Bassins Region. The study was registered in ClinicalTrials.gov (identifier: NCT04029454). A health center is designated as a cluster, and the introduction of HepB-BD will be rolled out sequentially in 24 centers. Following an initial period in which no health center administers HepB-BD, one center will be randomly allocated to incorporate HepB-BD. Then, at a regular interval, another center will be randomized to cross from the control to the intervention period, until all 24 centers integrate HepB-BD. Pregnant women attending antenatal care will be systematically invited to participate. Infants born during the control period will follow the conventional immunization schedule (8-12-16 weeks), while those born in the interventional period will receive HepB-BD in addition to the routine vaccines (0-8-12-16 weeks). The primary outcome, the proportion of hepatitis B surface antigen (HBsAg) positivity in infants aged at 9 months, will be compared between children born before and after HepB-BD introduction. The study will generate data that may assist governments and stakeholders in sub-Saharan Africa to make evidence-based decisions about whether to add HepB-BD into the national immunization programs.
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Feng Y, Yao T, Han Y, Shi J, Dong S, Wu Y, Shao Z, Liu H, Guo H, Chai G, Liu L, Wang F, Wang J, Liang X, Wang S. Immunogenicity and safety of a high-dose and prolonged-schedule hepatitis B vaccine among chronic kidney disease patients: a randomized, parallel-controlled trial. Expert Rev Vaccines 2021; 20:743-751. [PMID: 34058948 DOI: 10.1080/14760584.2021.1915777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: The immunogenicity against hepatitis B vaccine is unsatisfactory in the chronic kidney disease (CKD) patients, and studies evaluating augmented vaccine regimens to enhance immunogenicity have been inconclusive.Objectives: To evaluate the immunogenicity and safety of four-standard-dose and four-triple-dose regimens hepatitis B vaccine among CKD patients in China.Research design and methods: We conducted a multicenter, randomized, parallel-controlled trial including 273 patients with CKD who were randomly allocated to receive 3 or 4 doses of 20 or 60 µg of recombinant hepatitis B vaccine.Main outcome measures: Seroconversion rates, high-level response rates, and geometric mean concentrations (GMCs) of anti-HBs at months 3 and 7.Results: The seroconversion rates and high-level responses in the IM20 × 4 group and the IM60 × 4 group were higher than those in the IM20 × 3 group at months 3 and 7 (P < 0.05). The IM60 × 4 group had better immune responses than the IM20 × 4 group at month 3 (P < 0.05); however, no significant difference was noted at month 7 (P > 0.05).Conclusions: Both the four-standard-dose and four-triple-dose regimens improved immune response compared to the three-standard-dose regimen of hepatitis B vaccination in CKD patients, and the additional effect of higher dose was minimal.Trial registration: The trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT03962881).
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Affiliation(s)
- Yongliang Feng
- School of Public Health, Shanxi Medical University, Taiyuan, China.,Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Tian Yao
- School of Public Health, Shanxi Medical University, Taiyuan, China.,Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Yujie Han
- School of Public Health, Shanxi Medical University, Taiyuan, China.,Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Jing Shi
- School of Public Health, Shanxi Medical University, Taiyuan, China.,Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Shuang Dong
- School of Public Health, Shanxi Medical University, Taiyuan, China.,Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Yuanting Wu
- School of Public Health, Shanxi Medical University, Taiyuan, China.,Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Zhihong Shao
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Hongting Liu
- Department of nephrology, Yuncheng Central Hospital, Yuncheng, China
| | - Hongping Guo
- Department of nephrology, Linfen People's Hospital, Linfen, China
| | - Guowei Chai
- Department of nephrology, Houma People's Hospital, Houma, China
| | - Liming Liu
- Department of nephrology, Linfen Central Hospital, Linfen, China
| | - Fuzhen Wang
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jianmin Wang
- Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China.,Department of nephrology, Linfen Central Hospital, Linfen, China
| | | | - Suping Wang
- School of Public Health, Shanxi Medical University, Taiyuan, China.,Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
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Xu B, Xu C, Feng J, Chen J, Rui Y, Qiu Z, Zhu J, Tang J, Lou H, Chen T, Ge H, Ge X, Wang Z, Huang H, Pan M, Dai Y, Hu Y, Zhou YH. Reduced mother-to-child transmission of hepatitis B after implementation of completely charge-free active-passive immunoprophylaxis: an observational cohort study. Expert Rev Vaccines 2021; 20:899-905. [PMID: 33960275 DOI: 10.1080/14760584.2021.1927723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objectives: China has implemented universal hepatitis B vaccination since 2002 and provided charge-free hepatitis B immunoglobulin (HBIG) to infants of HBV-infected mothers since July 2011. We aimed to compare mother-to-child transmission (MTCT) in children born before and since July 2011.Methods: In total, 5,149 children of HBV-infected mothers were tested for HBV markers. Group one contained 1,160 children born during August 2002-June 2011 and group two contained 3,989 children born during July 2011-June 2016.Results: In total, 92 (1.8%, 95% confidence interval [95%CI] 1.4-2.2) children were infected with HBV. None (0%, 95%CI 0.0-0.1) of 3,716 children of mothers with negative hepatitis B e antigen (HBeAg) was infected, whereas 92 (6.4%, 95%CI 5.2-7.8) of 1,433 children of HBeAg-positive mothers were infected (p < 0.0001). Among children of HBeAg-positive mothers, MTCT occurred in 10.3% (19/185) (95%CI 6.3-15.6) in group one and 5.8% (73/1,248) (95%CI 4.6-7.3) in group two (p = 0.02).Conclusions: Implementing charge-free active-passive immunoprophylaxis greatly reduces MTCT of HBV in children of HBeAg-positive mothers, highlighting the importance of timely administration of both hepatitis B vaccine and HBIG to prevent MTCT. The still remaining MTCT suggests that reducing maternal virus load before delivery is an additional important measure.
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Affiliation(s)
- Biyun Xu
- Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Chenyu Xu
- Department of Obstetrics and Gynecology, Zhenjiang Fourth People's Hospital, Zhenjiang, Jiangsu, China
| | - Jing Feng
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing, China
| | - Jie Chen
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing, China
| | - Yanjing Rui
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing, China
| | - Ziyan Qiu
- Department of Mass Health Care, Sihong County Maternal and Child Health Hospital, Sihong, Jiangsu, China
| | - Jihua Zhu
- Department of Mass Health Care, Rugao Municipal Center for Maternal and Child Health Care and Family Planning, Jiangsu, Jiangsu, China
| | - Jie Tang
- Department of Obstetrics and Gynecology, Wujin Hospital, Changzhou, Jiangsu, China
| | - Haiqin Lou
- Department of Mass Health Care, Nantong Municipal Maternal and Child Health Hospital, Nantong, Jiangsu, China
| | - Tingmei Chen
- Department of Obstetrics and Gynecology, Zhenjiang Fourth People's Hospital, Zhenjiang, Jiangsu, China
| | - Hongyan Ge
- Department of Obstetrics and Gynecology, Zhenjiang Fourth People's Hospital, Zhenjiang, Jiangsu, China
| | - Xiaoyun Ge
- Department of Mass Health Care, Nantong Municipal Maternal and Child Health Hospital, Nantong, Jiangsu, China
| | - Zhihong Wang
- Department of Mass Health Care, Rugao Municipal Center for Maternal and Child Health Care and Family Planning, Jiangsu, Jiangsu, China
| | - Hongyu Huang
- Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Mingjie Pan
- Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yimin Dai
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing, China
| | - Yali Hu
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing, China
| | - Yi-Hua Zhou
- Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
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Gosset A, Nishimwe ML, Diallo MY, Deroo L, Diallo A, Ba EH, Carrieri PM, Sokhna C, Vray M, Shimakawa Y, Boyer S. The Costs of Introducing the Hepatitis B Birth Dose Vaccine into the National Immunization Programme in Senegal (NéoVac Study). Vaccines (Basel) 2021; 9:521. [PMID: 34070184 PMCID: PMC8158493 DOI: 10.3390/vaccines9050521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/12/2021] [Accepted: 05/15/2021] [Indexed: 11/17/2022] Open
Abstract
Some African countries are still reluctant to introduce the hepatitis B vaccine birth dose (HepB-BD) into their expanded program of immunization (EPI), partly because of logistical, economic, and cost information constraints. To assist decision-makers in these countries, we assessed the economic and financial costs of HepB-BD introduction in Senegal in 2016. We performed a micro-costing study in a representative sample of Senegal's EPI sites at all levels in 2018. Information on EPI and HepB-BD activity-related inputs and costs was collected using standardized questionnaires and semi-structured interviews. Using inverse probability weighting, we computed weighted average costs associated with HepB-BD introduction for each EPI level, country-level aggregated costs and estimated costs per newborn. Economic and financial costs from a government perspective were estimated in US dollars for 2015, 2016 and 2017. Total economic costs were USD 143,364 in 2015, USD 759,406 in 2016 and USD 867,311 in 2017, while financial costs were USD 127,745, USD 82,519 and USD 29,853, respectively. When annualizing pre-introduction and initial training costs, the economic (financial) cost per vaccinated newborn was USD 2.10 (USD 0.30) in 2016 and USD 1.90 (USD 0.20) in 2017. Our estimates provide valuable information to implement HepB-BD in Sub-Saharan African countries that have not yet integrated this vaccine.
