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Lefèvre L, Quenard F, Cabras O, Medo E, Barry TA, Cabié A, Cuzin L. Vaccination coverage against three viral sexually transmitted diseases, among 18-to-30-year-olds seen between May 2023 and May 2024 in the Martinique University Hospital CeGIDD. Infect Dis Now 2025; 55:105055. [PMID: 40089154 DOI: 10.1016/j.idnow.2025.105055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2025] [Accepted: 03/12/2025] [Indexed: 03/17/2025]
Abstract
OBJECTIVE AND METHODS We retrospectively assessed protection against HBV (defined by HBs Ab > 10 UI/L), HAV (defined by positive IgG), and HPV (defined by at least one shot) in 1161 patients aged 18---30 years old who consulted at an HIV and STI screening center (CeGIDD) between May 2023 and May 2024. Results are presented by gender, sexual orientation and PrEP use. RESULTS All in all, 59% (621/1051) of the population was HBV-immune. Among MSM, bisexual men and transgender people, 17% (18/105) were HAV-immune, a proportion rising to 40% (42/105) at the end of the study period. Among PrEP patients, 18% (13/78) were HAV-immune and 64% (50/78) were HBV-immune. HPV vaccination was given to 12% (68/569) of women, 13% (72/583) of men, 37% (54/147) of MSM, bisexual men and transgender patients, and to 41% (32/78) of PrEP users. CONCLUSION All health workers should be fully aware of the relevant recommendations and actively involved in enhancing patient protection.
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Affiliation(s)
- L Lefèvre
- Infectious and Tropical Diseases Unit, Martinique University Hospital, Fort de France, Martinique
| | - F Quenard
- Infectious and Tropical Diseases Unit, Martinique University Hospital, Fort de France, Martinique
| | - O Cabras
- Infectious and Tropical Diseases Unit, Martinique University Hospital, Fort de France, Martinique
| | - E Medo
- Infectious and Tropical Diseases Unit, Martinique University Hospital, Fort de France, Martinique
| | - T A Barry
- Infectious and Tropical Diseases Unit, Martinique University Hospital, Fort de France, Martinique
| | - A Cabié
- Infectious and Tropical Diseases Unit, Martinique University Hospital, Fort de France, Martinique; Antilles University, EA4537, Fort de France, Martinique; Inserm CIC1424, Martinique University Hospital, Fort de France, Martinique
| | - L Cuzin
- Infectious and Tropical Diseases Unit, Martinique University Hospital, Fort de France, Martinique; CERPOP, Toulouse University, INSERM UMR1295, UPS, Toulouse, France.
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Gong X, Zheng C, Fang Q, Xu W, Yin Z. Survey of Hepatitis B Vaccination Coverage and Surface Antibody-Positive Rates in People Aged 1-59 Years in 2006 and 2024. Open Forum Infect Dis 2024; 11:ofae589. [PMID: 39431151 PMCID: PMC11488135 DOI: 10.1093/ofid/ofae589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Accepted: 10/02/2024] [Indexed: 10/22/2024] Open
Abstract
Background Implementing hepatitis B vaccination is an important strategy to reduce hepatitis B virus infection and disease burden. Suboptimal adult hepatitis B vaccination coverage limits the further reduction of hepatitis B virus infection. Methods A multistage stratified random sampling method was adopted to survey the permanent population aged 1-59 in 2006 and 2024. We calculated the vaccination coverage rate, hepatitis B surface antibody (HBsAb)-positive rate, rate difference, and their 95% confidence intervals (CIs) of the 2 survey populations, and used the 95% CI and χ2 test to determine whether the difference in rate was statistically significant. Results Six hundred twenty-three people were surveyed in 2006 and 606 people were surveyed in 2024. From 2006 to 2024, the hepatitis B vaccination coverage among people aged 1-59 years increased from 54.1% to 78.9%, and the HBsAb-positive rate increased from 46.2% to 57.6%. There was no significant difference in vaccination coverage in the population <15 years of age, but the antibody-positive rate increased significantly. The vaccination coverage rate of the 15-59 age group increased significantly, but there was no statistical difference in the antibody positivity rate of the 15-49 age group, and the antibody positivity rate of the 50-59 age group increased significantly. Conclusions Hepatitis B vaccination coverage among adults was still insufficient. Hepatitis B vaccine-mediated immunity was low in adults aged 30-49 years. It is recommended to update the guidelines for hepatitis B vaccination of adults in China, cancel the assessment of risk factors and prevaccination serological screening, and emphasize universal vaccination of all unvaccinated adults to increase coverage.
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Affiliation(s)
- Xiaoying Gong
- Department of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang, China
| | - Canjie Zheng
- Department of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang, China
| | - Quanjun Fang
- Department of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang, China
| | - Wenjie Xu
- Department of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang, China
| | - Zhiying Yin
- Department of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang, China
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Satake M, Sugiyama M, Mizokami M, Tanaka J. Incidences of new hepatitis B infection and anti-hepatitis B core-negative occult hepatitis B infection among Japanese blood donors in relation to anti-hepatitis B surface antigen levels. J Med Virol 2024; 96:e29823. [PMID: 39039862 DOI: 10.1002/jmv.29823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 07/05/2024] [Accepted: 07/15/2024] [Indexed: 07/24/2024]
Abstract
A transfusion-transmitted hepatitis B virus (HBV) infection caused by blood only positive for anti-hepatitis B surface antigen (anti-HBs) was reported. Occult HBV infection (OBI) with sole anti-HBs among blood donors is an issue. The incidence of HBV infection among repeat blood donors was investigated with a detailed HBV infection phase, focusing on the influence of anti-HBs level. This study followed 3 435 653 donors for HBV DNA conversion over 4 years and 9 months. Infection phase was determined based on marker changes over DNA conversion. This study identified 115 hepatitis B surface antigen (HBsAg) conversions, 72 DNA-only conversions, and 15 DNA plus anti-hepatitis B core (anti-HBc) conversions among donors all negative for HBV DNA, HBsAg, and anti-HBc. Total incidence was 2.38/100 000 person-years (PY). None of these 202 new HBV infections arose in the group with anti-HBs titer ≥ 10 mIU/mL. In total, 30 anti-HBc-negative OBIs were identified (incidence; 0.35/100 000 PY); 7 showed typical secondary anti-HBs response, and 23 showed stable anti-HBc and anti-HBs levels at DNA conversion. The HBV infection-protective ability of anti-HBs ≥ 10 mIU/mL was reinforced. In addition to new infections, the blood donor population includes anti-HBc-positive- and negative OBI with immune reactions or abortive HBV infection.
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Affiliation(s)
- Masahiro Satake
- Blood Service Headquarters, Japanese Red Cross, Tokyo, Japan
| | - Masaya Sugiyama
- Department of Viral Pathogenesis and Controls, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masashi Mizokami
- Genome Medical Sciences Project, National Center for Global Health and Medicine, Tokyo, Japan
| | - Junko Tanaka
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Sintusek P, Buranapraditkun S, Khunsri S, Polsawat W, Vichaiwattana P, Poovorawan Y. Antibody persistence of standard versus double three-dose hepatitis B vaccine in liver transplant children: a randomized controlled trial. Sci Rep 2024; 14:499. [PMID: 38177354 PMCID: PMC10767042 DOI: 10.1038/s41598-024-51149-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/01/2024] [Indexed: 01/06/2024] Open
Abstract
Rapid hepatitis B (HB) surface antibody (anti-HBs) loss is prevalent after liver transplantation (LT). Herein, we evaluated anti-HBs persistence after HB vaccination using two regimens in LT children. We recruited 66 previously immunized LT children with anti-HBs level of < 100 mIU/mL. Participants were randomly reimmunized with standard-three-dose (SD) and double-three-dose (DD) intramuscular HB vaccination at 0, 1, and 6 months. Anti-HBs were assessed at every outpatient visit. Antibody loss defined as anti-HBs levels < 100 mIU/mL after three-dose vaccination. After three-dose vaccination, 81.8% and 78.7% of participants in the SD and DD groups, had anti-HBs levels > 100 mIU/mL, with a geometric mean titer (GMT) of 601.68 and 668.01 mIU/mL (P = 0.983). After a mean follow-up of 2.31 years, the anti-HBs GMT was 209.81 and 212.61 mIU/mL in the SD and DD groups (P = 0.969). The number of immunosuppressants used and an anti-HBs level < 1 mIU/mL at baseline were independently associated with anti-HB loss. The DD regimen strongly increased the risk of anti-HBs loss (adjusted hazard ratio, 2.97 [1.21-7.31]; P = 0.018). The SD HB reimmunization regimen effectively maintained protective anti-HBs levels in children undergoing LT, making it the preferred regimen for such children with anti-HB loss.Trial registration: TCTR20180723002.
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Affiliation(s)
- Palittiya Sintusek
- Center of Excellence in Thai Pediatric Gastroenterology, Hepatology and Immunology (TPGHAI), Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital and the Thai Red Cross Society, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Supranee Buranapraditkun
- Center of Excellence in Thai Pediatric Gastroenterology, Hepatology and Immunology (TPGHAI), Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital and the Thai Red Cross Society, Chulalongkorn University, Bangkok, 10330, Thailand
- Division of Allergy and Clinical Immunology, Department of Medicine, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Siriporn Khunsri
- Center of Excellence in Thai Pediatric Gastroenterology, Hepatology and Immunology (TPGHAI), Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital and the Thai Red Cross Society, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Warunee Polsawat
- Excellence Center for Organ Transplantation, King Chulalongkorn Memorial Hospital and the Thai Red Cross Society, Bangkok, 10330, Thailand
| | - Preeyaporn Vichaiwattana
- Excellence Center of Clinical Virology, Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Yong Poovorawan
- Excellence Center of Clinical Virology, Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, 10330, Thailand.
