Immunization against Hepatitis B Surface Antigen (HBsAg) in a Cohort of Nursing Students Two Decades after Vaccination: Surprising Feedback

Verso, Maria Gabriella; Costantino, Claudio; Vitale, Francesco; Amodio, Emanuele

doi:10.3390/vaccines8010001

Cited by 19 publications

(12 citation statements)

References 27 publications

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“…Studies concerning the assessment of the persistence of protective antibody titers in the pediatric population have shown that 15-50% of responder subjects may have low or non-detectable antibody concentrations after 5-24 years since the vaccination [34][35][36]. The results obtained in the present study are, in this respect, in accordance with the collected data in the literature.…”

Section: Discussionsupporting

confidence: 91%

“…However, this percentage does not imply a susceptibility status for these subjects: the WHO affirms that even if the anti-HBs titers are not detectable following the immunization series, no booster dose is needed [1][2][3]. This is a consequence of the immune memory widely described for hepatitis B vaccination in the scientific literature [35,38].…”

Section: Discussionmentioning

confidence: 99%

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Hepatitis B Seroprevalence in the Pediatric and Adolescent Population of Florence (Italy): An Update 27 Years after the Implementation of Universal Vaccination

et al. 2020

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Background: Hepatitis B still represents a health concern, although safe and effective vaccines have been available since 1982. Italy introduced a program of universal vaccination against hepatitis B in 1991. The aim of this study was to assess the immunity levels towards hepatitis B in a sample of sera from the pediatric and adolescent population in the province of Florence, Central Italy, twenty-seven years after the implementation of universal vaccination. Methods: A total of 165 sera samples were collected from the resident population of Florence aged 1–18 years. The anti-HBs and anti-HBc enzyme-linked immunosorbent Assay (ELISA) tests were performed on all samples. The anamnestic and vaccination status data were also collected. Results: Seroprevalence of anti-HBs was approximately 60%, with children aged 1–5 years having the highest positivity rate (81.6%), and decreasing trends in the older age groups. The zero prevalence of anti-HBc shows that the detected protective immunity is mainly due to vaccination, and natural infection was not reported in the studied population. Conclusions: The seroprevalence of anti-HBs and the lack of anti-HBc in this study highlights that immunity levels have been derived mainly from immunization. This confirms how vaccination dramatically reduced circulation of the hepatitis B virus in Italy in the pediatric and adolescent population twenty-seven years after implementation of the mandatory universal program.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Hepatitis B Seroprevalence in the Pediatric and Adolescent Population of Florence (Italy): An Update 27 Years after the Implementation of Universal Vaccination

et al. 2020

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“…The students were evaluated for levels of anti-HBsAg antibodies showing a difference between receiving HBV vaccination at adolescence and at infancy. Vaccinated students at adolescence showed a significant association with an increased possibility of having anti-HBsAg titers ≥ 10 mIU/mL than those who were vaccinated at infancy (69% vs. 31.7%) [137]. But, on the other hand, the vaccine is not effective against an already established infection nor against escape mutants at vaccination.…”

Section: Discussionmentioning

confidence: 85%

A Systematic Review of the Current Hepatitis B Viral Infection and Hepatocellular Carcinoma Situation in Mediterranean Countries

Madihi

Syed

Lazar

et al. 2020

BioMed Research International

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Viral hepatitis B is a global public health problem affecting nearly two billion subjects; 3.3% of whom are from the WHO (World Health Organization) Eastern Mediterranean Region (EMRO). It induces both acute and chronic hepatic disorders with subsequent liver cirrhosis and hepatocellular carcinoma (HCC) in a considerable percentage of patients based on the age of exposure. In this review, hepatitis B virus (HBV) and HCC prevalence, distribution and prevalence of different genotypes, and male/female infection frequencies in relation to the vaccination status in the Mediterranean countries were reported. Study Design. This systematic review describes the prevalence of hepatitis B infection, genotype distribution of hepatitis B virus, and prevalence and incidence of hepatocellular carcinoma in Mediterranean countries belonging to three different continents: Southern Europe (Spain, France, Italy, Croatia, and Greece), North Africa (Morocco, Algeria, Tunisia, Libya, and Egypt), and the Near East region (Syria, Lebanon, Turkey, Israel, and Palestine). We tried to collect new data from electronic databases: PubMed, ScienceDirect, ResearchGate, Google Scholar, and public health reports between 1980 and 2019. For each publication, we recorded reference, publication year, study characteristics (date, locations, sample size, and study population), and participant characteristics (population group, year, age, and sex). No language limitation was imposed, and articles or reports from non-peer-reviewed sources were not considered for this analysis. The main keywords were HBV prevalence, hepatitis B infection, HBV genotype, and HCC. Inclusion and Exclusion Criteria. Healthy population-based studies included the following sample populations: (i) voluntary blood donors, (ii) pregnant women, (iii) community studies, (iv) hemodialysis patients, (v) hospitalized patients, (vi) healthcare workers, (vii) sex workers, (viii) drug abusers, and (ix) prisoners. We excluded studies from the following special groups who were assumed to be at a special high risk: patients from sexually transmitted disease clinics and thalassemia clinics and professional or paid blood donors.

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“…At the same time, about 30-60% of adults vaccinated against HBV will have anti-HBs concentrations decline to <10 mIU/mL within 9-11 years [20].…”

Section: Discussionmentioning

confidence: 99%

Kinetics of Anti-Hepatitis B Surface Antigen Titers in Nurse Students after a Two-Year Follow-Up

et al. 2020

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Infection caused by hepatitis B virus (HBV) can be prevented through a safe and effective vaccine. This study analysed the kinetics of serum antibodies against hepatitis B surface antigen (HBsAg) (anti-HBs) titers in relation to previous vaccine boosters in Italian nursing students who were followed up for two years. Serum anti-HBs titers were evaluated at the first visit, after vaccine booster (if required) and at visit after two years. Overall, 483 students (mean age = 21.7 years; SD = 3.7) with median anti-HBs IgG titer of 6 mUI/mL (interquartile range (IQR) = 0–34) were enrolled. A total of 254 (52.5%) students with a titer lower than 10 mIU/mL were offered an anti-HBV booster at the first visit. Among these students, an exponential relation between anti-HBs IgG titer, one month after HBV booster and anti-HBs IgG titer two years later was found (y = 3.32 exp (0.0045x); R2 = 0.48; p < 0.001). Students with anti-HBV titer higher than 10 mIU/mL (N = 229) were followed up, and anti-HBs IgG titers at follow-up visit linearly correlated with anti-HBV baseline titers (y = 0.86x + 26.2; R2 = 0.67; p < 0.001). A decrease in anti-HBs titers can be expected a few years after the anti-HBV booster dose. This reduction is more pronounced than that observed in students not administered the booster dose and is exponential with respect to basal titers assessed after the booster dose.

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Immunization against Hepatitis B Surface Antigen (HBsAg) in a Cohort of Nursing Students Two Decades after Vaccination: Surprising Feedback

Cited by 19 publications

References 27 publications

Hepatitis B Seroprevalence in the Pediatric and Adolescent Population of Florence (Italy): An Update 27 Years after the Implementation of Universal Vaccination

Hepatitis B Seroprevalence in the Pediatric and Adolescent Population of Florence (Italy): An Update 27 Years after the Implementation of Universal Vaccination

A Systematic Review of the Current Hepatitis B Viral Infection and Hepatocellular Carcinoma Situation in Mediterranean Countries

Kinetics of Anti-Hepatitis B Surface Antigen Titers in Nurse Students after a Two-Year Follow-Up

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