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Affiliation(s)
- Andréa Gosset
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, 13385 Marseille, France; (A.G.); (M.L.N.); (M.Y.D.); (P.M.C.)
| | - Marie Libérée Nishimwe
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, 13385 Marseille, France; (A.G.); (M.L.N.); (M.Y.D.); (P.M.C.)
| | - Mamadou Yaya Diallo
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, 13385 Marseille, France; (A.G.); (M.L.N.); (M.Y.D.); (P.M.C.)
| | - Lucas Deroo
- Unité d’Epidémiologie des Maladies Emergentes, Institut Pasteur, 75015 Paris, France; (L.D.); (M.V.); (Y.S.)
| | - Aldiouma Diallo
- VITROME, Vecteurs-Infections Tropicales et Méditerranées, Campus IRD-UCAD de Hann, Dakar CP 18524, Senegal; (A.D.); (E.H.B.); (C.S.)
| | - El Hadji Ba
- VITROME, Vecteurs-Infections Tropicales et Méditerranées, Campus IRD-UCAD de Hann, Dakar CP 18524, Senegal; (A.D.); (E.H.B.); (C.S.)
| | - Patrizia Maria Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, 13385 Marseille, France; (A.G.); (M.L.N.); (M.Y.D.); (P.M.C.)
| | - Cheikh Sokhna
- VITROME, Vecteurs-Infections Tropicales et Méditerranées, Campus IRD-UCAD de Hann, Dakar CP 18524, Senegal; (A.D.); (E.H.B.); (C.S.)
- VITROME, Aix Marseille Univ, IRD, SSAS, IHU-MI, AP-HM, 13385 Marseille, France
| | - Muriel Vray
- Unité d’Epidémiologie des Maladies Emergentes, Institut Pasteur, 75015 Paris, France; (L.D.); (M.V.); (Y.S.)
- Unité d’Epidémiologie des Maladies Infectieuses, Institut Pasteur, Dakar BP 220, Senegal
- INSERM, 75013 Paris, France
| | - Yusuke Shimakawa
- Unité d’Epidémiologie des Maladies Emergentes, Institut Pasteur, 75015 Paris, France; (L.D.); (M.V.); (Y.S.)
| | - Sylvie Boyer
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, 13385 Marseille, France; (A.G.); (M.L.N.); (M.Y.D.); (P.M.C.)
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Périères L, Marcellin F, Lo G, Protopopescu C, Ba EH, Coste M, Touré Kane C, Maradan G, Diallo A, Sokhna C, Boyer S, On Behalf Of The Anrs AmBASS Survey Study Group. Hepatitis B Vaccination in Senegalese Children: Coverage, Timeliness, and Sociodemographic Determinants of Non-Adherence to Immunisation Schedules (ANRS 12356 AmBASS Survey). Vaccines (Basel) 2021; 9:510. [PMID: 34063390 DOI: 10.3390/vaccines9050510] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 12/15/2022] Open
Abstract
Detailed knowledge about hepatitis B virus (HBV) vaccination coverage and timeliness for sub-Saharan Africa is scarce. We used data from a community-based cross-sectional survey conducted in 2018–2019 in the area of Niakhar, Senegal, to estimate coverage, timeliness, and factors associated with non-adherence to the World Health Organisation-recommended vaccination schedules in children born in 2016 (year of the birth dose (BD) introduction in Senegal) and 2017–2018. Vaccination status was assessed from vaccination cards, surveillance data, and healthcare post vaccination records. Among 241 children with available data, for 2016 and 2017–2018, respectively, 31.0% and 66.8% received the BD within 24 h of birth (BD schedule), and 24.3% and 53.7% received the BD plus at least two pentavalent vaccine doses within the recommended timeframes (three-dose schedule). In logistic regression models, home birth, dry season birth, and birth in 2016 were all associated with non-adherence to the recommended BD and three-dose schedules. Living over three kilometres from the nearest healthcare post, being the firstborn, and living in an agriculturally poorer household were only associated with non-adherence to the three-dose schedule. The substantial proportion of children not vaccinated according to recommended schedules highlights the importance of considering vaccination timeliness when evaluating vaccination programme effectiveness. Outreach vaccination activities and incentives to bring children born at home to healthcare facilities within 24 h of birth, must be strengthened to improve timely HBV vaccination.
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Ball M, Liverman R, Serluco A, Yildirim I. Vaccine-induced protection against hepatitis B in pediatric solid organ transplant patients. Pediatr Transplant 2021; 25:e13920. [PMID: 33217081 DOI: 10.1111/petr.13920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/28/2020] [Accepted: 10/26/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Vaccination against hepatitis B virus (HBV) has led to a worldwide reduction in disease burden and mortality. Vaccine immunogenicity data in transplanted children are limited, and vaccine-induced protection may be reduced. We evaluated HBV vaccination coverage, seroprotection rates, and factors influencing vaccine immunity among pediatric solid organ transplant (SOT) patients. METHODS We retrospectively identified patients ≤21 years of age evaluated for SOT and/or transplanted at our center between January 1, 2015, and December 31, 2018. A detailed chart review was conducted using a standard questionnaire to gather information on demographic, clinical, and laboratory features of patients' HBV vaccination, and hepatitis B surface antibody (HBsAb) titers. RESULTS A total of 381 patients undergoing evaluation and/or transplantation were included: 139 (36.5%) liver, 138 (36.2%) kidney, and 104 (27.3%) heart. Overall, HBsAb at evaluation was reactive in 216 (56.7%), indeterminate in 17 (4.5%), non-reactive in 138 (36.2%), and not available in 10 (2.6%). Of those that completed a primary HBV vaccine series (n = 304), HBsAb was reactive in 164 (53.9%), indeterminate in 13 (4.3%), non-reactive in 119 (39.1%), and not available in 8 (2.6%). For those up to date for age on HBV vaccinations with non-reactive/indeterminate titers at evaluation, revaccination and a follow-up HBsAb were available in 45 patients of which 33 (73.3%) seroconverted to a reactive HBsAb titer. CONCLUSION Vaccine-induced protection against HBV infection among high-risk pediatric SOT recipients can be improved by serology-based intervention. Though the absence of HBsAb does not always indicate loss of protection, boosting or completing primary series is recommended.
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Affiliation(s)
- Michael Ball
- Department of Pharmacy, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Rochelle Liverman
- Department of Pharmacy, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Anastacia Serluco
- Department of Pharmacy, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Inci Yildirim
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale School of Medicine, New Haven, CT, USA.,Yale Institute of Global Health, New Haven, CT, USA
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Liu H, Meng Z, Wang H, Zhang S, Huang Z, Geng X, Guo R, Wu Z, Hong Z. Robust Immune Responses Elicited by a Hybrid Adjuvant Based on β-Glucan Particles from Yeast for the Hepatitis B Vaccine. ACS Appl Bio Mater 2021; 4:3614-3622. [PMID: 35014447 DOI: 10.1021/acsabm.1c00111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The use of particulate adjuvants offers an interesting method for enhancing and modulating the immune responses elicited by vaccines. Aluminum salt (Alum) is one of the most important immune adjuvants approved by the Food and Drug Administration for use in humans because of its safety and efficacy, but it lacks the capacity to induce strong cellular and mucosal immune responses. In this study, we designed an antigen delivery system that combines aluminum salts with β-glucan particles. The β-glucan-aluminum particles (GP-Al) exhibited a highly uniform size of 2-4 μm and could highly specifically target antigen-presenting cells (APCs) and strongly induce dendritic cell (DC) maturation and cytokine secretion. In vivo studies showed that both WT mice and HBV-Tg mice immunized with hepatitis B surface antigen (HBsAg)-containing GP-Al displayed high anti-HBsAg IgG titers in the serum. Furthermore, in contrast to mice receiving the antigen alone, mice immunized with the particulate adjuvant exhibited IgG2a antibody titers and higher antigen-specific IFN-γ levels in splenocytes. In conclusion, we developed GP-Al microspheres to serve as a hepatitis B vaccine to enhance both humoral and cellular immune responses, representing a safe and promising system for antigen delivery.