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Obeng MA, Okwan DK, Adankwah E, Owusu PK, Gyamerah SA, Duah KB, Paintsil EK. Seroconversion and Prevalence of Hepatitis B Surface Antigen among Vaccinated Health Care Workers in Ashanti Region, Ghana. Adv Med 2023; 2023:2487837. [PMID: 38149294 PMCID: PMC10751156 DOI: 10.1155/2023/2487837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 11/28/2023] [Accepted: 12/08/2023] [Indexed: 12/28/2023] Open
Abstract
Background Health care workers (HCWs) constantly stand at a high risk of exposure to the hepatitis B virus because of the nature of their work. Hence, it is mandatory for HCWs to undergo hepatitis B vaccination. However, most HCWs in Ghana do not check their HBsAb titre after completion of their primary vaccination. This study assessed the prevalence of HBsAg and the seroconversion rate among vaccinated health care workers in the Ashanti Region, Ghana. Materials and Methods A semistructured open-ended questionnaire was pretested and administered to 424 HCWs. Two (2) ml of blood was drawn and qualitative analyses (HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb) were done on the blood samples. Samples that tested positive to HBsAb were quantified using ELISA. Data obtained were analysed using GraphPad Prism 9. Results Out of the 424 study participants, 271 (63.9%) were females and 153 (36.1%) were males. Seroconversion (≥1 mIU/mL) and seroprotection (≥10 mIU/mL) through vaccination only among study participants were 67.5% (n/N = 286/424) and 58.0% (n/N = 246/424), respectively. Prevalence of hepatitis B viral infection was 2.4% (n/N = 10/424). Anti-HBc seropositivity was 13.2%, and anti-HBs seronegativity was 24.1%. 2.4% (n/N = 10/424) of study participants were negative to HBsAg but positive to HBcAb. In addition, 8.5% (n/N = 36/424) of the study participants were seroprotected due to exposure and recovery from previous HBV infection. Age, the number of doses received, taking a booster dose, and keeping a vaccination record card were significant factors influencing seroconversion status. Conclusion This study reaffirms the need for HCWs to undergo a supervised primary hepatitis B vaccination course. Postvaccination serological testing should be done for all HWCs to confirm immunity and reduce their chances of contracting HBV infection.
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Affiliation(s)
- Michael Agyemang Obeng
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Daniel Kobina Okwan
- Department of Anatomy, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ernest Adankwah
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Medical Diagnostics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Samuel Asante Gyamerah
- Department of Statistics and Actuarial Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kluivert Boakye Duah
- Department of Statistics and Actuarial Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ellis Kobina Paintsil
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Giráldez-Gallego Á, Rodríguez-Seguel EDP, Valencia-Martín R, Morillo-García Á, Salamanca-Rivera C, Ruiz-Pérez R, Cuaresma-Duque M, Rosso-Fernández C, Ferrer-Ríos MT, Sousa-Martín JM, Praena-Fernández JM, Desongles-Corrales T, Rodríguez-Pérez A, Camino-Durán F, Gasch-Illescas A, Ampuero-Herrojo J, Pascasio-Acevedo JM. Three double-dose reinforced hepatitis B revaccination scheme for patients with cirrhosis unresponsive to the standard regimen: an open-label randomised clinical trial. Gut 2023; 73:166-174. [PMID: 36963815 DOI: 10.1136/gutjnl-2022-328222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 03/14/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVE We aimed to compare the response rates between two different hepatitis B virus vaccination schedules for cirrhotic subjects who were non-responders to the first three 40 µg doses (month 0-1-2), and identify factors associated with the final response. DESIGN A total of 120 cirrhotic patients (72.5% decompensated) were randomised at a 1:1 ratio to receive a single 40 µg booster vaccination at month 6 (classical arm) versus an additional round of three new 40 µg doses administered at monthly intervals (experimental arm). The main outcome was the rate of postvaccinal anti-hepatitis B surface antibodies levels ≥10 mIU/mL. RESULTS Efficacy by ITT analysis was higher in the experimental arm (46.7%) than in the classical one (25%); OR 2.63, p=0.013. The experimental arm increased response rates compared with the classical one from 31% to 68% (OR 4.72; p=0.007), from 24.4% to 50% (OR 3.09; p=0.012) and from 24.4% to 53.8% (OR 3.62; p=0.007), in Child A, Model for End-Stage Liver Disease (MELD) <15 and MELD-Na<15 patients, respectively. Patients with more advanced liver disease did not benefit from the reinforced scheme. Both regimens showed similar safety profiles. Multivariable analysis showed that the experimental treatment was independently response associated when adjusted across three logistic regression models indicating equivalent cirrhosis severity. CONCLUSION For cirrhotic patients, the revaccination of non-responders to the first three dose cycle, with three additional 40 µg doses, achieved significantly better response rates to those obtained with an isolated 40 µg booster dose. TRIAL REGISTRATION NUMBER NCT01884415.
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Affiliation(s)
- Álvaro Giráldez-Gallego
- Unit for the Clinical Management of Digestive Diseases, Virgen del Rocío University Hospital, Seville, Andalusia, Spain
- Liver Diseases, Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Andalusia, Spain
| | - Elisa Del Pilar Rodríguez-Seguel
- Liver Diseases, Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Andalusia, Spain
- Digestive Diseases Research Unit, Virgen Del Rocío University Hospital, Seville, Andalusia, Spain
- Cell Biology Department, Faculty of Biology, University of Seville, Seville, Andalusia, Spain
| | - Raquel Valencia-Martín
- Preventive Medicine and Public Health Department, Virgen del Rocío University Hospital, Seville, Andalusia, Spain
- Department of Preventive Medicine and Public Health, Faculty of Medicine. University of Seville, Seville, Andalusia, Spain
| | - Áurea Morillo-García
- Preventive Medicine and Public Health Department, Virgen del Rocío University Hospital, Seville, Andalusia, Spain
- Department of Preventive Medicine and Public Health, Faculty of Medicine. University of Seville, Seville, Andalusia, Spain
| | - Celia Salamanca-Rivera
- Preventive Medicine and Public Health Department, Virgen del Rocío University Hospital, Seville, Andalusia, Spain
- Department of Preventive Medicine and Public Health, Faculty of Medicine. University of Seville, Seville, Andalusia, Spain
| | - Ricardo Ruiz-Pérez
- Liver Diseases, Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Andalusia, Spain
- Digestive Diseases Research Unit, Virgen Del Rocío University Hospital, Seville, Andalusia, Spain
| | - María Cuaresma-Duque
- Liver Diseases, Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Andalusia, Spain
- Digestive Diseases Research Unit, Virgen Del Rocío University Hospital, Seville, Andalusia, Spain
| | - Clara Rosso-Fernández
- Clinical Trial Unit, Virgen del Rocío University Hospital, Seville, Andalusia, Spain
| | - María Teresa Ferrer-Ríos
- Unit for the Clinical Management of Digestive Diseases, Virgen del Rocío University Hospital, Seville, Andalusia, Spain
- Liver Diseases, Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Andalusia, Spain
| | - José Manuel Sousa-Martín
- Unit for the Clinical Management of Digestive Diseases, Virgen del Rocío University Hospital, Seville, Andalusia, Spain
- Liver Diseases, Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Andalusia, Spain
| | - Juan Manuel Praena-Fernández
- Statistics, Methodology and Evaluation for Clinical Investigation, Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Andalusia, Spain
- Department of Nursery, Faculty of Nursing, Physiotherapy and Podiatry. University of Seville, Seville, Andalusia, Spain
| | | | | | - Francisco Camino-Durán
- Preventive Medicine and Public Health Department, Virgen del Rocío University Hospital, Seville, Andalusia, Spain
| | - Antonia Gasch-Illescas
- Preventive Medicine and Public Health Department, Virgen del Rocío University Hospital, Seville, Andalusia, Spain
- Department of Preventive Medicine and Public Health, Faculty of Medicine. University of Seville, Seville, Andalusia, Spain
- Prevention in Health and Longevity Centre, Institut Pasteur de Lille, Lille, Hauts de France, France
- Infectious and Immune System Diseases-Epidemiology and Public Health, Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Andalusia, Spain
| | - Javier Ampuero-Herrojo
- Unit for the Clinical Management of Digestive Diseases, Virgen del Rocío University Hospital, Seville, Andalusia, Spain
- Liver Diseases, Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Andalusia, Spain
- Department of Medicine, Faculty of Medicine. University of Seville, Seville, Andalusia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Seville, Andalusia, Spain
| | - Juan Manuel Pascasio-Acevedo
- Unit for the Clinical Management of Digestive Diseases, Virgen del Rocío University Hospital, Seville, Andalusia, Spain
- Liver Diseases, Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Andalusia, Spain
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McLean C, Dijkman K, Gaddah A, Keshinro B, Katwere M, Douoguih M, Robinson C, Solforosi L, Czapska-Casey D, Dekking L, Wollmann Y, Volkmann A, Pau MG, Callendret B, Sadoff J, Schuitemaker H, Zahn R, Luhn K, Hendriks J, Roozendaal R. Persistence of immunological memory as a potential correlate of long-term, vaccine-induced protection against Ebola virus disease in humans. Front Immunol 2023; 14:1215302. [PMID: 37727795 PMCID: PMC10505757 DOI: 10.3389/fimmu.2023.1215302] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/09/2023] [Indexed: 09/21/2023] Open
Abstract
Introduction In the absence of clinical efficacy data, vaccine protective effect can be extrapolated from animals to humans, using an immunological biomarker in humans that correlates with protection in animals, in a statistical approach called immunobridging. Such an immunobridging approach was previously used to infer the likely protective effect of the heterologous two-dose Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen. However, this immunobridging model does not provide information on how the persistence of the vaccine-induced immune response relates to durability of protection in humans. Methods and results In both humans and non-human primates, vaccine-induced circulating antibody levels appear to be very stable after an initial phase of contraction and are maintained for at least 3.8 years in humans (and at least 1.3 years in non-human primates). Immunological memory was also maintained over this period, as shown by the kinetics and magnitude of the anamnestic response following re-exposure to the Ebola virus glycoprotein antigen via booster vaccination with Ad26.ZEBOV in humans. In non-human primates, immunological memory was also formed as shown by an anamnestic response after high-dose, intramuscular injection with Ebola virus, but was not sufficient for protection against Ebola virus disease at later timepoints due to a decline in circulating antibodies and the fast kinetics of disease in the non-human primates model. Booster vaccination within three days of subsequent Ebola virus challenge in non-human primates resulted in protection from Ebola virus disease, i.e. before the anamnestic response was fully developed. Discussion Humans infected with Ebola virus may benefit from the anamnestic response to prevent disease progression, as the incubation time is longer and progression of Ebola virus disease is slower as compared to non-human primates. Therefore, the persistence of vaccine-induced immune memory could be considered as a potential correlate of long-term protection against Ebola virus disease in humans, without the need for a booster.
