Effects of hepatitis B immunization on prevention of mother-to-infant transmission of hepatitis B virus and on the immune response of infants towards hepatitis B vaccine

Zhang, Lei; Gui, Xien; Teter, Caroline; Zhong, H.; Pang, Z.; Ding, Lixiong; Li, Fengliang; Zhou, Yun; Zhang, Ling

doi:10.1016/j.vaccine.2014.08.078

Cited by 56 publications

(43 citation statements)

References 26 publications

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“…Another proposed inhibitory mechanism that may contribute to inadequate infant response to vaccine is related to high titers of maternal antibodies that persist over a period of 6 to 12 months. The reduced antibody generation by maternal antibodies to protein tetanus and hepatitis B vaccines as well as conjugated Hib vaccine have been reported (28,29), and this phenomenon may be explained by a hypothesis of the downregulation of B cell responses mediated through a cross-link between a B cell receptor and the inhibitory Fc␥-receptor IIB by a vaccine-antibody complex (29).…”

Section: Discussionmentioning

confidence: 98%

Impaired Antigen-Specific Immune Response to Vaccines in Children with Antibody Production Defects

Szczawińska-Popłonyk

Bręborowicz

Samara

et al. 2015

Clin Vaccine Immunol

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The impaired synthesis of antigen-specific antibodies, which is indispensable for an adaptive immune response to infections, is a fundamental pathomechanism that leads to clinical manifestations in children with antibody production defects. The aim of this study was to evaluate the synthesis of antigen-specific antibodies following immunization in relation to peripheral blood B cell subsets in young children with hypogammaglobulinemia. Twenty-two children, aged from 8 to 61 months, with a deficiency in one or more major immunoglobulin classes participated in the study. Postvaccination antibodies against tetanus and diphtheria toxoids, the surface antigen of the hepatitis B virus, and the capsular Haemophilus influenzae type b polysaccharide antigen were assessed along with an immunophenotypic evaluation of peripheral blood B lymph cell maturation. A deficiency of antibodies against the tetanus toxoid was assessed in 73% of cases and that against the diphtheria toxoid was assessed in 68% of cases, whereas a deficiency of antibodies against the surface antigen of the hepatitis B virus was revealed in 59% of the children included in the study. A defective response to immunization with a conjugate vaccine with the Haemophilus influenzae type b polysaccharide antigen was demonstrated in 55% of hypogammaglobulinemic patients. Increased proportions of transitional B lymph cells and an accumulation of plasmablasts accompanied antibody deficiencies. The defective response to vaccine protein and polysaccharide antigens is a predominating disorder of humoral immunity in children with hypogammaglobulinemia and may result from a dysfunctional state of the cellular elements of the immune system. A ntibody production defects are the most common category of pediatric primary immunodeficiencies (PIDs) (1, 2). The hallmark of these immunodeficiency conditions is the defective production of antigen-specific antibodies that are an indispensable element of the adaptive immune response to pathogens (3, 4). While the poor response to vaccines is another feature of humoral PIDs, the ability to synthesize postvaccination antibodies against toxoids and polysaccharides is the most specific expression of the immune response to antigens. In the evaluation of the immune response associated with antibody production, the response to vaccination against hepatitis B is not routinely recommended because of the large proportion of adults, up to between 1% and 3% of vaccinated individuals, who do not effectively synthesize antibodies against hepatitis B virus surface antigen (HBs). In infants and children, the efficiency of recombinant vaccines against hepatitis B, assessed on the basis of postvaccination anti-HBs antibody concentration over 10 mIU/ml, is estimated at 85% to 100% (5, 6). The minimal protective level of neutralizing antibodies against diphtheria and tetanus toxoids has been estimated at 0.01 to 0.1 IU/ml, whereas to achieve long-term immunity, a concentration of specific antibodies, up to 1.0 IU/ml, may be required. The synthesis of...