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Affiliation(s)
- Hui Liu
- Henan Key Laboratory of Immunology and Targeted Drug, Henan Collaborative Innovation Center of Molecular Diagnosis and Laboratory Medicine, School of Laboratory Medicine, Xinxiang Medical University, Xinxiang, Henan 453003, China.,State Key Laboratory of Medicinal Chemical Biology, College of Life Sciences, Nankai University, Tianjin 300071, China
| | - Ziyu Meng
- State Key Laboratory of Medicinal Chemical Biology, College of Life Sciences, Nankai University, Tianjin 300071, China.,NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300134, China
| | - Hesuiyuan Wang
- State Key Laboratory of Medicinal Chemical Biology, College of Life Sciences, Nankai University, Tianjin 300071, China
| | - Shuo Zhang
- Henan Key Laboratory of Immunology and Targeted Drug, Henan Collaborative Innovation Center of Molecular Diagnosis and Laboratory Medicine, School of Laboratory Medicine, Xinxiang Medical University, Xinxiang, Henan 453003, China
| | - Zhen Huang
- Henan Key Laboratory of Immunology and Targeted Drug, Henan Collaborative Innovation Center of Molecular Diagnosis and Laboratory Medicine, School of Laboratory Medicine, Xinxiang Medical University, Xinxiang, Henan 453003, China
| | - Xiaofang Geng
- Henan Key Laboratory of Immunology and Targeted Drug, Henan Collaborative Innovation Center of Molecular Diagnosis and Laboratory Medicine, School of Laboratory Medicine, Xinxiang Medical University, Xinxiang, Henan 453003, China
| | - Rui Guo
- College of Biomedical Engineering, Xinxiang Medical University, Xinxiang, Henan 453003, China
| | - Zhenzhou Wu
- State Key Laboratory of Medicinal Chemical Biology, College of Life Sciences, Nankai University, Tianjin 300071, China
| | - Zhangyong Hong
- State Key Laboratory of Medicinal Chemical Biology, College of Life Sciences, Nankai University, Tianjin 300071, China
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Akbar SMF, Al Mahtab M, Begum F, Hossain SAS, Sarker S, Shrestha A, Khan MSI, Yoshida O, Hiasa Y. Implications of Birth-Dose Vaccination against Hepatitis B Virus in Southeast Asia. Vaccines (Basel) 2021; 9:374. [PMID: 33921259 DOI: 10.3390/vaccines9040374] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/09/2021] [Accepted: 04/10/2021] [Indexed: 02/07/2023] Open
Abstract
The World Health Organization (WHO) South-East Asia Regional Office (SEARO) covers 11 countries with a combined population of about 2 billion people, making it the most populous of the six WHO regions. In 1992, the WHO advocated including the hepatitis B vaccine in the Expanded Program of Immunization (EPI) and vaccinating all infants and children three times within 1 year of birth (HepB3). Recently, the WHO advocate birth-dose hepatitis B vaccination (HepB-BD) as soon as possible after birth, preferably within 24 hours. In 2016, the SEARO endorsed a regional hepatitis B control goal with a target of hepatitis B surface antigen (HBsAg) seroprevalence of ≤1% among children aged ≥5 years by 2020. Of the 11 SEARO countries, four achieved this target on schedule. Out of these four countries, two countries (Bangladesh and Nepal) have not adopted HepB-BD in EPI program. On the other hand, the coverage of HepB3 is not satisfactory in some SEARO countries, including India which adopted HepB-BD but could not achieve the overall target of SEARO. Thus, it is a point of debate whether emphasis should be placed on proper implementation of HepB3 or whether a new agenda of HepB-BD should be incorporated in developing countries of SEARO. The article discusses strengthening and expanding the Hepatitis B vaccination program in SEARO countries with an emphasis on HepB and HepB-BD programs.
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Li AY, Liu Z, Song Y, Xiao Y, Jiang J, Li L, Zhai X, Liu J, Duan Z, Ding F, Liu J, Zhuang H, Zhu L, Jiang J, Zou H, Wang J, Li J. Reduction of the occurrence of occult HBV infection in infants by increasing the dose of hepatitis B vaccine: a large prospective cohort study. Emerg Microbes Infect 2021; 9:1881-1891. [PMID: 32779526 PMCID: PMC7473118 DOI: 10.1080/22221751.2020.1808533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Occult hepatitis B virus (HBV) infection (OBI) has been observed among infants born to hepatitis B surface antigen (HBsAg)-positive mothers despite successful immunoprophylaxis. This study enrolled 549 infants [349 infants received a 10μg/dose of hepatitis B vaccine (HepB), and 200 infants received 20μg/dose HepB] born to HBsAg-positive mothers with HBV DNA load >6log10IU/mL. The anti-HBs levels in the 10μg group were significantly lower than that in the 20μg group both at 7 [652.48 (564.05-754.82) vs. 1541.72 (1268.69-1873.51) mIU/mL, P<0.001] and 12 months old [257.44 (220.29-300.88) vs. 1073.41 (839.27-1372.78) mIU/mL, P<0.001]. The OBI incidence in the 10μg group was significantly higher than that in the 20μg group at both 7 [21.55% (25/116) vs. 7.56% (9/119), P=0.002] and 12 months old [17.07% (14/82) vs. 6.90% (6/87), P=0.041]. OBI incidence in infants with anti-HBs levels <100mIU/mL was higher than that of those with anti-HBs ≥100mIU/mL [35.71% (5/14) vs. 13.12% (29/221), P=0.036]. This study showed that increasing the immunisation dose from 10μg to 20μg significantly improved anti-HBs levels and decreased OBI incidence in infants with a high maternal viral load. We recommend 20μg HepB to treat this high-risk population.
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Affiliation(s)
- Authors Yi Li
- Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Zhixiu Liu
- Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Yarong Song
- Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Yiwei Xiao
- Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Jing Jiang
- Department of Clinical Research, First Hospital of Jilin University, Changchun, People's Republic of China
| | - Lili Li
- Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Xiangjun Zhai
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, People's Republic of China
| | - Jianxun Liu
- Zhengzhou Municipal Center for Disease Control and Prevention, Zhengzhou, People's Republic of China
| | - Zhongping Duan
- Beijing Youan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Feng Ding
- Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Jia Liu
- Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Hui Zhuang
- Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Liguo Zhu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, People's Republic of China
| | - Jie Jiang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, People's Republic of China
| | - Huaibin Zou
- Beijing Youan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Jie Wang
- Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
| | - Jie Li
- Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People's Republic of China
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Aneja A, Lal SB, Sharma AK, Rawat A, Singh S. Clinical Characteristics of Children With Celiac Disease Not Responding to Hepatitis B Vaccination in India. JPGN Rep 2021; 2:e046. [PMID: 37206938 PMCID: PMC10191543 DOI: 10.1097/pg9.0000000000000046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/15/2020] [Indexed: 05/21/2023]
Abstract
The immunological response to hepatitis B virus (HBV) vaccine may be suboptimal in children with celiac disease (CD), but the reasons for this are not well defined. Objectives This study was undertaken to assess the immune response to HBV vaccine in CD children and to explore the possible factors affecting the immune response. Methods The study population consisted of 3 groups-50 newly diagnosed CD children (group 1), 50 previously diagnosed CD children who were on gluten free diet (GFD) >3 months (group 2), and 100 age and gender matched healthy controls (group 3). The patient characteristics were recorded, and the blood samples were analyzed for HBsAg and anti-HBs titers. The nonresponders were given a booster dose of HBV vaccine and reevaluated after 6 weeks. Results Positive anti-HBs response was found in 46% in newly diagnosed CD children, 60% in CD children on GFD, and 83% in healthy controls (P < 0.001). The immune response to HBV vaccine in CD children was inferior to that in healthy children (53% vs 83%, P < 0.001). The immune response was found to be significantly affected by age at diagnosis, delay in diagnosis, type of presentation, and compliance to GFD. 44 out of 45 (97.77%) nonresponders from CD group seroconverted after a single booster dose. Conclusion Early diagnosis and good compliance to GFD may improve the immune response to HBV vaccine in CD children. Single additional booster dose is sufficient to attain optimal immune response.
