Seroprevalence of hepatitis B and immune response to hepatitis B vaccination in Chinese college students mainly from the rural areas of western China and born before HBV vaccination integrated into expanded program of immunization

Abstract

The prevalence of hepatitis B surface antigen (HBsAg) in a population aged 15 y or older was high in China, but an immunization strategy for this population was unavailable. We investigated the seroprevalence of hepatitis B and immune response to HBV vaccine in Chinese college students (n=2040 participants), 11.1%, 80.8%, and 8.1% had confirmed, unknown and no HBV vaccination history, respectively. The seropositive rates for HBsAg, anti-HBs sole and anti-HBs plus anti-HBc were 12.6%, 25.7%, and 30.1%, respectively. The HBsAg seropositive rate was significantly lower in participants with confirmed HBV vaccination history than in those with unknown or no vaccination history (5.3%, 13.6%, and 12.6%, respectively, P=0.0019). The anti-HBs alone seropositive rate was significantly higher in participants with confirmed HBV vaccination history than in those with unknown or no vaccination history (37.6%, 25.3%, and 13.8%, respectively, P<0.0001). Participants negative for HBsAg, anti-HBs, and anti-HBc at baseline (n=600) were given three doses of recombinant HBV vaccine (GlaxoSmithKline) at month 0, 1, and 6. Robust immune response was elicited after two and three doses (seroprotective rate: 91.9% and 99.0%, respectively, and geometric mean concentration [GMC]: 95.8 and 742.6 IU/L, respectively). Fourteen months after the third dose, the anti-HBs seroprotective rate of the group remained more than 97%. The seroprotective rates and GMCs did not differ significantly by vaccination history. This study suggested that three doses of 20 μg HBV vaccine were needed for college students negative for HBsAg, anti-HBs, and anti-HBc to ensure high seroprotective rates and concentrations.

Changes and analysis of anti‐HBs titres after primary immunization in 1‐ to 16‐year‐old Chinese children: A hospital‐based study

“…A hepatitis B vaccination programme was initiated in China since 1992, in which all infants were given a dose of the vaccine at birth, at 1 month and at 6 months old. The original plasma‐derived vaccine was replaced by the yeast‐derived HBV vaccine in 2000 . Starting in 2005, the Chinese government began to provide free vaccine to all infants, and the HBsAg carrier rate decreased from 9.8% in 1992 to 7.2% in 2006 .…”

“…The original plasma-derived vaccine was replaced by the yeast-derived HBV vaccine in 2000. 6 Starting in 2005, the Chinese government began to provide free vaccine to all infants, and the HBsAg carrier rate decreased from 9.8% in 1992 to 7.2% in 2006. 7 The coverage rate of the 3-dose hepatitis B vaccine in infants was 99% in 2014 in China.…”

Strategy vaccination against Hepatitis B in China

“…31 A study on the HBV immunization strategy for college students found that 3 doses of HBV vaccines could induce a higher protection rate and anti-HBs concentrations compared with one dose of the HBV vaccine, in students with isolated positive anti-HBc. 32 Immunization strategies for accidental exposure prevention The following procedures should be followed in the event of accidental exposure. Serologic testing of HBsAg, anti-HBs, and ALT levels should be checked immediately after exposure and rechecked within 3¡6 months.…”

Anti-Hepatitis B Antibody Levels In Immunized Medical Students: Are They At Risk?

“…In China, studies found high levels of anti-HBs seroconversion. Among college students, they found that only 0.8 to 1% that did not achieve anti-HBs seroprotection after complete vaccination 6,7 . Among children and adolescents aged 5 to 15 years, the rate of non-seroconversion was lower (0.3 to 0.8%) 7,8 .…”