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Section: Discussionmentioning

confidence: 98%

Impaired Antigen-Specific Immune Response to Vaccines in Children with Antibody Production Defects

Szczawińska-Popłonyk

Bręborowicz

Samara

et al. 2015

Clin Vaccine Immunol

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“…However, the main cause of chronic HBV infection in vaccinated children remained the perinatal transmission of HBV from HBsAg+ mothers . In an area where HBV genotype B and C were prevalent, 3.3% and 7.9% chronic HBV infections were detected in Chinese children born to HBsAg+/HBeAg− or HBsAg+/HBeAg+ mothers receiving HBV vaccine and HBIG, respectively . Similarly, 9.3% chronic HBV infections were detected in vaccinated Taiwanese children born to HBsAg+/HBeAg+ mothers .…”

Section: Discussionmentioning

confidence: 99%

Low occurrence of HBsAg but high frequency of transient occult HBV infection in vaccinated and HBIG‐administered infants born to HBsAg positive mothers

Zhou

Allain

et al. 2017

Journal of Medical Virology

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The status of chronic and occult HBV infection (OBI) in neonatal hepatitis B vaccine and immunoglobulin (HBIG) vaccinated infants born to HBsAg+ mothers was investigated at a major hospital in China. Seventy-seven and 15 blood samples were collected in first or second follow-up detection from the vaccinated babies aged 3-36 months born to 43 HBsAg+ or plus 25 HBeAg+ mothers. HBV infection was analyzed between the paired baby and mother by serology and DNA analysis. Among 77 children born to 68 HBsAg+ mothers, 3.9% (3/77) were HBsAg+, and 36.4% (28/77) were HBV DNA+/HBsAg- (OBIs) by a single PCR, respectively. Thirteen of 28 HBV DNA+/HBsAg- samples were conformed by two PCRs or S sequence, which accounted for 16.9% (13/77) of children. Three HBsAg+ and six OBIs were genotyped in consistent with their mother's HBV strains. Of 77 babies' blood samples, anti-HBs reactivity varied slightly according to age groups, while passively transmitted anti-HBc reactivity declined from 100% high reactivity at age 3-5 months to mostly negative at age ≥12 months. Babies with apparent OBI had higher levels of anti-HBc and lower levels of anti-HBs than those without OBI but all eight OBI babies with second follow-up samples became HBV DNA negative beyond 1 year of age. The vaccinated infants born to HBsAg+ mothers presented the low rate of HBsAg occurrence as vaccination failure and high frequency of viral persistence in the form of transient OBIs since no evidence of active HBV infection occurred beyond 1 year of age.

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“…91 In the 2002-2009 VSD, the frequency of HBV vaccination was 3.73/1,000 pregnancies; however, vaccination was possible in cases where the woman and/or provider were unaware of the pregnancy. 40 A Chinese study conducted in 2002 reported a lower anti-HB positive rate (56.3%) in pregnant women, 92 which may suggest the extended HBV vaccination in women of child-bearing age should be considered. …”

Section: Hb Vaccine Immunizationmentioning

confidence: 99%

Viral hepatitis vaccination during pregnancy

Zhao

Jin

Zhang

et al. 2016

Human Vaccines & Immunotherapeutics

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Viral hepatitis is a serious global public health problem. It is also a common cause of jaundice and gestational complications in pregnant women. Moreover, infected mothers can transmit the virus to their fetus or neonate, which may increase disease burden and decrease quality of life. To date, commercial vaccines have been developed for hepatitis A, B, and E and are available to the general population. The Advisory Committee on Immunization Practices currently accepts emergency vaccination against hepatitis A and B during pregnancy due to benefits that overweight the potential risks. While there are limited data from trials with limited numbers of samples that suggest the efficacy or safety of hepatitis B and E vaccines in pregnant women, additional data are necessary to provide evidence of vaccination during pregnancy.

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Effects of hepatitis B immunization on prevention of mother-to-infant transmission of hepatitis B virus and on the immune response of infants towards hepatitis B vaccine

Cited by 56 publications

References 26 publications

Impaired Antigen-Specific Immune Response to Vaccines in Children with Antibody Production Defects

Impaired Antigen-Specific Immune Response to Vaccines in Children with Antibody Production Defects

Low occurrence of HBsAg but high frequency of transient occult HBV infection in vaccinated and HBIG‐administered infants born to HBsAg positive mothers

Viral hepatitis vaccination during pregnancy

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