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Affiliation(s)
- Aradhana Aneja
- From the Division of Paediatric Gastroenterology, Hepatology & Nutrition
| | - Sadhna B. Lal
- From the Division of Paediatric Gastroenterology, Hepatology & Nutrition
| | | | - Amit Rawat
- Division of Paediatric Immunology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Surjit Singh
- Division of Paediatric Immunology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
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Kyuregyan KK, Kichatova VS, Isaeva OV, Potemkin IA, Malinnikova EY, Lopatukhina MA, Karlsen AA, Asadi Mobarhan FA, Mullin EV, Slukinova OS, Ignateva ME, Sleptsova SS, Oglezneva EE, Shibrik EV, Isaguliants MG, Mikhailov MI. Coverage with Timely Administered Vaccination against Hepatitis B Virus and Its Influence on the Prevalence of HBV Infection in the Regions of Different Endemicity. Vaccines (Basel) 2021; 9:vaccines9020082. [PMID: 33498794 PMCID: PMC7912110 DOI: 10.3390/vaccines9020082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 01/26/2023] Open
Abstract
Universal hepatitis B vaccination of newborns was implemented in Russia starting from 1998. From 1998 to 2019, the incidence of acute hepatitis B reduced from 43.8 to 0.57 cases per 100,000 population. Here, we assessed the timely coverage of newborns with the birth dose (HepB-BD), second dose (HepB-2nd), and three vaccine doses (HepB3) in two remote regions of Russia with low (Belgorod Oblast) and high (Yakutia) levels of hepatitis B virus (HBV) endemicity. Vaccination data were obtained from the medical records of 1000 children in Yakutia and 2182 children in Belgorod Oblast. Sera of healthy volunteers from Belgorod Oblast (n = 1754) and Yakutia (n = 1072) across all age groups were tested for serological markers of HBV to assess the infection prevalence and herd immunity. Average HepB-BD coverage was 99.2% in Yakutia and 89.4% in Belgorod Oblast (p < 0.0001) and in both regions varied significantly, from 66% to 100%, between medical centers. The principal reason for the absence of HepB-BD was parent refusal, which accounted for 63.5% of cases of non-vaccination (83/123). While timely HepB-2nd coverage was only 55.4%–64.7%: HepB3 coverage by the age of one year exceeded 90% in both study regions. HBV surface antigen (HBsAg) prevalence in the 1998–2019 birth cohort was 0.2% (95% CI: 0.01–1.3%) in Belgorod Oblast and 3.2% (95% CI: 1.9–5.2%) in Yakutia. The proportion of persons testing negative for both antibodies to HBsAg (anti-HBs) and antibodies to HBV core antigen (anti-HBc) in the 1998–2019 birth cohort was 26.2% (125/481) in Belgorod Oblast and 32.3% (162/501) in Yakutia. We also assessed the knowledge of and attitude towards vaccination among 782 students and teachers of both medical and non-medical specialties from Belgorod State University. Only 60% of medical students knew that hepatitis B is a vaccine-preventable disease. Both medical and nonmedical students, 37.8% and 31.3%, respectively, expressed concerns about safety and actual necessity of vaccination. These data indicate the need to introduce a vaccine delivery audit system, improve medical education with respect to vaccination strategies and policies, and reinforce public knowledge on the benefits of vaccination.
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Affiliation(s)
- Karen K. Kyuregyan
- Department of Viral Hepatitis, Russian Medical Academy of Continuous Professional Education, 125993 Moscow, Russia; (V.S.K.); (O.V.I.); (I.A.P.); (E.Y.M.); (A.A.K.); (M.I.M.)
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
- Correspondence:
| | - Vera S. Kichatova
- Department of Viral Hepatitis, Russian Medical Academy of Continuous Professional Education, 125993 Moscow, Russia; (V.S.K.); (O.V.I.); (I.A.P.); (E.Y.M.); (A.A.K.); (M.I.M.)
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
| | - Olga V. Isaeva
- Department of Viral Hepatitis, Russian Medical Academy of Continuous Professional Education, 125993 Moscow, Russia; (V.S.K.); (O.V.I.); (I.A.P.); (E.Y.M.); (A.A.K.); (M.I.M.)
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
| | - Ilya A. Potemkin
- Department of Viral Hepatitis, Russian Medical Academy of Continuous Professional Education, 125993 Moscow, Russia; (V.S.K.); (O.V.I.); (I.A.P.); (E.Y.M.); (A.A.K.); (M.I.M.)
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
| | - Elena Yu. Malinnikova
- Department of Viral Hepatitis, Russian Medical Academy of Continuous Professional Education, 125993 Moscow, Russia; (V.S.K.); (O.V.I.); (I.A.P.); (E.Y.M.); (A.A.K.); (M.I.M.)
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
| | - Maria A. Lopatukhina
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
| | - Anastasia A. Karlsen
- Department of Viral Hepatitis, Russian Medical Academy of Continuous Professional Education, 125993 Moscow, Russia; (V.S.K.); (O.V.I.); (I.A.P.); (E.Y.M.); (A.A.K.); (M.I.M.)
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
| | - Fedor A. Asadi Mobarhan
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
| | - Eugeniy V. Mullin
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
| | - Olga S. Slukinova
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
| | - Margarita E. Ignateva
- The Sakha Republic (Yakutia) Regional Department of Rospotrebnadzor, 677027 Yakutsk, Russia;
| | - Snezhana S. Sleptsova
- Medical Institute, M.K. Ammosov North-Eastern Federal University, 677010 Yakutsk, Russia;
| | - Elena E. Oglezneva
- Belgorod Regional Department of Rospotrebnadzor, 308023 Belgorod, Russia;
- Medical Faculty, Belgorod State National Research University, 308015 Belgorod, Russia
| | - Elena V. Shibrik
- Department of Health and Social Protection of the Population of Belgorod Region, 308005 Belgorod, Russia;
| | - Maria G. Isaguliants
- Department of Microbiology, Tumor and Cell Biology, Biomedicum, Karolinska Institute, 17165 Solna, Sweden;
- Laboratory of Molecular Pathogenesis of Chronic viral Infections, NF Gamaleja Research Center of Epidemiology and Microbiology, 123098 Moscow, Russia
- Research Department, Riga Stradins University, LV-1007 Riga, Latvia
| | - Mikhail I. Mikhailov
- Department of Viral Hepatitis, Russian Medical Academy of Continuous Professional Education, 125993 Moscow, Russia; (V.S.K.); (O.V.I.); (I.A.P.); (E.Y.M.); (A.A.K.); (M.I.M.)
- Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia; (M.A.L.); (F.A.A.M.); (E.V.M.); (O.S.S.)
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Wang M, Zeng W, Zhang Z, Zhang W, Su H, Zhang Z, Jiang L, Liu Y, Shi Q. The Improvement of Immune Effect of Recombinant Human Beta-Defensin 2 on Hepatitis B Vaccine in Mice. Viral Immunol 2020; 34:96-111. [PMID: 33370550 DOI: 10.1089/vim.2020.0052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Immunization with hepatitis B vaccine is an effective measure for prevention and control of hepatitis B Virus (HBV) infection. Although lots of efforts to improve the effect of hepatitis B vaccine have been made, the function of human beta defensin 2 (hBD2) on hepatitis B vaccine keeps unclear. In this article, we report that hBD2 not only promoted the activation and maturation of immature dendritic cells (iDCs) by increasing MHC II and CD86 expression, but it also significantly upregulated the mRNA level of IL-6 and IL-12B in mouse bone marrow-derived dendritic cells. The serum concentrations of IFN-γ in mice stimulated with 300 ng hBD2 increased from 25.21 to 42.04 pg/mL, with a time extension from 4 to 12 h post-injection. During the process of three times immunization (1, 14, 28 days) with 3 μg hepatitis B vaccine combined with or without 300 ng hBD2 with a 2 week interval in BALB/c mice, the antibody against HBsAg (HBsAb) concentration in serum at every time point of observation in the combined group was statistically higher than the hepatitis B vaccine group. The serum concentration of IgG2a subclass HBsAb on the 14th day post last injection in the combined group was significantly higher than the hepatitis B vaccine group. Further, the splenic cells from the mice treated with both hBD2 and hepatitis B vaccine possessed a greater ability to produce a surface antigen of hepatitis B virus (HBsAg) specific IFN-γ than those treated with hepatitis B vaccine alone. The percentages of CD3+/CD4+ T cells and CD3+/CD8+ T lymphocytes in spleens from the mice treated with 300 ng hBD2 were statistically higher than the phosphate buffered saline group. These data suggest that hBD2 improves iDC maturation and the immune efficiency of hepatitis B vaccine in BALB/c mice.