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Affiliation(s)
| | - Karin Dijkman
- Janssen Vaccines and Prevention, Leiden, Netherlands
| | | | | | | | | | | | | | | | | | | | | | | | | | - Jerry Sadoff
- Janssen Vaccines and Prevention, Leiden, Netherlands
| | | | - Roland Zahn
- Janssen Vaccines and Prevention, Leiden, Netherlands
| | - Kerstin Luhn
- Janssen Vaccines and Prevention, Leiden, Netherlands
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Soriano V, Aguilera A, Benito R, González-Díez R, Miró E, Liendo P, Rodríguez-Diaz JC, Cabezas T, Richart A, Ramos JM, Barea L, Álvarez C, Treviño A, Gómez-Gallego F, Corral O, de Mendoza C. Susceptibility to hepatitis B virus infection in adults living in Spain. Liver Int 2023; 43:1015-1020. [PMID: 36809581 DOI: 10.1111/liv.15548] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 01/11/2023] [Accepted: 02/20/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND A protective hepatitis B virus (HBV) vaccine has been available for four decades. Universal HBV vaccination of infants is recommended by the WHO since the 1990s. Furthermore, HBV immunization is advised for all adults with high-risk behaviours and no seroprotection. However, HBV vaccine coverage remains globally suboptimal. The advent of new more efficacious trivalent HBV vaccines has renewed the interest in HBV vaccination. At present, the extent of current HBV susceptibility in adults remains unknown in Spain. METHODS HBV serological markers were assessed on a large and representative sample of adults in Spain, including blood donors and individuals belonging to high-risk groups. Serum HBsAg, anti-HBc and anti-HBs were tested in specimens collected during the last couple of years. RESULTS From 13 859 consecutive adults tested at seven cities across the Spanish geography, overall 166 (1.2%) had positive HBsAg. Past HBV infection was recognized in 14% and prior vaccine immunization in 24%. Unexpectedly, 37% of blood donors and 63% of persons belonging to high-risk groups had no serum HBV markers and therefore were potentially HBV susceptible. CONCLUSION Roughly 60% of adults living in Spain seem to be HBV susceptible. Waning immunity might be more common than expected. Hence, HBV serological testing should be performed at least once in all adults regardless of risk exposures. HBV vaccine full courses or boosters should be administered to all adults lacking serological evidence of HBV protection.
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Affiliation(s)
| | - Antonio Aguilera
- Hospital Clínico Universitario de Santiago & GI-1209 USC, Santiago de Compostela, Spain
| | - Rafael Benito
- Hospital Universitario Lozano Blesa & Universidad de Zaragoza, Zaragoza, Spain
| | | | | | | | | | | | - Alberto Richart
- Centro de Transfusión de la Comunidad de Madrid, Madrid, Spain
| | | | - Luisa Barea
- Centro de Transfusión de la Comunidad de Madrid, Madrid, Spain
| | - Carmen Álvarez
- Universidad Internacional de La Rioja (UNIR), Madrid, Spain
| | - Ana Treviño
- Universidad Internacional de La Rioja (UNIR), Madrid, Spain
| | | | - Octavio Corral
- Universidad Internacional de La Rioja (UNIR), Madrid, Spain
| | - Carmen de Mendoza
- Puerta de Hierro University Hospital & Research Institute, Majadahonda, Spain
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Ward JW, Wanlapakorn N, Poovorawan Y, Shouval D. Hepatitis B Vaccines. PLOTKIN'S VACCINES 2023:389-432.e21. [DOI: 10.1016/b978-0-323-79058-1.00027-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2025]
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Agallou M, Koutsoni OS, Michail M, Zisimopoulou P, Tsitsilonis OE, Karagouni E. Antibody and T-Cell Subsets Analysis Unveils an Immune Profile Heterogeneity Mediating Long-term Responses in Individuals Vaccinated Against SARS-CoV-2. J Infect Dis 2022; 227:353-363. [PMID: 36259394 PMCID: PMC9620767 DOI: 10.1093/infdis/jiac421] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Based on the fact that coronavirus disease 2019 (COVID-19) is still spreading despite worldwide vaccine administration, there is an imperative need to understand the underlying mechanisms of vaccine-induced interindividual immune response variations. METHODS We compared humoral and cellular immune responses in 127 individuals vaccinated with either BNT162b2, mRNA-1273, or ChAdOx1-nCoV-19 vaccine. RESULTS Both mRNA vaccines induced faster and stronger humoral responses as assessed by high spike- and RBD-specific antibody titers and neutralizing efficacy in comparison to ChAdOx1-nCoV-19 vaccine. At 7 months postvaccination, a decreasing trend in humoral responses was observed, irrespective of the vaccine administered. Correlation analysis between anti-S1 IgG and interferon- (IFN-) production unveiled a heterogeneous immune profile among BNT162b2-vaccinated individuals. Specifically, vaccination in the high-responder group induced sizable populations of polyfunctional memory CD4 helper T cells (TH1), follicular helper T cells (TFH), and T cells with features of stemness (TSCM), along with high neutralizing antibody production that persisted up to 7 months. In contrast, low responders were characterized by significantly lower antibody titers and memory T cells and a considerably lower capacity for interleukin-2 and IFN- production. CONCLUSIONS We identified that long-term humoral responses correlate with the individuals ability to produce antigen-specific persistent memory T-cell populations.
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Affiliation(s)
- Maria Agallou
- Immunology of Infection Laboratory, Hellenic Pasteur Institute, Athens, Greece
| | - Olga S Koutsoni
- Laboratory of Cellular Immunology, Hellenic Pasteur Institute, Athens, Greece
| | - Maria Michail
- Laboratory of Molecular Neurobiology and Immunology, Hellenic Pasteur Institute, Athens, Greece,Department of Biology, National and Kapodistrian University of Athens, Athens, Greece
| | - Paraskevi Zisimopoulou
- Laboratory of Molecular Neurobiology and Immunology, Hellenic Pasteur Institute, Athens, Greece
| | - Ourania E Tsitsilonis
- Department of Biology, National and Kapodistrian University of Athens, Athens, Greece
| | - Evdokia Karagouni
- Correspondence: Evdokia Karagouni, PhD, Hellenic Pasteur Institute, 127 Vas. Sofias Ave, 115 21 Athens, Greece ()
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11
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Huang Y, Yang Y, Wu T, Li Z, Xu H, Huang A, Zhao Y. Complementary Presence of HBV Humoral and T-cell Response Provides Protective Immunity after Neonatal Immunization. J Clin Transl Hepatol 2022; 10:660-668. [PMID: 36062290 PMCID: PMC9396322 DOI: 10.14218/jcth.2021.00272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/08/2021] [Accepted: 10/14/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND AND AIMS Hepatitis B vaccination is the most cost effective way to prevent hepatitis B virus (HBV) infection. Hepatitis B vaccine (HepB) efficacy is usually assessed by anti-hepatitis B surface antigen (HBsAg) level, but there are few reports of humoral and cellular immune responses to HepB in children after neonatal vaccination. METHODS A group of 100 children with a history of primary hepatitis B immunization were included in this study to evaluate the efficacy of HepB. Blood samples were obtained from 80 children before, and 41 children after, a single HepB booster dose. Children with low anti-HBsAg (HBs) titers of <100 mIU/mL received a booster dose after giving their informed consent. Anti-HBsAg, T-cell response and percentage of B-cell subsets were assayed before and after the booster. RESULTS Of the 80 children, 81.36% had positive T cell and anti-HBsAg responses at baseline. After the booster dose, the anti-HBsAg titer (p<0.0001), positive HBsAg-specific T-cell response (p=0.0036), and spot-forming cells (p=0.0003) increased significantly. Compared with pre-existing anti-HBsAg titer <10 mIU/mL, the anti-HBsAg (p=0.0005) and HBsAg-specific T-cell responses (p<0.0001) increased significantly in preexisting anti-HBsAg titer between 10 and 100 mIU/mL group. Change of the HBV-specific humoral response was the reverse of the T-cell response with age. Peripheral blood lymphocytes, B cells, and subset frequency decreased. CONCLUSIONS HBV immunization protection persisted at least 13 years after primary immunization because of the complementary presence of HBV-specific humoral antibodies and a T-cell immune response. One dose of a HepB booster induced protective anti-HBsAg and promoted an HBsAg-specific T-cell response. In HBV endemic regions, a HepB booster is recommended to children without anti-HBsAg because of effectiveness in HBV prevention.
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Affiliation(s)
- Yunmei Huang
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Yuting Yang
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Tingting Wu
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Zhiyu Li
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Hongmei Xu
- Department of Infection, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Ailong Huang
- Institute for Viral Hepatitis, Ministry of Education Key Laboratory of Molecular Biology on Infectious Diseases, Chongqing Medical University, Chongqing, China
| | - Yao Zhao
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children’s Hospital of Chongqing Medical University, Chongqing, China
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12
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Han Y, Cao N, Lu X, Yao T, Shi J, Wu Y, Dong S, Shao Z, Wang J, Liu H, Guo H, Chai G, Liu L, Wang F, Feng Y, Liang X, Wang S. Duration of immunogenicity of high-dose and prolonged-schedule hepatitis B vaccine among patients with chronic kidney disease: A one year follow-up study in China. Expert Rev Vaccines 2022; 21:1675-1682. [DOI: 10.1080/14760584.2022.2112951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Yujie Han
- School of Public Health, Shanxi Medical University, Taiyuan, China
- Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Na Cao
- School of Public Health, Shanxi Medical University, Taiyuan, China
- Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Xiaoxiao Lu
- School of Public Health, Shanxi Medical University, Taiyuan, China
- Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Tian Yao
- Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
- First Hospital of Shanxi Medical University, Taiyuan, China
| | - Jing Shi
- School of Public Health, Shanxi Medical University, Taiyuan, China
- Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Yuanting Wu
- School of Public Health, Shanxi Medical University, Taiyuan, China
- Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Shuang Dong
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Zhihong Shao
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Jianmin Wang
- Department of Nephrology, Linfen Central Hospital, Linfen, China
| | - Hongting Liu
- Department of Nephrology, Yuncheng Central Hospital, Yuncheng, China
| | - Hongping Guo
- Department of Nephrology, Linfen People’s Hospital, Linfen, China
| | - Guowei Chai
- Department of Nephrology, Houma People’s Hospital, Houma, China
| | - Liming Liu
- Department of Nephrology, Linfen Central Hospital, Linfen, China
| | - Fuzhen Wang
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yongliang Feng
- School of Public Health, Shanxi Medical University, Taiyuan, China
- Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
| | - Xiaofeng Liang
- Institute of Vaccine Industry, Jinan University, Guangzhou, China
- Institute of Disease control and prevention, Jinan University, Guangzhou, China
- Chinese Preventive Medicine Association, Beijing, China
| | - Suping Wang
- School of Public Health, Shanxi Medical University, Taiyuan, China
- Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China
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13
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Sintusek P, Buranapraditkun S, Wanawongsawad P, Posuwan N, Thantiworasit P, Wanlapakorn N, Klaewsongkram J, Suratannon N, Chaijitraruch N, Chongsrisawat V, Poovorawan Y. Safety and Immunogenicity of Standard and Double Doses of Hepatitis B Vaccine in Children after Liver Transplantation: An Open-Label, Randomised Controlled Trial. Vaccines (Basel) 2022; 10:92. [PMID: 35062752 PMCID: PMC8778427 DOI: 10.3390/vaccines10010092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 12/10/2022] Open
Abstract
A high prevalence of hepatitis B (HepB) antibody loss after liver transplantation (LT) and de novo HepB infection (DNH) was documented, hence revaccination to prevent DNH is crucial. This study aimed to compare the safety and immunogenicity of two HepB vaccine regimens in liver-transplanted children. Liver-transplanted children who were previously immunised but showed HepB surface antibodies (anti-HBs) ≤ 100 mIU/mL were randomised to receive a standard three-dose (SD) and double three-dose (DD) vaccine intramuscularly in months 0-1-6. Anti-HBs and T-cell-specific response to the HepB antigen were assessed. A total of 61 children (54.1% male, aged 1.32 ± 1.02 years) completed the study without any serious adverse reaction. The seroprotective rate was 69.6% vs. 60% (p = 0.368) and 91.3% vs. 85% (p = 0.431) in SD and DD after the first and third 3-dose vaccinations, respectively. The geometric mean titre (95% confidence interval) of anti-HBs in SD and DD were 443.33 (200.75-979.07) vs. 446.17 (155.58-1279.50) mIU/mL, respectively, at completion. Numbers of interferon-γ-secreting cells were higher in hyporesponders/responders than in nonresponders (p = 0.003). The significant factors for the immunologic response to HepB vaccination were anti-HB levels prevaccination, tacrolimus trough levels, and time from LT to revaccination. SD and DD had comparative immunogenicity and were safe for liver-transplanted children who were previously immunised.
