Persistence of long-term immunity to hepatitis B among adolescents immunized at birth

Chaves, Sandra S.; Fischer, Gayle E.; Groeger, Justina; Patel, Priti R.; Thompson, Nicola D.; Teshale, Eyasu H.; Kuartei, Stevenson; Yano, Victor; Armstrong, Gregory L.; Samandari, Taraz; Kamili, Saleem; Drobeniuc, Jan; Hu, Dale J.

doi:10.1016/j.vaccine.2011.12.106

Cited by 54 publications

(51 citation statements)

References 31 publications

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“…Other studies of anamnestic response to a challenge dose of HB vaccine years after receiving the recombinant product in infancy have shown variable results [9][10][11][12][13][14] ; these studies vary by primary series schedule, dosage administered, number of doses for the primary series, and degree of endemicity of HB infection in the study areas. Our study data are unique for several reasons.…”

Section: Discussionmentioning

confidence: 99%

“…The magnitude and duration of (primary and boosted) immune response is affected by multiple factors, including age at first dose, potential effect of natural boosting (increased titers in response to exposure to infection), primary series dose and response, and interval between challenge dose and primary series, each of which have differed with country of origin of the available research. [5][6][7][8][9][10][11][12][13] Investigators have determined the duration of protection of HB vaccine among people in countries with varying degrees of HB endemicity. Results from Alaska examining duration of protection 22 years after plasma-derived HB vaccine was administered to infants have shown that higher anti-HBs titer after the primary series and higher anti-HBs before a challenge dose of vaccine predicted a more vigorous anamnestic response.…”

Section: What This Study Addsmentioning

confidence: 99%

“…10 In some areas of higher HB endemicity, rates of anamnestic responses to a challenge dose of vaccine seem somewhat less vigorous and were as low as 70% in Palau. [11][12][13] In an area of high HB endemicity in Thailand, anamnestic responses to a challenge dose of vaccine were achieved in 95% of participants 20 years after a 4-dose infant series of recombinant HB vaccine. 14 For the TCPA practices with space available for study personnel to conduct enrollment, an initial, automated phone call was made to the households of age-appropriate patients describing the study and asking interested families to call the research line.…”

Section: What This Study Addsmentioning

confidence: 99%

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Duration of Protection After Infant Hepatitis B Vaccination Series

et al. 2014

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BACKGROUND: Little is known about duration of protection after the infant primary series of hepatitis B (HB) vaccine in settings of low HB endemicity. This study sought to determine the proportion of adolescents immunized as infants who had protective titers of antibody to hepatitis B surface antigen (anti-HBs) before and after a challenge dose of vaccine. METHODS: US-born 16- through 19-year-olds who received a recombinant HB vaccine 3-dose series initiated within 7 days of birth (group 1) or at ≥4 weeks of age (group 2) and completed by 12 months of age were enrolled. Participants had serologic testing before and 2 weeks after randomization to receive a challenge dose of 10 µg or 20 µg of Engerix-B. Baseline and postchallenge levels of anti-HBs were compared by group, challenge dosage, and demographic and behavioral characteristics. RESULTS: At baseline, 24% had protective anti-HBs levels of ≥10 IU/mL; 92% achieved protective levels after challenge dose. Although group 1 had a lower proportion of seroprotection at baseline, group and challenge dosage were not associated with postchallenge proportion of seroprotection. Being in group 2, higher test dosage, higher baseline geometric mean titer, and nonwhite race were associated with significantly higher geometric mean titer after challenge dose. CONCLUSIONS: More than 90% of study participants immunized against HB as infants exhibited a seroprotective response to a challenge dose of vaccine. Duration of protection from the primary infant HB vaccine series extended through the adolescent years in the setting of low HB endemicity.

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Section: Discussionmentioning

confidence: 99%

Section: What This Study Addsmentioning

confidence: 99%

Section: What This Study Addsmentioning

confidence: 99%

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Duration of Protection After Infant Hepatitis B Vaccination Series

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“…[8] The duration of HBVvaccineinduced immunity after primary immunisation during infancy is not known. [12,13] Although specific antibody levels decline rapidly after vaccination, protection through immune memory is thought to extend into adulthood. The waning of vaccineinduced immunity could leave adolescents and adults at risk of HBV infection.…”

mentioning

confidence: 99%

“…The waning of vaccineinduced immunity could leave adolescents and adults at risk of HBV infection. [13] …”

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confidence: 99%

Investigating hepatitis B immunity in patients presenting to a paediatric haematology and oncology unit in South Africa

et al. 2014

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Evidence for a change in the epidemiology of hepatitis B virus infection after nearly two decades of universal hepatitis B vaccination in South Africa

Amponsah-Dacosta

Lebelo

Rakgole

et al. 2014

Journal of Medical Virology

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The hepatitis B vaccine has been part of the South African Expanded Program on Immunization since April 1995 but its long-term impact remains unknown. This study tested 1,206 sera collected from patients aged 1-25 years from various health facilities across the country for HBV serological markers and HBV DNA. Based on the year the vaccine was introduced, samples were stratified by age into pre- and post-vaccine introduction populations, which were then compared for evidence of immunity and chronic carriage using the Chi-square test. Where HIV status was known, subset analyses were performed. Immunity to HBV infection increased from 13.0% in the pre- to 57.0% in the post-vaccine introduction population (P < 0.001). This decreased with increasing age within the post-vaccine introduction population (76.1% for 1-5 years, 50.0% for 6-10 years, and 46.3% for 11-16 years). In addition, HBV chronic carriage was significantly (P = 0.003) reduced in the post- (1.4%) compared to the pre-vaccine introduction population (4.2%). The difference in prevalence of active HBV infection in the serologically exposed pre- and post-vaccine introduction populations was not statistically significant. Subset analyses showed that evidence of immunity was significantly (P < 0.001) higher in the HIV negative compared to the HIV positive subset in both populations. Universal hepatitis B vaccination has been a remarkable success, with a significant increase in immunity to HBV infection. The observation that HBV chronic carriage increases as immunity wanes over time calls into question whether the time has come to consider a pre-adolescence vaccine booster dose policy.

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Persistence of long-term immunity to hepatitis B among adolescents immunized at birth

Cited by 54 publications

References 31 publications

Duration of Protection After Infant Hepatitis B Vaccination Series

Duration of Protection After Infant Hepatitis B Vaccination Series

Investigating hepatitis B immunity in patients presenting to a paediatric haematology and oncology unit in South Africa

Evidence for a change in the epidemiology of hepatitis B virus infection after nearly two decades of universal hepatitis B vaccination in South Africa

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