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Affiliation(s)
- Meizhen Wang
- Department of Immunology, School of Basic Medical Sciences, Nanchang University, Nanchang, People's Republic of China.,The Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Wenxing Zeng
- Department of Immunology, School of Basic Medical Sciences, Nanchang University, Nanchang, People's Republic of China.,Department of Clinical Examination, Yichun City People's Hospital, Yichun, People's Republic of China
| | - Zhigang Zhang
- The Community Health Service Center of Jianbei Sub-District Administration, Hebei, People's Republic of China
| | - Weidong Zhang
- Center for Tropical Medicine and Infectious Disease, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.,Department of Immunology and Molecular Microbiology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Hong Su
- Department of Immunology, School of Basic Medical Sciences, Nanchang University, Nanchang, People's Republic of China
| | - Zhiyong Zhang
- Department of Immunology, School of Basic Medical Sciences, Nanchang University, Nanchang, People's Republic of China.,Department of Clinical Examination, Jiangxi Provincial People's Hospital, Nanchang, People's Republic of China
| | - Lixia Jiang
- Department of Clinical Examination, the First Affiliated Hospital of Gannan Medical University, Ganzhou, People's Republic of China
| | - Yulin Liu
- Department of Immunology, School of Basic Medical Sciences, Nanchang University, Nanchang, People's Republic of China
| | - Qiaofa Shi
- Department of Immunology, School of Basic Medical Sciences, Nanchang University, Nanchang, People's Republic of China.,Jiangxi Province Key Laboratory of Tumor Pathogenesis and Molecular Pathology, Nanchang, People's Republic of China.,Jiangxi Province Key Laboratory of Infection and Immunity, Nanchang, People's Republic of China
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40
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Piekarska A, Wisniewski P, Lewandowski K, Gil L, Trzonkowski P, Bieniaszewska M, Zaucha JM. Immune Status Against Hepatitis B in Patients After Allogeneic Hematopoietic Cell Transplantation-Factors Affecting Early and Long-Lasting Maintenance of Protective Anti-HBs Titers. Front Immunol 2020; 11:586523. [PMID: 33335530 PMCID: PMC7736697 DOI: 10.3389/fimmu.2020.586523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/28/2020] [Indexed: 11/13/2022] Open
Abstract
The immunization of allogeneic hematopoietic cell transplantation (HCT) recipients against vaccine-preventable diseases is a part of posttransplantation guidelines. We conducted a prospective study to assess clinical and immunological parameters that would determine the response and long-term maintenance of protective antibody titers upon the hepatitis B virus (HBV) vaccination after HCT. The investigated variables included: vaccination of the HCT recipients and their donors prior to HCT, chronic graft versus host disease (cGVHD) and the timing of post-HCT vaccination, and B- and T-cell subtype status. Forty-two patients were immunized with three or more doses of recombinant hepatitis B surface antigen (rHBsAg) administered according to the individualized schedule of 0-1-2-6-(12) months. After vaccination, seroconversion was achieved in the whole group. The vaccines were categorized according to the antibody (Ab) titers as weak (WRs; 28.7%), good (GRs; 38%) or very good responders (VGRs; 3.3%). In multivariate logistic regression, severe cGVHD (OR= 15.5), and preceding donor immunization (OR= 0.13) were independent predictors of a weak response to vaccination. A prior belonging to the WR group impaired the durability of protection (OR= 0.17) at a median follow-up of 11.5 years. Patients with severe cGVHD showed a trend toward lower median Ab titers, although they required a higher rate of booster vaccine doses. All VGRs had CD4+ cells > 0.2 x 106/L. There was a lower mean rate of CD4+IL2+ lymphocytes in WRs. Vaccination demonstrated the immunomodulatory effect on B-cell and T-cell subsets and a Th1/Th2 cytokine profile, while shifts depended on a history of severe cGVHD and the type of vaccine responder. To conclude, vaccination of HCT donors against HBV allows a better response to vaccination in the respective HCT recipients. Double doses of rHBsAg should be considered in patients with cGVHD and in those not immunized before HCT. A dedicated intensified vaccination schedule should be administered to WRs.
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Affiliation(s)
- Agnieszka Piekarska
- Department of Hematology and Transplantology, Medical University of Gdansk, Gdansk, Poland
| | - Piotr Wisniewski
- Department of Endocrinology and Internal Diseases, Medical University of Gdansk, Gdansk, Poland
| | | | - Lidia Gil
- Department of Hematology and Stem Cell Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Trzonkowski
- Department of Clinical Immunology, Medical University of Gdansk, Gdansk, Poland
| | - Maria Bieniaszewska
- Department of Hematology and Transplantology, Medical University of Gdansk, Gdansk, Poland
| | - Jan Maciej Zaucha
- Department of Hematology and Transplantology, Medical University of Gdansk, Gdansk, Poland
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41
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Elzouki AN, Lubbad R, Elzouki I, Elhaddad A, Ibrahim A. Frequency of hepatitis B and C in health care providers at three referral hospitals in Libya. Pan Afr Med J 2020; 37:214. [PMID: 33520053 PMCID: PMC7821797 DOI: 10.11604/pamj.2020.37.214.23997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/19/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction the aim of the present study was to determine the frequency of HBsAg and anti-HCV antibodies in health care providers (HCPs) at three referral hospitals in Libya, and to correlate the HBsAg status with history of hepatitis B vaccination among HCPs. Methods one hundred eighty-two HCPs, with a mean age (±SD) of 32.9±8 years and age range from 20 to 59 years, were enrolled in this study. They were 50 doctors, 68 nurses, 42 laboratory technicians, 12 hospital cleaners, five anesthesia technicians and five midwives. They were tested, after obtained a written consent, for the presence of HBsAg and anti-HCV antibodies by enzyme linked immuno-sorbent assay (ELISA) techniques. A pre-test questionnaire was filled by each HCP to verify place of work, working period, type of work, status of HBV vaccination, and history of needle stick injury. Results four HCPs have anti-HCV antibodies positive (2.2%) and nine were HBsAg positive (4.9%). Only 52% (95/182) of the HCPs received full dose of hepatitis B vaccine, while the others either not completed the vaccination schedule or have not receive it. One hundred (54.9%) of the participants had exposed to blood via needle stick injury during their work, 6 (6%) of them were HBsAg positive and three (3%) were anti-HCV positive. Needle stick injury was considered as primary risk factor in 66.7% (6/9 HCPs) of HBsAg-positives and 75% (3/4 subjects) of anti-HCV-positives. Conclusion the present study showed a higher frequency of HBsAg than anti-HCV among HCPs in three major hospitals in Libya. This difference may be explained by the low hepatitis B vaccination rate and the high rate of needle stick injury among this high risk group for these infections.