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Grants
- Thai Pediatric Gastroenterology, Hepatology and Immunology (TPGHAI) Research Unit, Faculty of Medicine, Chulalongkon University, King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, 10330, Thailand
- The 100th Anniversary Chulalongkorn University Fund for Doctoral Scholarship, Chulalongkorn University
- RA63/012 Ratchadapiseksompotch Fund, Faculty of Medicine, Chulalongkorn University
- MRG6280190 the Thailand Research Fund, Thailand Science research and Innovation
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Affiliation(s)
- Palittiya Sintusek
- Division of Gastroenterology, Department of Pediatrics, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; (P.S.); (N.C.); (V.C.)
- Thai Pediatric Gastroenterology, Hepatology and Immunology (TPGHAI) Research Unit, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkon University, The Thai Red Cross Society, Bangkok 10330, Thailand;
| | - Supranee Buranapraditkun
- Thai Pediatric Gastroenterology, Hepatology and Immunology (TPGHAI) Research Unit, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkon University, The Thai Red Cross Society, Bangkok 10330, Thailand;
- Division of Allergy and Clinical Immunology, Department of Medicine, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Thai Red Cross Society, Bangkok 10330, Thailand; (P.T.); (J.K.)
- Center of Excellence in Vaccine Research and Development (Chula Vaccine Research Center-Chula VRC), Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Piyaporn Wanawongsawad
- Excellence Center for Organ Transplantation, King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand;
| | - Nawarat Posuwan
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; (N.P.); (N.W.)
| | - Pattarawat Thantiworasit
- Division of Allergy and Clinical Immunology, Department of Medicine, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Thai Red Cross Society, Bangkok 10330, Thailand; (P.T.); (J.K.)
| | - Nasamon Wanlapakorn
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; (N.P.); (N.W.)
| | - Jettanong Klaewsongkram
- Division of Allergy and Clinical Immunology, Department of Medicine, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Thai Red Cross Society, Bangkok 10330, Thailand; (P.T.); (J.K.)
| | - Narissara Suratannon
- Pediatric Allergy and Clinical Immunology Research Unit, Division of Allergy and Immunolgy, Department of Pediatrics, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, The Thai Red Cross Society, Bangkok 10330, Thailand;
| | - Nataruks Chaijitraruch
- Division of Gastroenterology, Department of Pediatrics, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; (P.S.); (N.C.); (V.C.)
| | - Voranush Chongsrisawat
- Division of Gastroenterology, Department of Pediatrics, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; (P.S.); (N.C.); (V.C.)
| | - Yong Poovorawan
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; (N.P.); (N.W.)
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14
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Shah NJ, Aloysius MM, Sharma NR, Pallav K. Advances in treatment and prevention of hepatitis B. World J Gastrointest Pharmacol Ther 2021. [DOI: 10.4292/wjg.v12.i4.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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15
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Shah NJ, Aloysius MM, Sharma NR, Pallav K. Advances in treatment and prevention of hepatitis B. World J Gastrointest Pharmacol Ther 2021; 12:56-78. [PMID: 34316384 PMCID: PMC8290928 DOI: 10.4292/wjgpt.v12.i4.56] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/22/2021] [Accepted: 05/22/2021] [Indexed: 02/06/2023] Open
Abstract
Chronic hepatitis B (CHB) continues to contribute to worldwide morbidity and mortality significantly. Scientists, clinicians, pharmaceutical companies, and health organizations have dedicated substantial Intellectual and monetary resources to finding a cure, increasing immunization rates, and reducing the global burden of CHB. National and international health-related organizations including the center for disease control, the national institute of health, the American Association for the study of liver disease (AASLD), The European association for the study of the Liver (EASL), The Asia Pacific association for the study of the Liver (APASL) and the world health organization release periodic recommendations for disease prevention and treatment. Our review of the most recent guidelines by EASL, AASLD, APASL, and Taiwan Association for the Study of the Liver revealed that an overwhelming majority of cited studies were published before 2018. We reviewed Hepatitis B-related literature published 2018 onwards to identify recent developments and current barriers that will likely direct future efforts towards eradicating hepatitis B. The breakthrough in our understanding of the hepatitis B virus life cycle and resulting drug development is encouraging with significant room for further progress. Data from high-risk populations, most vulnerable to the devastating effects of hepatitis B infection and reactivation remain sparse. Utilization of systems approach, optimization of experimental models, identification and validation of next-generation biomarkers, and precise modulation of the human immune response will be critical for future innovation. Within the foreseeable future, new treatments will likely complement conventional therapies rather than replace them. Most Importantly, pragmatic management of CHB related population health challenges must be prioritized to produce real-world results.
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Affiliation(s)
- Niraj James Shah
- Department of Internal Medicine, Digestive Disease, University of Mississippi Medical Center, Jackson, MS 39216, United States
| | - Mark M Aloysius
- Department of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, PA 18505, United States
| | - Neil Rohit Sharma
- Department of Internal Medicine, Interventional Oncology and Surgical Endoscopy, Parkview Regional Medical Center, Parkview Cancer Institute, Fort Wayne, IN 46845, United States
| | - Kumar Pallav
- Department of Internal Medicine, Interventional Oncology and Surgical Endoscopy, Parkview Regional Medical Center, Parkview Cancer Institute, Fort Wayne, IN 46845, United States
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16
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Abaalkhail FA, Al-Hamoudi WK, Khathlan A, Alghamdi S, Alghamdi M, Alqahtani SA, Sanai FM. SASLT practice guidelines for the management of Hepatitis B virus - An update. Saudi J Gastroenterol 2021; 27:115-126. [PMID: 33976009 PMCID: PMC8265399 DOI: 10.4103/sjg.sjg_539_20] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 02/23/2021] [Indexed: 12/30/2022] Open
Abstract
Infection with hepatitis B virus (HBV) remains an important public health problem with a high burden worldwide. The Saudi Association for the Study of Liver diseases and Transplantation formed a working group to develop HBV practice guidelines in Saudi Arabia. The methodology used to develop these guidelines was based on reviewing the available evidence, local data, and major international practice guidelines on the management of HBV. The aim of these guidelines is to assist healthcare providers in the management of HBV in Saudi Arabia. These updated guidelines summarize the latest local studies performed on HBV epidemiology, major changes in the prevalence of this virus, and advances in disease management.
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Affiliation(s)
- Faisal A. Abaalkhail
- Gastroenterology Section, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- College of Medicine, Al Faisal University, Riyadh, Saudi Arabia
| | - Waleed K. Al-Hamoudi
- Liver Disease Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Medicine, Liver Transplant Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Abdullah Khathlan
- Department of Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Saad Alghamdi
- Department of Medicine, Liver Transplant Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mohammed Alghamdi
- Department of Medicine, King Fahd Military Medical Complex, Dhahran, Saudi Arabia
| | - Saleh A. Alqahtani
- Department of Medicine, Liver Transplant Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, USA
| | - Faisal M. Sanai
- Liver Disease Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Gastroenterology Unit, Department of Medicine, King Abdulaziz Medical City, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
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17
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Miao N, Zheng H, Sun X, Zhang G, Wang F. Protective effect of vaccinating infants with a 5 µg recombinant yeast-derived hepatitis B vaccine and the need for a booster dose in China. Sci Rep 2020; 10:18155. [PMID: 33097788 PMCID: PMC7584599 DOI: 10.1038/s41598-020-75338-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 10/14/2020] [Indexed: 01/05/2023] Open
Abstract
In 2002, China integrated hepatitis B vaccine (HepB) into its Expanded Program on Immunization (EPI) using HepB vaccine containing 5 µg of antigen. Although not recommended nationally, there was a common clinical practice in China of screening children for anti-HBs antibody level and giving a booster dose to HBV surface antigen (HBsAg)-negative children with non-protective anti-HBs antibody levels. We report an evaluation of the protective effectiveness of the 5 µg HepB vaccine and the serological response to the booster dose. We used data from a 2014 hepatitis B serological survey to determine HBsAg positivity and anti-HBs antibody levels among children who received and did not receive a booster dose. We determined HepB coverage from the Children Immunization Information Management System (CIIMS). We obtained and analyzed reports of acute Hepatitis B (AHB) during 2008-2014 obtained from the National Notifiable Disease Reporting System (NNDRS). The HBsAg-positive rate among children who had not received a booster dose was 0.41%, and did not increase with age (i.e., time since infant immunization). The anti-HBs positivity rate among the 6% of children who received a booster dose (88.41%) was higher than among those who had not received a booster (60.85%); anti-HBs antibody levels declined with age regardless of booster dose status. There was no statistically significant difference in HBsAg positivity between children who received a booster dose and those who did not. The AHB incidence among children born between 2002 and 2007 did not increase with age. Use of routine 5 µg HepB vaccine was not associated with an increase in AHB or of HBsAg positivity by time since vaccination, providing supportive evidence that individuals vaccinated with the 5 µg HepB vaccine do not need a booster dose. Although a booster dose was associated with increases in anti-HBs antibody levels, our study provided no evidence to support the need for this clinical practice. We should continue to strengthen serological monitoring of children, especially for those born to HBsAg positive mothers.
