Suitable hepatitis B vaccine for adult immunization in China: a systematic review and meta-analysis

Abstract

Hepatitis B virus (HBV) infection remains an important public health problem in China, and adults need to be vaccinated. This systematic review and meta-analysis assessed the appropriate immunization of adults in China. Only randomized controlled trials (RCTs) were eligible, and seroprotection was defined as anti-HBs≥ 10 mIU/ml; 18,308 participants in 27 studies were included. Relative risk (RR) and random effects models were used. Twenty micrograms of HBV vaccine resulted in a better response than 10 μg (RR: 1.05, 95% confidence interval (CI): 1.02 to 1.08), and the 0-, 1-, and 6-month schedule was more effective than the 0-, 1-, and 2 - or 3-month schedule (RR: 0.98, 95% CI: 0.96 to 1.00). No significant differences were observed between 10 μg and 5 μg (RR: 1.05, 95% CI: 0.88 to 1.01); (yeast-derived hepatitis B vaccines) YDV and recombinant Chinese hamster ovary cell (CHO) hepatitis B vaccine (RR: 1.01, 95% CI: 0.98 to 1.04); domestic and imported (RR: 1.02, 95% CI: 0.99 to 1.05); or 0-, 1-, and 6-month and 0-, 1-, and 12-month schedules (RR: 1.02, 95% CI: 0.89 to 1.08). In conclusion, 20 μg of vaccine is recommended for adults in China, and the 0-, 1-, and 12-month immunization program schedule is also worth choosing when it is not possible to complete the 0-, 1-, and 6-month schedule.

Trend analysis and age-period-cohort effects on morbidity and mortality of liver cancer from 2010 to 2020 in Guangzhou, China

“…A series of driving stimuli caused by HBV promotes the transformation of liver cells, leading to DNA damage, aging, chronic inflammation, hepatitis, cirrhosis, impairing the immune system, and eventually leading to liver cancer (33)(34)(35). China began to promote the use of hepatitis B vaccine in 1992, and the inclusion of hepatitis B vaccine in the child immunization program in 2002 was an important measure for the prevention and control of the hepatitis B epidemic (36,37). Despite the fact that the vaccination proved to be effective primary prevention measure, comprehensive neonatal hepatitis B vaccination policy has only been implemented in East Asian countries such as China and South Korea for about 30 years, and the average duration of hepatitis B vaccination is only 5~10 years, indicating that risk inhibition has not yet been fully reflected.…”

A cross-sectional study on dental surgeons’ immune status against hepatitis B virus in the Public Health System

“…What may justify this high prevalence of non-vaccination or non-protection among Brazilian dental surgeons is the possibility of a gradual decline of antibody levels, from 13 to 60%, one year after the end of the immunization schedule 21 . Other factors associated to anti-HBs seroconversion can affect the production of antibodies, reducing the effectiveness of vaccinated individuals' immunization, such as vaccine storage methods, correct administration of doses, the immunization program and the protocol followed by each healthcare service 25 . In addition, we verified through a systematic review and meta-analysis that male, adult, elderly individuals with BMI (Body Mass Index) ≥ 25, who smoke and have concomitant comorbidities, have higher risks of immunization failure, reinforcing the importance of performing the anti-HBs evaluation, and providing booster doses of the vaccine against HBV 26 .…”

Persistence of Immunity in Adults after 1, 5 and 10 Years with Recombinant Hepatitis B Vaccine in Beijing in 2010–2020

“…Currently, new cases of acute hepatitis B in China are reported mainly in adults, who have become the primary population of new HBV infections over 20 years of age [10]. In addition, in the USA, the population aged 25 to 44 are the highest proportion of new HBV infections [11]. In 2011, the guidelines for adult hepatitis B vaccination were issued by the Chinese Center for Disease Control and Prevention (CDC) and the Chinese Preventive Medicine Association (CPMA), recommending that all unvaccinated adults, especially those at high risk for HBV infection, should be targets for vaccination [12].…”