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Affiliation(s)
- Abdel-Naser Elzouki
- Department of Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.,Weill Cornell Medical College, Doha, Qatar
| | - Rafat Lubbad
- Department of Medicine, Althora Hospital, Albaida, Libya
| | - Islam Elzouki
- Department of Medicine, Tripoli Central Hospital, Tripoli, Libya
| | - Ahmed Elhaddad
- Department of Medicine, Infectious Disease Unit, Benghazi Medical Center, Benghazi, Libya.,Faculty of Medicine, Benghazi University, Benghazi, Libya
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Abstract
Hepatitis B virus (HBV) vaccination is recommended for health-care professionals because of their frequent contact with blood. At one medical school, new students undergo HBV antibody tests upon admission, and antibody-negative individuals receive the HBV vaccine. We aimed to characterize individuals who remained antibody negative after HBV vaccination. Between 2009 and 2017, we enrolled 1064 first-year students from a medical school where their HBV antibody test and vaccination records remained. We analyzed data regarding the hepatitis B surface antibody (anti-HBs) test record during admission, vaccination record for antibody-negative participants, anti-HBs test result after completing the three vaccination doses, drug name of the vaccine used, sex, body mass index (BMI), and age. We calculated the yearly percentage of antibody-negative individuals and analyzed the characteristics of vaccine-refractory cases by logistic regression analysis. Of the 1064 participants, 999 were initially antibody negative. They were vaccinated with HBV thrice and tested for antibodies after vaccination. The average age of participants was 20.1 y, with 677 males. Although the type of vaccine has been changed since 2016, the average rate of refractoriness from 2009 to 2015 was 6.9% per year and 18.6% after 2016. Logistic regression analyses showed that sex (male vs. female; OR, 1.787), BMI (OR. 1.171), and vaccine type (genotype A vs. genotype C: OR, 3.144) were significant factors associated with antibody-negative individuals. Vaccine type differences altered the proportion of antibody-refractory individuals, with no association with age. The data on vaccine refractoriness will be continuously analyzed in the future while considering other factors.
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Affiliation(s)
- Takeshi Yoda
- Department of Public Health, Kawasaki Medical School, Kurashiki, Japan.,Department of Health and Sports Science, Kawasaki University of Medical Welfare, Kurashiki, Japan
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Jia Q, Yu F, Zhou Q, Chen X, Gu Z, Ma C. Predictive effect of five hepatitis B virus markers on re-vaccination time of hepatitis B vaccine. Exp Ther Med 2020; 20:1709-1715. [PMID: 32742400 DOI: 10.3892/etm.2020.8859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 04/23/2020] [Indexed: 11/05/2022] Open
Abstract
Examination of predictive effect of five hepatitis B virus (HBV) markers on the re-vaccination time of hepatitis B vaccine was assessed. A total of 3,243 patients examined by five HBV markers in Women and Children's Health Care Hospital of Linyi from January 2015 to December 2017 were selected as the subjects and analyzed retrospectively. According to the previous time of hepatitis B antibody vaccination, subjects were divided into three groups: Short-term group (previous time of hepatitis B vaccination <5 years, n=798); medium-term group (>5 years - ≤10 years, n=1,242); long-term group (>10 years, n=1,203). The enzyme linked immunosorbent assay was used to qualitatively analyze the five HBV markers, and chemiluminescence immunoassay was used to quantitatively analyze the five HBV markers. Hepatitis B surface antigen (HBsAg) in the long-term group and the medium-term group was significantly lower than that in the short-term group (P<0.001). HBsAg, hepatitis B e antigen, hepatitis B e antibody, hepatitis B core antibody in the long-term group was significantly higher than that in the medium-term and short-term group (P<0.050). The hepatitis B surface antibody in the long-term group was significantly lower than that in the other two groups (P<0.050). According to the previous time of the hepatitis B antibody vaccination, the patients in the long-term group were subdivided into three groups: Group A (vaccination time: 10-13 years, n=420); group B (13-15 years, n=377) and group C (>15 years, n=406). Geometric mean titer in group A was significantly lower than that in the other two groups (P<0.050). In conclusion, the protective effect of hepatitis B antibody vaccine is satisfactory for 10 years after vaccination, and re-vaccination is recommended after more than 13 years of vaccination when the virus begins to increase significantly, in order to prevent the occurrence of hepatitis B.
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Affiliation(s)
- Qiuhua Jia
- Department of Medical Test, Women and Children's Health Care Hospital of Linyi, Linyi, Shandong 276000, P.R. China
| | - Fei Yu
- Department of Clinical Laboratory, Affiliated Hospital of Shandong Medical College, Linyi, Shandong 276000, P.R. China
| | - Qi Zhou
- Department of Medical Test, Women and Children's Health Care Hospital of Linyi, Linyi, Shandong 276000, P.R. China
| | - Xiaoyan Chen
- Department of Medical Test, Women and Children's Health Care Hospital of Linyi, Linyi, Shandong 276000, P.R. China
| | - Zhaoqi Gu
- Department of Medical Test, Women and Children's Health Care Hospital of Linyi, Linyi, Shandong 276000, P.R. China
| | - Chunling Ma
- Experimental Center of Molecular Biology, Shandong Medical College, Linyi, Shandong 276000, P.R. China
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Huang H, Xu C, Liu L, Chen L, Zhu X, Chen J, Feng J, Chen T, Xu B, Yang J, Xu B, Pan M, Dai Y, Hu Y, Zhou YH. Increased protection of earlier use of immunoprophylaxis in preventing perinatal transmission of hepatitis B virus. Clin Infect Dis 2020; 73:e3317-e3323. [PMID: 32634824 DOI: 10.1093/cid/ciaa898] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/24/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Passive-active immunoprophylaxis against mother-to-child transmission (MTCT) of hepatitis B virus (HBV) recommends administer hepatitis B immunoglobulin (HBIG) and birth dose hepatitis B vaccine in infants within 12 or 24 hours after birth. With this protocol, MTCT of HBV still occurs in 5-10% infants of HBV-infected mothers with positive hepatitis B e antigen (HBeAg). METHODS The present study aimed to investigate whether earlier administration of HBIG and hepatitis B vaccine after birth can further increase the protection efficacy. RESULTS Totally, 1140 HBV-infected pregnant women were enrolled, and 982 infants (9 twins) of 973 mothers were finally followed up at 9.6 ± 1.9 months age. HBIG and birth dose vaccine were administered in newborn infants with a median 0.17 hour (0.02-1.0) after birth. The overall rate of MTCT was 0.9% (9/982), with none (0%) of 607 infants of HBeAg-negative mothers and 9 (2.4%) of 375 infants of HBeAg-positive mothers. All nine HBV-infected infants were born to mothers with HBV DNA >2.75×106 IU/ml. Maternal HBV DNA levels >1×106 IU/ml was an independent risk factor (OR = 10.627, 95% CI: 2.135-+∞) for immunoprophylaxis failure. CONSLUSIONS Earlier use (within one hour after birth) of HBIG and hepatitis B vaccine can provide better protection efficacy against MTCT of HBV.
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Affiliation(s)
- Hongyu Huang
- Department of Experimental Medicine and Jiangsu Key Laboratory for Molecular Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Chenyu Xu
- Department of Obstetrics and Gynecology, Zhenjiang Fourth People's Hospital, Zhenjiang, China
| | - Lanhua Liu
- Department of Obstetrics and Gynecology, Taixing People's Hospital, Taizhou, China
| | - Liping Chen
- Department of Obstetrics and Gynecology, Nantong First People's Hospital, Nantong, China
| | - Xiaoqin Zhu
- Department of Obstetrics and Gynecology, Huai'an Maternal and Children's Hospital, Huai'an, China
| | - Jie Chen
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Jing Feng
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Tingmei Chen
- Department of Obstetrics and Gynecology, Zhenjiang Fourth People's Hospital, Zhenjiang, China
| | - Biao Xu
- Department of Obstetrics and Gynecology, Taixing People's Hospital, Taizhou, China
| | - Jishi Yang
- Department of Obstetrics and Gynecology, Taixing People's Hospital, Taizhou, China
| | - Biyun Xu
- Department of Biostatistics, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Mingjie Pan
- Department of Experimental Medicine and Jiangsu Key Laboratory for Molecular Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Yimin Dai
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Yali Hu
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Yi-Hua Zhou
- Department of Experimental Medicine and Jiangsu Key Laboratory for Molecular Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.,Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
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Kisangau EN, Awour A, Juma B, Odhiambo D, Muasya T, Kiio SN, Too R, Lowther SA. Prevalence of hepatitis B virus infection and uptake of hepatitis B vaccine among healthcare workers, Makueni County, Kenya 2017. J Public Health (Oxf) 2020; 41:765-771. [PMID: 30351408 DOI: 10.1093/pubmed/fdy186] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 09/10/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) is a vaccine-preventable infection that can spread in healthcare setting. Data on HBV infections and vaccine in African healthcare workers (HCWs) are limited. We estimated HBV infection prevalence, hepatitis B vaccination status and identified factors associated with vaccination in one Kenyan county. METHODS Randomly selected HCWs completed a questionnaire about HBV exposure and self-reported immunization histories, and provided blood for testing of selected HBV biomarkers to assess HBV infection and vaccination status: HBV core antibodies (anti-HBc), HBV surface antigen (HBsAg) and HBV surface antibodies (anti-HBs). Prevalence odds ratios (OR) with 95% confidence intervals (95% CI) were calculated to identify factors associated with vaccination. RESULTS Among 312 HCWs surveyed, median age was 31 years (range: 19-67 years). Of 295 blood samples tested, 13 (4%) were anti-HBc and HBsAg-positive evidencing chronic HBV infection; 139 (47%) had protective anti-HBs levels. Although 249 (80%) HCWs received ≥1 HBV vaccine dose, only 119 (48%) received all three recommended doses. Complete vaccination was more likely among those working in hospitals compared to those working in primary healthcare facilities (OR = 2.5; 95% CI: 1.4-4.3). CONCLUSION We recommend strengthening county HCW vaccination, and collecting similar data nationally to guide HBV prevention and control.