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Affiliation(s)
- Ning Miao
- Chinese Center for Disease Control and Prevention, Nanwei Road, Xicheng District, Beijing, China
| | - Hui Zheng
- Chinese Center for Disease Control and Prevention, Nanwei Road, Xicheng District, Beijing, China
| | - Xiaojin Sun
- Chinese Center for Disease Control and Prevention, Nanwei Road, Xicheng District, Beijing, China
| | - Guomin Zhang
- Chinese Center for Disease Control and Prevention, Nanwei Road, Xicheng District, Beijing, China
| | - Fuzhen Wang
- Chinese Center for Disease Control and Prevention, Nanwei Road, Xicheng District, Beijing, China.
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18
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Istrate A, Azoicăi D, Almaş A, Rădulescu A. Variable anti-HBs antibody titers in vaccinated birth cohorts - A cross-sectional population-based study. Vaccine 2020; 38:7015-7023. [PMID: 32962805 DOI: 10.1016/j.vaccine.2020.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 09/02/2020] [Accepted: 09/10/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND After the introduction of hepatitis B (HB) vaccination in 1995 in newborns, two catch-up campaigns targeted unvaccinated 9 year old in 2000-2003 (born 1991-1994) and the 18 year old in 2004-2008 (born 1986-1990), resulting in several birth-cohorts. Our objective was to assess the anti-HBs titers in each birth-cohort. METHODS We included all outpatients (78.5%) and hospitalized patients with measured anti-HBs antibody titers in the Teaching Hospital of Infectious Diseases, Cluj-Napoca, Romania, during April 2014 - December 2018 (without HB history). We compared the anti-HBs titers in all birth-cohorts using the Lexis surfaces (titers by age, time period and cohort patterns). We also evaluated the number of acute HB in the corresponding inpatient birth-cohorts and special groups. RESULTS We included 2963 participants, mean age = 31.0 ± 14.2, 64.1% women. The birth-cohort 1995-2006, vaccinated after delivery (n = 424, 3-dose HB vaccine coverage > 90%), had significantly lower protective titers (41.3% >10 mIU/mL) compared to the other birth-cohorts: born after 2007 (also vaccinated at birth, 67.0%, n = 106), 1991-1994 (age 9, 74.3%, n = 847), 1986-1990 (age 18, 71.3%, n = 543). In the unvaccinated cohort (n = 1043, mean age = 45.5 ± 12.4) protective titers were found in 44.8%, probably after self-limited HB infection. Concordant results were found using the proportion of patients with detectable or robust titers, and median or geometric mean titers. Four breakthrough acute HB infections were hospitalized of the corresponding vaccinated cohorts (birth years 1988, 1990, 1995, 1996). Data on a few tested infants (n = 47, not included in the main study) demonstrated good protection, 88.9%. CONCLUSIONS Our study demonstrated the long-term evidence of protection of HBV vaccine at two decades following the primary immunization and a booster seems unsupported. Further studies should be done to assess the need of a booster dose within the general population and special groups.
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Affiliation(s)
- Alexandru Istrate
- Clinical Hospital of Infectious Diseases, Cluj-Napoca, Romania, 23, Iuliu Moldovan Street, 400348 Cluj-Napoca, Romania
| | - Doina Azoicăi
- University of Medicine and Pharmacy "Grigore T. Popa", Iasi, Romania, 16, Universității Street, 700115 Iași, Romania
| | - Ariana Almaş
- Clinical Hospital of Infectious Diseases, Cluj-Napoca, Romania, 23, Iuliu Moldovan Street, 400348 Cluj-Napoca, Romania
| | - Amanda Rădulescu
- Clinical Hospital of Infectious Diseases, Cluj-Napoca, Romania, 23, Iuliu Moldovan Street, 400348 Cluj-Napoca, Romania; University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania, 8, Victor Babeş Street, 400012 Cluj-Napoca, Romania.
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19
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Salama II, Sami SM, Elserougy SM, Emam HM, Salama SI, Elhariri HM, Hemeda SA, Hassanain AI, Abdel Mohsen AM, Fouad WA, El Etreby LA, Said ZN. Humoral Immune Memory to Hepatitis B Vaccine after Primary Vaccination of Children and Adolescents in Assiut, Egypt. Oman Med J 2020; 35:e175. [PMID: 33083033 PMCID: PMC7538637 DOI: 10.5001/omj.2020.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 04/14/2020] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES We sought to assess the prevalence of hepatitis B virus (HBV) seroprotection among vaccinated children in the Assiut governorate, Egypt, and assess a booster dose immune memory response among non-seroprotected children. METHODS Using a multistage cluster sample, 566 children were recruited from three clusters: one urban and two rural. Children were aged from nine months to 16 years old. All participants received the full three doses of the compulsory HBV vaccine during infancy. Serum hepatitis B surface antigen (HBsAg), total anti-hepatitis B core (anti-HBc) antibodies, and quantitative detection of anti-HBs were measured using enzyme-linked immunosorbent assay. Repeatedly positive samples for HBsAg/anti-HBc were submitted for quantitative HBV DNA detection using real-time polymerase chain reaction. Non-seroprotective participants (anti-HBs < 10 IU/L) were given a booster dose of HBV vaccine. Two weeks later, a blood sample was taken from each child to assess an anamnestic response. RESULTS The seroprotection rate was 53.2%, and only two children had HBV breakthrough infection (0.4%) with positive serum anti-HBc and HBV DNA. Age was the only significant predictor for non-seroprotection with an adjusted odds ratio (OR) of 3.2, 9.4, and 9.9 among children aged 5-10, 11-15, and > 15 years, respectively, compared to younger children (p < 0.001). About 85% of non-seroprotected children developed an anamnestic response after receiving the booster dose, and 84.3% of responders had a good response (3 100 IU/L). Undetectable pre-booster titer was found to be the only risk factor for non-response to booster with OR = 3.2 (p < 0.010). About 95.7% of children who were not responding to booster dose developed immune response after receiving the three doses of HBV vaccine. CONCLUSIONS Older age of children was the only significant predictor for HBV non-seroprotection. High anamnestic response rate signifies the presence of immune memory with long-term protection despite the waning of anti-HBs over time. However, some children with pre-booster undetectable anti-HBs titers may be unable to develop anamnestic response, and a second vaccination series might be necessary for HBV protection for these children.
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Affiliation(s)
- Iman I. Salama
- Community Medicine Research Department, National Research Center, Cairo, Egypt
| | - Samia M. Sami
- Child Health Department, National Research Center, Cairo, Egypt
| | - Safaa M. Elserougy
- Department of Environmental and Occupational Medicine, National Research Center, Cairo, Egypt
| | - Hanaa M. Emam
- Dermatology and Venereology, National Research Center, Cairo, Egypt
| | - Somaia I. Salama
- Community Medicine Research Department, National Research Center, Cairo, Egypt
| | - Hazem M. Elhariri
- Community Medicine Research Department, National Research Center, Cairo, Egypt
| | - Samia A. Hemeda
- Community Medicine Research Department, National Research Center, Cairo, Egypt
| | | | | | - Walaa A. Fouad
- Community Medicine Research Department, National Research Center, Cairo, Egypt
| | - Lobna A. El Etreby
- Community Medicine Research Department, National Research Center, Cairo, Egypt
| | - Zeinab N. Said
- Microbiology and Immunology Department, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt
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Zanella B, Bechini A, Boccalini S, Sartor G, Tiscione E, Working Group DHS, Working Group AOUMeyer, Working Group AUSLTC, Bonanni P. Hepatitis B Seroprevalence in the Pediatric and Adolescent Population of Florence (Italy): An Update 27 Years after the Implementation of Universal Vaccination. Vaccines (Basel) 2020; 8:vaccines8020156. [PMID: 32235670 PMCID: PMC7348992 DOI: 10.3390/vaccines8020156] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Hepatitis B still represents a health concern, although safe and effectivevaccines have been available since 1982. Italy introduced a program of universal vaccination againsthepatitis B in 1991. The aim of this study was to assess the immunity levels towards hepatitis B in asample of sera from the pediatric and adolescent population in the province of Florence, CentralItaly, twenty-seven years after the implementation of universal vaccination. METHODS A total of 165sera samples were collected from the resident population of Florence aged 1-18 years. The anti-HBsand 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-HBswas 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 thedetected protective immunity is mainly due to vaccination, and natural infection was not reportedin the studied population. CONCLUSIONS The seroprevalence of anti-HBs and the lack of anti-HBc inthis study highlights that immunity levels have been derived mainly from immunization. Thisconfirms how vaccination dramatically reduced circulation of the hepatitis B virus in Italy in thepediatric and adolescent population twenty-seven years after implementation of the mandatoryuniversal program.
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Affiliation(s)
- Beatrice Zanella
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (A.B.); (S.B.); (E.T.)
| | - Angela Bechini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (A.B.); (S.B.); (E.T.)
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (A.B.); (S.B.); (E.T.)
| | - Gino Sartor
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (G.S.);
| | - Emilia Tiscione
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (A.B.); (S.B.); (E.T.)
| | - Working Group DHS
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy; (G.S.);
| | | | | | - Paolo Bonanni
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.Z.); (A.B.); (S.B.); (E.T.)
- Correspondence: ; Tel.: +39-055-2751084
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Park SK, Choi CH, Chun J, Lee H, Kim ES, Park JJ, Park CH, Lee BI, Jung Y, Park DI, Kim DY, Park H, Jeen YT. Prevention and management of viral hepatitis in inflammatory bowel disease: a clinical practice guideline by the Korean Association for the Study of Intestinal Diseases. Intest Res 2020; 18:18-33. [PMID: 32013312 PMCID: PMC7000641 DOI: 10.5217/ir.2019.09155] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 12/27/2019] [Indexed: 02/06/2023] Open
Abstract
The treatment of inflammatory bowel disease (IBD) has been revolutionized for the last 10 years by the increasing use of immunomodulators and biologics. With immunosuppression of this kind, opportunistic infection is an important safety concern for patients with IBD. In particular, viral hepatitis is determined by the interaction between the virus and the host's immunity, and the risk of reactivation increases if immunity is compromised by immunosuppression therapy. Parts of Asia, including Korea, still show intermediate endemicity for the hepatitis A virus and hepatitis B virus compared with the United States and Western Europe. Thus, members of IBD research group of the Korean Association for the Study of Intestinal Diseases have produced a guideline on the prevention and management of viral hepatitis in IBD.