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Affiliation(s)
- E N Kisangau
- Kenya Field Epidemiology and Laboratory Training Program (FELTP), Ministry of Health, Nairobi, Kenya.,School of Public Health, Moi University, Eldoret, Kenya
| | - A Awour
- Division of Global Health Protection, Centers for Disease Control and Prevention, Village Market, Nairobi, Kenya
| | - B Juma
- Division of Global Health Protection, Centers for Disease Control and Prevention, Village Market, Nairobi, Kenya
| | - D Odhiambo
- Kenya Medical Research Institute, Centers for Disease Control and Prevention Laboratory, Nairobi, Kenya
| | - T Muasya
- Kenya Medical Research Institute, Center for Virus Research, Hepatitis Laboratory, Nairobi, Kenya
| | - S N Kiio
- County Department of Health, Makueni County, Kenya
| | - R Too
- School of Public Health, Moi University, Eldoret, Kenya
| | - S A Lowther
- Division of Global Health Protection, Centers for Disease Control and Prevention, Village Market, Nairobi, Kenya
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Bassoum O, Kimura M, Tal Dia A, Lemoine M, Shimakawa Y. Coverage and Timeliness of Birth Dose Vaccination in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2020; 8:vaccines8020301. [PMID: 32545322 PMCID: PMC7350240 DOI: 10.3390/vaccines8020301] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 06/06/2020] [Accepted: 06/06/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Depending on the epidemiological context of each country, three vaccines are recommended by the World Health Organization (WHO) to be administered as soon as possible after birth (birth vaccines); namely, BCG, zero dose of oral polio vaccine (OPV0), and birth dose of hepatitis B vaccine (HepB-BD). The timely administration of these vaccines immediately after birth might pose significant challenges in sub-Saharan Africa, where about half of childbirths occur outside health facilities. We therefore conducted a systematic review and meta-analysis to estimate the coverage rate of these vaccines at a specific timing in neonates in sub-Saharan Africa. Methods: We searched PubMed, Embase, CINAHL, and Web of Science for studies conducted in sub-Saharan Africa and published up to March 31, 2017, which provided a coverage rate of the birth vaccines at any specific time points within 28 days after birth. Two investigators independently screened the titles and abstracts and extracted data from the eligible full-text articles. This study was registered in PROSPERO (CRD42017071269). Results: Of 7283 articles identified, we finally included 31 studies with 204,111 infants in the meta-analysis. The pooled coverage rates at day 0–1 after birth were 14.2% (95% CI: 10.1–18.9) for BCG and 1.3% (0.0–4.5) for HepB-BD. No data were available for OPV0 at day 0–1. The coverage at day 28 was 71.7% (63.7–79.2) for BCG, 60.8% (45.8–74.7) for HepB-BD, and 76.1% (67.1–84.0) for OPV0. No significant difference in the vaccine coverage was observed between infants born in healthcare facilities and those born outside facilities. Conclusions: The rates of vaccine coverage immediately after birth were very low for BCG and HepB-BD, and no data for OPV0. We need additional data to better define barriers and facilitators for the timely administration of the birth vaccines in sub-Saharan Africa, since the delay in its provision may increase the burden of these vaccine-preventable diseases.
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Affiliation(s)
- Oumar Bassoum
- Faculté de Médecine, de Pharmacie et d’Odontologie, Université Cheikh Anta Diop de Dakar, Dakar-Fann 5005, Senegal; (O.B.); (A.T.D.)
- Institut de Santé et Développement, Université Cheikh Anta Diop de Dakar, Dakar-Fann 16390, Senegal
| | - Moe Kimura
- Department of Metabolism, Digestion and Reproduction, Section of Hepatology and Gastroenterology, Imperial College, London W2 1NY, UK; (M.K.); (M.L.)
- Faculty of Medicine, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Anta Tal Dia
- Faculté de Médecine, de Pharmacie et d’Odontologie, Université Cheikh Anta Diop de Dakar, Dakar-Fann 5005, Senegal; (O.B.); (A.T.D.)
- Institut de Santé et Développement, Université Cheikh Anta Diop de Dakar, Dakar-Fann 16390, Senegal
| | - Maud Lemoine
- Department of Metabolism, Digestion and Reproduction, Section of Hepatology and Gastroenterology, Imperial College, London W2 1NY, UK; (M.K.); (M.L.)
| | - Yusuke Shimakawa
- Unité d’Épidémiologie des Maladies Émergentes, Institut Pasteur, 25-28 rue du Dr Roux, 75015 Paris, France
- Correspondence: or ; Tel.: +33-(0)1-4061-3887; Fax: +33-(0)1-4568-8876
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Na YG, Kim M, Han M, Huh HW, Kim JS, Kim JC, Park JH, Lee HK, Cho CW. Characterization of Hepatitis B Surface Antigen Loaded Polylactic Acid-Based Microneedle and Its Dermal Safety Profile. Pharmaceutics 2020; 12:pharmaceutics12060531. [PMID: 32527003 PMCID: PMC7355901 DOI: 10.3390/pharmaceutics12060531] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/02/2020] [Accepted: 06/05/2020] [Indexed: 12/19/2022] Open
Abstract
A surge of interest in microneedle (MN) vaccines as a novel vaccination system has emerged. Before the clinical application of MN vaccine, an assessment of potential biological risks to skin and quality control of MN must be performed. Therefore, the present study aims to evaluate the physicochemical properties of MN and to evaluate the histological changes and inflammatory cell infiltrations after the application of MN with hepatitis B surface antigen (HBsAg). During in vitro and in vivo release testing, HBsAg MN released over 70% of HBsAg at 30 min. During the pyrogen test of HBsAg MN in rabbit, no rabbit showed an individual rise in temperature of 0.5 °C or more. MN with HBsAg produced the moderate immunization in mice. MN application did not alter the thickness of dermal and epidermal layers in mice. In addition, the topical applications of MN and MN for hepatitis B vaccine did not acutely induce the inflammation, allergic reaction, dermal toxicity and skin irritation. Thus, the MN system for the delivery of HBsAg could be the promising technology in the hepatitis B vaccination.
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Affiliation(s)
- Young-Guk Na
- College of Pharmacy, Chungnam National University, Daejeon 34134, Korea; (Y.-G.N.); (M.K.); (M.H.); (H.W.H.)
| | - Minki Kim
- College of Pharmacy, Chungnam National University, Daejeon 34134, Korea; (Y.-G.N.); (M.K.); (M.H.); (H.W.H.)
| | - Mingu Han
- College of Pharmacy, Chungnam National University, Daejeon 34134, Korea; (Y.-G.N.); (M.K.); (M.H.); (H.W.H.)
| | - Hyun Wook Huh
- College of Pharmacy, Chungnam National University, Daejeon 34134, Korea; (Y.-G.N.); (M.K.); (M.H.); (H.W.H.)
| | - Ji-Seok Kim
- Department of BioNano Technology and Gachon BioNano Research Institute, Gachon University, Seongnam 13120, Korea; (J.-S.K.); (J.C.K.); (J.-H.P.)
| | - Jong Chan Kim
- Department of BioNano Technology and Gachon BioNano Research Institute, Gachon University, Seongnam 13120, Korea; (J.-S.K.); (J.C.K.); (J.-H.P.)
| | - Jung-Hwan Park
- Department of BioNano Technology and Gachon BioNano Research Institute, Gachon University, Seongnam 13120, Korea; (J.-S.K.); (J.C.K.); (J.-H.P.)
| | - Hong-Ki Lee
- College of Pharmacy, Chungnam National University, Daejeon 34134, Korea; (Y.-G.N.); (M.K.); (M.H.); (H.W.H.)