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Affiliation(s)
- Soo-Kyung Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chang Hwan Choi
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jaeyoung Chun
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Heeyoung Lee
- Center for Preventive Medicine and Public Health, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Eun Sun Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jae Jun Park
- Department of Internal Medicine, Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Chan Hyuk Park
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Bo-In Lee
- Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yunho Jung
- Division of Gastroenterology, Department of Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Dong-Il Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Do Young Kim
- Department of Internal Medicine, Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hana Park
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yoon Tae Jeen
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Roupa Z, Noula M, Farazi E, Stylianides A, Papaneophytou C. Vaccination Coverage and Awareness of Hepatitis B Virus Among Healthcare Students at a University in Cyprus. Mater Sociomed 2019; 31:190-196. [PMID: 31762701 PMCID: PMC6853741 DOI: 10.5455/msm.2019.31.190-196] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Introduction The risk for healthcare students to get infected by transmitting infectious viruses, including hepatitis B virus (HBV), in a hospital setting is extremely high through exposure to blood and/or body secretions. Aim The aim of this work was to evaluate both the vaccination history of healthcare students at a University in Cyprus and their serologic immunity against HBV. In addition, we assessed their knowledge and behaviors towards the transmission and prevention of hepatitis B (HB). Results Total amount of 168 students participated in this study and more than 50% of them provided complete documentation of vaccination history against HBV. Antibodies levels ×10 mIU/mL to HB surface antigen (HBsAg) were detected for the 98.8% of healthcare students while 1.2% of the participants tested positive for HBsAg and antibodies to HB core antigen indicating chronic infection. Our study also revealed significant gaps in the knowledge of healthcare students on the efficiency of the vaccine against HBV and in terms of the HBV transmission. Conclusions More information needs to be provided to healthcare students in Cyprus regarding HBV transmission and vaccination. In addition, there is a need for intervention to provide a safer workplace environment.
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Affiliation(s)
- Zoe Roupa
- Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus
| | - Maria Noula
- Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus
| | - Evi Farazi
- Department of Epidemiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Antonis Stylianides
- Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus
| | - Christos Papaneophytou
- Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus
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Simms KT, Smith MA, Caruana M, Canfell K. A hepatitis B vaccine booster shot at age 10 could be cost-saving in China: But is it too soon to tell? Int J Infect Dis 2019; 78:128-129. [DOI: 10.1016/j.ijid.2018.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Zhou Y, Zhou YH. Is revaccination required in children who received a full primary vaccination against hepatitis B in infancy? A letter in response to Changes and analysis of anti-HBs titres after primary immunization in 1-to 16-year-old Chinese children: A hospital-based study. J Viral Hepat 2018; 25:1220. [PMID: 29851210 DOI: 10.1111/jvh.12941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- Y Zhou
- Department of Infectious Diseases, Yixing People's Hospital, Yixing, Jiangsu, China
| | - Y-H Zhou
- Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital and Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, Jiangsu, China
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Posuwan N, Vorayingyong A, Jaroonvanichkul V, Wasitthankasem R, Wanlapakorn N, Vongpunsawad S, Poovorawan Y. Implementation of hepatitis B vaccine in high-risk young adults with waning immunity. PLoS One 2018; 13:e0202637. [PMID: 30125298 PMCID: PMC6101408 DOI: 10.1371/journal.pone.0202637] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 08/07/2018] [Indexed: 12/19/2022] Open
Abstract
Universal hepatitis B (HB) vaccination among Thai newborns was initiated in 1992. The first dose of the monovalent HB vaccine was given at birth, then at months 2 and 6 simultaneously with the diphtheria-tetanus-pertussis whole-cell (DTPw) vaccine. In 2008, Thailand replaced the monovalent HB vaccine at months 2 and 6 with a combined DTP-HB given at months 2, 4, and 6, with an added monovalent HB vaccine at month 1 for infants whose mothers were HBV carriers. Despite this rigorous HB vaccination schedule, vaccinated infants who are now adolescents do not possess a protective level of anti-HB surface antigen (anti-HBs) (≥10 mIU/ml). Thus, many young adults may be rendered susceptible to HB infection. Our objective was to determine how HB booster vaccination may benefit high-risk adolescents. We evaluated the serological records of a cohort of medical students (n = 291), which showed that 271 students (93.1%) possessed anti-HBs less than the accepted protective level (<10 mIU/ml) and subsequently received the HB vaccine booster prior to medical school enrollment. We then examined the anti-HB surface antibody (anti-HBs) in 216 individuals six weeks after they were immunized. We found that 61%, 88%, and 94% of individuals with pre-booster anti-HBs of <1 mIU/ml, 1-<3 mIU/ml, and 3-<10 mIU/ml achieved protective anti-HBs, respectively. Post-booster geometric mean titers were 305, 513, and 1,929 mIU/ml in these groups and correlated with pre-booster anti-HBs titers. These data suggest that medical students with known anti-HBs <1 mIU/ml will benefit from 3 doses of HB vaccine at 0, 1, and 6 months. Students with anti-HBs 1-<10 mIU/ml would benefit from an HB vaccine booster without further anti-HBs evaluation.
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Affiliation(s)
- Nawarat Posuwan
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Arnond Vorayingyong
- Academic Administration, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Rujipat Wasitthankasem
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nasamon Wanlapakorn
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sompong Vongpunsawad
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Yong Poovorawan
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Zhao X, Pang X, Wang F, Cui F, Wang L, Zhang W. Maternal folic acid supplementation and antibody persistence 5 years after hepatitis B vaccination among infants. Hum Vaccin Immunother 2018; 14:2478-2484. [PMID: 29923793 PMCID: PMC6284482 DOI: 10.1080/21645515.2018.1482168] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 05/08/2018] [Accepted: 05/18/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Maternal exposure to dietary factors during pregnancy may modulate the immunity of offspring by epigenetic programming. But the relationship between intrauterine environment and persistence of protective antibody after hepatitis B vaccination has not been reported. This study was to investigate the 5-year persistence of protective antibody response after primary hepatitis B vaccination, and its relationship with maternal folic acid supplementation. MATERIALS AND METHODS A total of 1461 children who completed a 3-dose 10 μg recombinant hepatitis B vaccine at birth and did not infect hepatitis B virus were followed up. Logistic regression and mediation analysis was used to explore the relationship between 5-year persistence of protective antibody and maternal nutrition. RESULTS Of 1403 children who did not revaccinated during the follow-up, 76.1% had protective hepatitis B surface antibody (anti-HBs) levels. Twenty percent of mothers did not take folate during pregnancy. Mediation analysis showed a total effect of folic acid supplementation on good persistence (odds ratio: 1.10, 95% CI: 1.03-1.17, p = 0.0010), a direct effect was 1.07 (95% CI: 1.01-1.13, p = 0.0128) and an indirect effect was 1.03 (95% CI: 1.00-1.06, p = 0.0672); the proportion of good persistence mediated by primary response was 30.3%. CONCLUSION This study indicated a good protective anti-HBs persistence at year 5 after 10 μg recombination hepatitis B vaccination in infants. Maternal folic acid supplementation may improve the persistence of protective antibodies through other pathways. Multi-center cohort studies should be conducted to verify this conclusion.
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Affiliation(s)
- Xinyu Zhao
- Dept of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Xinghuo Pang
- Beijing Center for Disease Control and Prevention, Beijing, China
| | - Fuzhen Wang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fuqiang Cui
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Li Wang
- Dept of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Wei Zhang
- Beijing Center for Disease Control and Prevention, Beijing, China
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Osiowy C. From infancy and beyond… ensuring a lifetime of hepatitis B virus (HBV) vaccine-induced immunity. Hum Vaccin Immunother 2018; 14:2093-2097. [PMID: 29641290 PMCID: PMC6150009 DOI: 10.1080/21645515.2018.1462428] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Despite the long-term efficacy and immune persistence observed following HBV vaccination of infants, the need for a booster dose following infant immunization continues to be deliberated. Evidence from HBV booster dose response studies and long-term immunization program reviews are the basis for the recommendation that a vaccine booster is not necessary. However, further studies continue to emerge and highlight the need for standardization among observational studies in order to appropriately compare outcomes. There is an assumption that neonatal and infant (within 12 months of age) vaccine immune responses are equivalent; however, evidence exists for distinct vaccine responses within the first year of life. HBV vaccine programs have evolved over time, particularly regarding the type and dosage of vaccine used. Several universal neonatal immunization programs initially incorporated a 2.5 μg dosage (Recombivax-HB, Merck). This dosage has been shown in multiple long-term studies and meta-analyses to be associated with a lower primary response, decreased antibody persistence over time, and a reduced booster response 10 to 20 years following immunization. Ongoing surveillance of this and other HBV neonatally-vaccinated populations, particularly in low endemic regions, is necessary to understand the impact on long-term protection in order to ensure lifelong protection against hepatitis B infection.
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Affiliation(s)
- Carla Osiowy
- a National Microbiology Laboratory , Public Health Agency of Canada , Winnipeg , Manitoba , Canada
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Klinger G, Chodick G, Levy I. Long-term immunity to hepatitis B following vaccination in infancy: Real-world data analysis. Vaccine 2018; 36:2288-2292. [PMID: 29573878 DOI: 10.1016/j.vaccine.2018.03.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 02/14/2018] [Accepted: 03/12/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Hepatitis B virus (HBV) vaccination has decreased the prevalence of chronic HBV infections and their sequelae. However, whether vaccination at birth provides lifelong protection is unclear. OBJECTIVE To assess long-term immunity following neonatal HBV immunization in a large population-based cohort. METHODS Using the database of a 2 million member sick fund in Israel, we identified all subjects born after introduction of universal HBV vaccination in Israel (January 1992 through December 2014), that were tested for hepatitis B surface antibody (anti-HBs Ab's). Years since vaccination were categorized into 5-year groups and linear trends in the seroprevalence of HBV immunity were calculated. Anamnestic response and presence of Hepatitis B surface antigen (HBs Ag) were assessed. RESULTS Included were 20,634 tested individuals. Mean (±SD) age at testing was 14.8 (±5.4) years. Mean anti-HBs Ab levels declined with time to 16.39 mIU/ml in the 15-20 year group (P < 0.001). The proportion of negative results increased gradually (P < 0.001) to 66.7% after 15 years. Anamnestic response assessment showed that 604 of 644 seronegative subjects (93.8%, 95% CI: 91.6-95.5%) became seropositive after a booster dose. HBs Ag was identified in 91 of the 20,634 (4.4 per 1000 study participants). CONCLUSIONS Following vaccination, anti-HB's Ab's progressively decline, with only a third of the population retaining protective levels after 15 years. In adolescence, anamnestic response shows that nearly all revaccinated adolescents exhibit immunity. A low rate of Hepatitis B infection was demonstrated despite vaccination of nearly all newborns.