- Correspondence: (H.-K.L.); (C.-W.C.); Tel.: +82-42-821-7301 (H.-K.L.); +82-42-821-5934 (C.-W.C.); Fax: +82-42-823-6566 (H.-K.L.); +82-42-823-6566 (C.-W.C.)
| | - Cheong-Weon Cho
- College of Pharmacy, Chungnam National University, Daejeon 34134, Korea; (Y.-G.N.); (M.K.); (M.H.); (H.W.H.)
- Correspondence: (H.-K.L.); (C.-W.C.); Tel.: +82-42-821-7301 (H.-K.L.); +82-42-821-5934 (C.-W.C.); Fax: +82-42-823-6566 (H.-K.L.); +82-42-823-6566 (C.-W.C.)
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Zeng QL, Yu ZJ, Shang J, Xu GH, Sun CY, Liu N, Li CX, Lv J, Liu YM, Liang HX, Li ZQ, Pan YJ, Hu QY, Li W, Zhang DW, Wang FS. Short-term Peginterferon-Induced High Functional Cure Rate in Inactive Chronic Hepatitis B Virus Carriers With Low Surface Antigen Levels. Open Forum Infect Dis 2020; 7:ofaa208. [PMID: 32626791 PMCID: PMC7324053 DOI: 10.1093/ofid/ofaa208] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/28/2020] [Indexed: 12/25/2022] Open
Abstract
Background None of the current guidelines recommend antiviral therapy for inactive hepatitis B virus (HBV) carriers (IHCs). Methods In this real-world, multicenter, nonrandomized study, 32 participants meeting the inclusion criteria were enrolled 1:1 for treatment with peginterferon α-2b or monitoring without treatment based on participant preference. The expected treatment duration was 48 weeks. The primary end point was hepatitis B surface antigen (HBsAg) loss. The HBV vaccine could be injected after HBsAg loss. Results All patients had HBsAg levels of <20 IU/mL. The mean baseline HBsAg levels were 6.6 IU/mL and 5.8 IU/mL in the treated and untreated groups, respectively. Fifteen (93.8%) participants achieved HBsAg loss, 5 obtained HBsAg seroconversion after undergoing a mean of 19.7 weeks of therapy in the treated group, and no one in the follow-up group achieved HBsAg loss during a mean follow-up time of 12.6 months (P < .0001). Generally, the therapy was well tolerated. Nine of 11 individuals who exhibited HBsAg loss benefited from receiving the HBV vaccine. Conclusions This study provides justification for further studies of short-course peginterferon α-2b for the functional cure of IHCs with low HBsAg levels. Additionally, HBV vaccine injection is beneficial after interferon-induced HBsAg loss.
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Affiliation(s)
- Qing-Lei Zeng
- Department of Infectious Diseases and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Zu-Jiang Yu
- Department of Infectious Diseases and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Jia Shang
- Department of Infectious Diseases, Henan Provincial People's Hospital, Zhengzhou, Henan Province, China
| | - Guang-Hua Xu
- Department of Infectious Diseases, The Affiliated Hospital of Yan'an University, Yan'an, Shaanxi Province, China
| | - Chang-Yu Sun
- Department of Infectious Diseases and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Na Liu
- Department of Infectious Diseases, The Affiliated Hospital of Yan'an University, Yan'an, Shaanxi Province, China
| | - Chun-Xia Li
- Department of Infectious Diseases, The Affiliated Hospital of Yan'an University, Yan'an, Shaanxi Province, China
| | - Jun Lv
- Department of Infectious Diseases and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yan-Min Liu
- Department of Infectious Diseases and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Hong-Xia Liang
- Department of Infectious Diseases and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Zhi-Qin Li
- Department of Infectious Diseases and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Ya-Jie Pan
- Department of Infectious Diseases and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Qiu-Yue Hu
- Department of Infectious Diseases and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Wei Li
- Department of Infectious Diseases, Henan Provincial People's Hospital, Zhengzhou, Henan Province, China
| | - Da-Wei Zhang
- Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Fu-Sheng Wang
- Treatment and Research Center for Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
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Choi YH, Perez-Cuevas MB, Kodani M, Zhang X, Prausnitz MR, Kamili S, O'Connor SM. Feasibility of Hepatitis B Vaccination by Microneedle Patch: Cellular and Humoral Immunity Studies in Rhesus Macaques. J Infect Dis 2020; 220:1926-1934. [PMID: 31408163 DOI: 10.1093/infdis/jiz399] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 08/05/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This study evaluated dissolvable microneedle patch (dMNP) delivery of hepatitis B vaccine in rhesus macaques and provides evidence that dMNP delivery elicits seroprotective anti-HBs levels comparable with human seroprotection, potentially useful for hepatitis B birth dose vaccination in resource-constrained regions. METHODS Sixteen macaques were each vaccinated twice; they were treated in 4 groups, with dMNP delivery of AFV at 24 ± 8 µg (n = 4) or 48 ± 14 µg (n = 4), intramuscular injection of AFV (10 µg; n = 4), or intramuscular injection of AAV (10 µg; n = 4). Levels of antibody to hepatitis B surface antigen (HBsAg) (anti-HBs) and HBsAg-specific T-cell responses were analyzed. RESULTS Six of 8 animals with dMNP delivery of AFV had anti-HBs levels ≥10 mIU/mL after the first vaccine dose. After dMNP delivery of AFV, interferon γ, interleukin 2, and interleukin 4 production by HBsAg-specific T cells was detected. A statistically significant positive correlation was detected between anti-HBs levels and cells producing HBsAg-specific interferon γ and interleukin 2 (T-helper 1-type cytokine) and interleukin 4 (T-helper 2-type cytokine) in all anti-HBs-positive animals. CONCLUSIONS dMNP delivery of AFV can elicit seroprotective anti-HBs levels in rhesus macaques that are correlated with human seroprotection, and it could be particularly promising for birth dose delivery of hepatitis B vaccine in resource-constrained regions.
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Affiliation(s)
- Youkyung H Choi
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Monica B Perez-Cuevas
- School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA
| | - Maja Kodani
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Xiugen Zhang
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Mark R Prausnitz
- School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA
| | - Saleem Kamili
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Siobhan M O'Connor
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, US Centers for Disease Control and Prevention, Atlanta, GA
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Dayyab FM, Iliyasu G, Ahmad BG, Bako AT, Ngamariju SS, Habib AG. Hepatitis B vaccine knowledge and self-reported vaccination status among healthcare workers in a conflict region in northeastern Nigeria. Ther Adv Vaccines Immunother 2020; 8:2515135519900743. [PMID: 32002499 PMCID: PMC6966246 DOI: 10.1177/2515135519900743] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 12/19/2019] [Indexed: 11/15/2022] Open
Abstract
Background Hepatitis B virus (HBV) infection is highly endemic in Nigeria. The primary objective of this study is to describe the knowledge, self-reported vaccination status, and intention of healthcare workers to receive hepatitis B vaccine at a tertiary referral center in conflict-ravaged northeastern Nigeria. Methods This was cross-sectional analytical study among medical practitioners, nurses, laboratory workers, health attendants, pharmacists, and radiographers working at Federal Medical Center Nguru, Yobe State. Written informed consent was obtained from all study participants. Data were obtained using questionnaires and entered into a Microsoft Excel spreadsheet, cleaned and analyzed using JMP Pro software. Results Of the 182 participants, we found that 151 (82.97%), 81 (44.51%), 85 (46.70%), and 33 (18.13%) had good knowledge of HBV, good knowledge of hepatitis B vaccine, were vaccinated against HBV by the least dose, and had a complete hepatitis B vaccination status, respectively. The lack of availability of the vaccine was the main reason for not receiving the vaccine among the unvaccinated 36/91 (39.56%), followed by not knowing where to access the vaccine 19/91 (20.88%). Conclusion The study highlights the need for strategies to ensure the availability of hepatitis B vaccine in conflict settings and need for vaccinology training given the suboptimal level of awareness and uptake of the hepatitis B vaccine among the healthcare workers.
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Affiliation(s)
| | - Garba Iliyasu
- Department of Medicine, Bayero University Kano, Kano, Nigeria
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