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Affiliation(s)
- Gil Klinger
- Tel Aviv University, Sackler School of Medicine, 55 Chaim Levanon St., Tel Aviv 69978, Israel; Maccabi Health Care Services, Maccabi Institute of Health Services Research, 27 Ha'Mered St., Tel Aviv 68125, Israel; Schneider Children's Medical Center of Israel, Neonatal Intensive Care Unit, 14 Kaplan St., Petach Tikva 49202, Israel.
| | - Gabriel Chodick
- Tel Aviv University, Sackler School of Medicine, 55 Chaim Levanon St., Tel Aviv 69978, Israel; Maccabi Health Care Services, Maccabi Institute of Health Services Research, 27 Ha'Mered St., Tel Aviv 68125, Israel.
| | - Itzhak Levy
- Tel Aviv University, Sackler School of Medicine, 55 Chaim Levanon St., Tel Aviv 69978, Israel; Maccabi Health Care Services, Maccabi Institute of Health Services Research, 27 Ha'Mered St., Tel Aviv 68125, Israel; Schneider Children's Medical Center of Israel, Infectious Disease Unit, 14 Kaplan St., Petach Tikva 49202, Israel.
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Terrault NA, Lok ASF, McMahon BJ, Chang KM, Hwang JP, Jonas MM, Brown RS, Bzowej NH, Wong JB. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology 2018; 67:1560-1599. [PMID: 29405329 PMCID: PMC5975958 DOI: 10.1002/hep.29800] [Citation(s) in RCA: 2791] [Impact Index Per Article: 398.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 01/11/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Norah A Terrault
- Division of Gastroenterology/Hepatology, University of California San Francisco, San Francisco, CA
| | - Anna S F Lok
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI
| | - Brian J McMahon
- Liver Diseases and Hepatitis Program, Alaska NativeTribal Health Consortium, Anchorage, AK
| | - Kyong-Mi Chang
- Division of Gastroenterology, Corporal Michael J. Crescenz VA Medical Center & University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Jessica P Hwang
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Maureen M Jonas
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA
| | - Robert S Brown
- Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, NY
| | | | - John B Wong
- Division of Clinical Decision Making, Tufts Medical Center, Tufts University School of Medicine, Boston, MA
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Saffar H, Khalilian AR, Saffar MJ, Ajami A. Long-term Protection Against the Hepatitis B Virus Detected Through an Early Response to a Booster Dose Injection. Indian Pediatr 2018. [DOI: 10.1007/s13312-018-1227-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Abstract
Objective
To determine the duration of protection conferred by the hepatitis B (HB) vaccination and the necessity of a booster dose.
Methods
Immediately after the initial blood sampling, 252 youths (aged 18.8-20.5 years, 52% females) with a history of neonatal HB vaccination with one dose of the HB vaccine received a booster. Serum concentrations of antibodies against the HB surface antigen were assessed in samples collected before and 10-14 days after the booster. Seroconversion from concentrations <10 to ≥10 IU/L were defined as a positive immune response.
Results
Of the 252 participants, 131 were serosusceptible and 114 responded.
Conclusions
Nearly 90% of young people preserved their long-term protection; the results of this study do not support the use of an HB booster vaccination.
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Zhao H, Zhou YH. Revaccination against hepatitis B in late teenagers who received vaccination during infancy: Yes or no? Hum Vaccin Immunother 2017; 14:456-463. [PMID: 29083945 PMCID: PMC5806661 DOI: 10.1080/21645515.2017.1397243] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The significance of vaccination against hepatitis B during infancy is recognized worldwide, however, whether booster or revaccination after a period of time following the primary vaccination is required remains controversial. Recently, cross-sectional epidemiological surveys found that HBsAg prevalence in subjects born after the implementation of mass vaccination was increased with age, which was attributed to waning of anti-HBs over time. However, comprehensive analysis of the closely related cross-sectional surveys showed that the age-specific increased HBsAg prevalence was more likely associated with the carry-over of the infection occurred in early life, likely due to imperfect coverage of hepatitis B vaccination at the beginning of its introduction. Latest studies showed that booster response could be observed in the majority of individuals vaccinated 30 years ago. Moreover, confirmed breakthrough HBV infection with severe consequences in successfully vaccinated individuals is extremely rare. Thus far no compelling evidence has been acquired to support booster vaccination in adolescence. The uncertainty regarding the duration of protection of hepatitis B vaccination, especially beyond 30 years after the primary vaccination, merits a systematically designed study to follow the same cohort of participants longitudinally, which differs from the cross-sectional studies reported previously, can hopefully offer more direct evidence to help us to determine whether revaccination of hepatitis B vaccine is necessary.
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Affiliation(s)
- Hong Zhao
- a Department of Infectious Diseases , The Second Hospital of Nanjing, The Second Affiliated Hospital of Southeast University , Nanjing , Jiangsu , China
| | - Yi-Hua Zhou
- b Departments of Laboratory Medicine and Infectious Diseases , Nanjing Drum Tower Hospital and Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School , Nanjing , Jiangsu , China
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Zhou YH. Be cautious for exceptional results in evaluating the effect of adolescent booster of hepatitis B vaccine. Int J Infect Dis 2017; 66:150-152. [PMID: 29138014 DOI: 10.1016/j.ijid.2017.11.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 11/03/2017] [Indexed: 01/16/2023] Open
Affiliation(s)
- Yi-Hua Zhou
- Departments of Experimental Medicine and Infectious Diseases, Nanjing Drum Tower Hospital and Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Jiangsu, China.
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Yoshioka N, Deguchi M, Hagiya H, Kagita M, Tsukamoto H, Takao M, Yoshida H, Yamamoto N, Akeda Y, Nabetani Y, Maeda I, Hidaka Y, Tomono K. Durability of immunity by hepatitis B vaccine in Japanese health care workers depends on primary response titers and durations. PLoS One 2017; 12:e0187661. [PMID: 29121107 PMCID: PMC5679562 DOI: 10.1371/journal.pone.0187661] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 10/24/2017] [Indexed: 12/17/2022] Open
Abstract
Background Health care workers (HCWs) are frequently exposed to hepatitis B virus (HBV) infection. The efficacy and safety of immunization with the hepatitis B (HB) vaccine are well recognized, but the durability of immunity and need for booster doses in those with secondary vaccine response failure remains controversial. Methods This was a retrospective cohort study performed at Osaka University Hospital, Japan. We examined antibodies against HB surface antigen (anti-HBs) titers annually after immunization for previously non-immunized HCWs. Primary responders were categorized by their sero-positive durations as short responders (those whose anti-HBs titers declined to negative range within 3 years), and long responders (those who retained positive anti-HBs levels for 3 years and more). We re-immunized short responders with either single or 3-dose boosters, the long responders with a single booster when their titers dropped below protective levels, and examined their sero-protection rates over time thereafter. Results From 2001 to 2012, data of 264 HCWs with a median age of 25.3 were collected. The rate of anti-HBs positivity after primary vaccination were 93.0% after three doses (n = 229), 54.5% after two doses (n = 11), and 4.2% after a single dose (n = 24). Of 213 primary responders, the anti-HBs levels of 95 participants (44.6%) fell below the protective levels, including 46 short responders and 49 long responders. HCWs with higher initial anti-HBs titers after primary vaccination had significantly longer durations of sero-positivity. For short responders, 3-dose booster vaccination induced a longer duration of anti-HBs positivity compared to a single-dose booster, whereas for long responders, a single-dose booster alone could induce prolonged anti-HBs positivity. Conclusion Our preliminary data suggested that it may be useful to differentiate HB vaccine responders based on their primary response durations to maintain protective levels of anti-HBs efficiently. A randomized, prospective, large-scale study is warranted to support our findings.
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Affiliation(s)
- Nori Yoshioka
- Division of Infection Control and Prevention, Osaka University Hospital, Suita, Osaka, Japan
- Laboratory for Clinical Investigation, Osaka University Hospital, Suita, Osaka, Japan
- * E-mail:
| | - Matsuo Deguchi
- Division of Infection Control and Prevention, Osaka University Hospital, Suita, Osaka, Japan
- Laboratory for Clinical Investigation, Osaka University Hospital, Suita, Osaka, Japan
| | - Hideharu Hagiya
- Division of Infection Control and Prevention, Osaka University Hospital, Suita, Osaka, Japan
| | - Masanori Kagita
- Laboratory for Clinical Investigation, Osaka University Hospital, Suita, Osaka, Japan
| | - Hiroko Tsukamoto
- Laboratory for Clinical Investigation, Osaka University Hospital, Suita, Osaka, Japan
| | - Miyuki Takao
- Laboratory for Clinical Investigation, Osaka University Hospital, Suita, Osaka, Japan
| | - Hisao Yoshida
- Division of Infection Control and Prevention, Osaka University Hospital, Suita, Osaka, Japan
| | - Norihisa Yamamoto
- Division of Infection Control and Prevention, Osaka University Hospital, Suita, Osaka, Japan
| | - Yukihiro Akeda
- Division of Infection Control and Prevention, Osaka University Hospital, Suita, Osaka, Japan
| | - Yoshiko Nabetani
- Division of Infection Control and Prevention, Osaka University Hospital, Suita, Osaka, Japan
- Nursing Department, Osaka University Hospital, Suita, Osaka, Japan
| | - Ikuhiro Maeda
- Laboratory for Clinical Investigation, Osaka University Hospital, Suita, Osaka, Japan
| | - Yoh Hidaka
- Laboratory for Clinical Investigation, Osaka University Hospital, Suita, Osaka, Japan
| | - Kazunori Tomono
- Division of Infection Control and Prevention, Osaka University Hospital, Suita, Osaka, Japan
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Detection of hepatitis B virus in bone allografts from donors with occult hepatitis B infection. Cell Tissue Bank 2017; 18:335-341. [PMID: 28748417 DOI: 10.1007/s10561-017-9644-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 07/22/2017] [Indexed: 01/12/2023]
Abstract
The implementation of nucleic acid testing in donor screening has improved the safety of tissue allografts. Although infectious disease transmission can be considered a rare event, the detection of occult hepatitis B infection remains challenging. The studies concerning this risk are mainly based on testing blood specimens. This work shows the correlation between results of samples obtained from donor blood and the corresponding tissue washing solution. Hepatitis B virus deoxyribonucleic acid was detected both in bone allografts from donors with serological profiles associated to active hepatitis B infection and occult hepatitis B infection. These results suggest that hepatitis B virus seems to concentrate in bone marrow even when a low viral load is present in peripheral blood. Even detection at molecular level is not enough to avoid the risk of hepatitis B virus transmission and a multiparametrical evaluation is required in tissue donor screening. The role of clinicians in recognition and reporting of allograft-associated infections is a major concern for the acquisition of experience to be applied in risk control of disease transmission.
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Wiedermann U, Garner-Spitzer E, Wagner A. Primary vaccine failure to routine vaccines: Why and what to do? Hum Vaccin Immunother 2016; 12:239-43. [PMID: 26836329 PMCID: PMC4962729 DOI: 10.1080/21645515.2015.1093263] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
There are 2 major factors responsible for vaccine failures, the first is vaccine-related such as failures in vaccine attenuation, vaccination regimes or administration. The other is host-related, of which host genetics, immune status, age, health or nutritional status can be associated with primary or secondary vaccine failures. The first describes the inability to respond to primary vaccination, the latter is characterized by a loss of protection after initial effectiveness. Our studies concentrate on the evaluation of immunological characteristics responsible for primary vaccine failures in different (risk) populations for which the underlying mechanisms are currently unknown. Here we summarise current knowledge and findings from our studies. About 2–10% of healthy individuals fail to mount antibody levels to routine vaccines. Comparing the immune responses to different vaccines in non-responder and high-responder vaccinees revealed that hypo-responsiveness is antigen/vaccine-specific at the humoral but not at the cellular level. We found that T-regulatory as well as B-regulatory cells and the production of IL-10 are involved in non/hypo-responsiveness. Non-responsiveness increases with age and in particular vaccination to a novel vaccine in persons > 65 years is associated with a high low/non-responder rate, indicating that vaccine schedules and doses (at least for primary vaccination) should be adapted according to age. In light of the growing number of allergic but also obese people, our current studies concentrate on these risk groups to reveal whether different vaccination approaches are necessary for optimal protection compared to healthy individuals. These studies are in line with the significant paradigm shift taking place in many fields of medical research and care, and will extend the concept of personalised medicine into the field of vaccinology.
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Affiliation(s)
- Ursula Wiedermann
- a Institute of Specific Prophylaxis and Tropical Medicine; Medical University Vienna ; Vienna , Austria
| | - Erika Garner-Spitzer
- a Institute of Specific Prophylaxis and Tropical Medicine; Medical University Vienna ; Vienna , Austria
| | - Angelika Wagner
- a Institute of Specific Prophylaxis and Tropical Medicine; Medical University Vienna ; Vienna , Austria
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Raven S, Hautvast J, Steenbergen JV, Akkermans R, Weykamp C, Smits F, Hoebe C, Vossen A. Diagnostic performance of serological assays for anti-HBs testing: Results from a quality assessment program. J Clin Virol 2016; 87:17-22. [PMID: 27987422 DOI: 10.1016/j.jcv.2016.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 12/02/2016] [Accepted: 12/06/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Post-vaccination testing after hepatitis B vaccination is indispensable to evaluate long-term immunological protection. Using a threshold level of antibodies against hepatitis B surface antigen (anti-HBs) to define serological protection, implies reproducible and valid measurements of different diagnostic assays. OBJECTIVES In this study we assess the performance of currently used anti-HBs assays. STUDY DESIGN In 2013, 45 laboratories participated in an external quality assessment program using pooled anti-HBs serum samples around the cutoff values 10IU/l and 100IU/l. Laboratories used either Axsym (Abbott Laboratories), Architect (Abbott Laboratories), Access (Beckman-Coulter), ADVIA Centaur anti-HBs2 (Siemens Healthcare Diagnostics), Elecsys, Modular or Cobas (Roche Diagnostics) or Vidas Total Quick (Biomerieux) for anti-HBs titre quantification. We analysed covariance using mixed-model repeated measures. To assess sensitivity/specificity and agreement, a true positive or true negative result was defined as an anti-HBs titre respectively above or below the cutoff value by ≥4 of 6 assays. RESULTS Different anti-HBs assays were associated with statistically significant (P<0.05) differences in anti-HBs titres in all dilutions. Sensitivity and specificity ranged respectively from 64%-100% and 95%-100%. Agreement between assays around an anti-HBs titre cutoff value of 10IU/l ranged from 93%-100% and was 44% for a cutoff value of 100IU/l. CONCLUSIONS Around a cutoff value of 10IU/l use of the Access assay may result in false-negative results. Concerning the cutoff value of 100IU/l, a sample being classified below or above this cutoff relied heavily on the specific assay used, with both the Architect and the Access resulting in false-negative results.
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Affiliation(s)
- Stijn Raven
- Academic Collaborative Centre for Public Health AMPHI, Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, The Netherlands; Department of Medical Microbiology, School of Public Health and Primary Care (CAPHRI), Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands.
| | - Jeannine Hautvast
- Academic Collaborative Centre for Public Health AMPHI, Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, The Netherlands
| | - Jim van Steenbergen
- Centre for Infectious Disease Control, Netherlands Institute of Public Health and the Environment, Bilthoven, The Netherlands; Centre of Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands
| | - Reinier Akkermans
- Academic Collaborative Centre for Public Health AMPHI, Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, The Netherlands
| | - Cas Weykamp
- MCA Laboratory, Queen Beatrix Hospital, Winterswijk, The Netherlands; On behalf of the Dutch Foundation for Quality Assessment in Medical Laboratories (SKML), The Netherlands
| | - Francis Smits
- Academic Collaborative Centre for Public Health AMPHI, Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, The Netherlands
| | - Christian Hoebe
- Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, The Netherlands; Department of Medical Microbiology, School of Public Health and Primary Care (CAPHRI), Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Ann Vossen
- Department of Medical Microbiology, Leiden University Medical Centre, The Netherlands
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Katoonizadeh A, Sharafkhah M, Ostovaneh MR, Norouzi A, Khoshbakht N, Mohamadkhani A, Eslami L, Gharravi A, Shayanrad A, Khoshnia M, Esmaili S, George J, Poustchi H, Malekzadeh R. Immune responses to hepatitis B immunization 10-18 years after primary vaccination: a population-based cohort study. J Viral Hepat 2016; 23:805-811. [PMID: 27126365 DOI: 10.1111/jvh.12543] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 03/16/2016] [Indexed: 01/05/2023]
Abstract
We evaluated the immune response to neonatal HBV immunization in children of infected parents 10-18 years after primary vaccination. Healthy individuals immunized with an infantile course of three doses of HBV vaccine were tested for persistence of anti-HB surface antibody (HBsAb). Those with an HBsAb level of <10 IU/mL received a booster dose of the vaccine with subsequent doses to those without protective titres. HBsAb concentrations were determined 4 weeks after each dose of the booster vaccine. The data were analysed separately for three age groups: 10-11, 12-14 and 15-18 years old. A total of 541 healthy individuals were studied. The highest seroprotection rate of 48% was observed in the youngest vaccinees (10-11 years old). This declined to 26.5% in the oldest (15-18 years old) group (P = 0.008). The youngest vaccinees showed the highest rate of anamnestic immune responses (96%). However, 25% of oldest individuals failed to mount an anamnestic immune response in challenge with a booster dose of the vaccine (P = 0.005), suggesting waning immunity with increasing age. Age (OR: 0.80; P = 0.01) and prebooster HBsAb levels (OR: 0.37; P = 0.01) identified responders to first booster doses of the vaccine by logistic regression analysis. The majority of high-risk vaccinees showed anamnestic immune response 10-11 years after primary immunization. However, we found a significant proportion (25%) of older individuals with no anamnetic response, which suggests a waning of immune memory. Detailed long-term follow-up studies are necessary to determine the risk of natural infection among these individuals before a booster schedule can be recommended.
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Affiliation(s)
- A Katoonizadeh
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - M Sharafkhah
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - M R Ostovaneh
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MA, USA
| | - A Norouzi
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - N Khoshbakht
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - A Mohamadkhani
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - L Eslami
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - A Gharravi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - A Shayanrad
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - M Khoshnia
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - S Esmaili
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Westmead, NSW, Australia
| | - J George
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Westmead, NSW, Australia
| | - H Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - R Malekzadeh
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Lu IC, Jean MCY, Lin CW, Chen WH, Perng DS, Lin CW, Chuang HY. Predictive factors for anti-HBs status after 1 booster dose of hepatitis B vaccine. Medicine (Baltimore) 2016; 95:e5023. [PMID: 27684874 PMCID: PMC5265967 DOI: 10.1097/md.0000000000005023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
In Taiwan, infants need to receive 3 doses of hepatitis B virus (HBV) vaccine under the public health policy from the government. However, there are many young adults who even though received complete HBV vaccination in their childhood would lose the positive response of anti-hepatitis B surface antibody (HBs) and need the booster dose of HBV vaccine. The aim of our study is to determine the powerful predictive factor for screening the candidates who need only 1 booster dose of HB vaccine then they can regain positive postbooster anti-HBs status (≧10 mIU/mL) or protective postbooster anti-HBs status (≧100 mIU/mL).We recruited 103 university freshmen who were born after July 1986 with complete HBV vaccination in childhood, but displayed negative results for hepatitis B surface antigen and anti-HBs levels at their health examinations upon university entry. They received 1 booster dose of HB vaccine, and their anti-HBs titers were rechecked 4 weeks after the booster administration. Multivariate analysis logistic regression for positive postbooster anti-HBs status (≧10 mIU/mL, model 1) and protective postbooster anti-HBs status (≧100 mIU/mL, model 2) was done with predictive factors of prebooster anti-HBs level, body mass index, serum glutamate pyruvate transaminase level, and sex.Twenty-four students got positive postbooster anti-HBs status (10-100 mIU/mL) and 50 students got protective postbooster anti-HBs status (≧100 mIU/mL). In the model of multivariate analysis logistic regression for positive postbooster anti-HBs status (≧10 mIU/mL), prebooster anti-HBs level was the strongest predictive factor. The odds ratio was 218.645 and the P value was 0.001. Even in the model of multivariate analysis logistic regression for protective postbooster anti-HBs status (≧100 mIU/mL), prebooster anti-HBs level was still the strongest predictive factor, but the odds ratio of a protective booster effect was 2.143, with 95% confidence interval between 1.552 and 2.959, and the P value was less than 0.001.Prebooster anti-HBs level can be the powerful predictive factor for positive postbooster anti-HBs status (≧10 mIU/mL) and protective postbooster anti-HBs status (≧100 mIU/mL). According to the result of this study, if someone received complete HBV vaccination in childhood, but displayed negative results for hepatitis B surface antigen and anti-HBs levels around 2 decades later, 1 booster dose of HBV vaccine could help him or her to regain positive postbooster anti-HBs status (≧10 mIU/mL) under the strong predictive factor of prebooster anti-HBs level higher than 1 mIU/mL. The other 2 HBV vaccines could be saved and the case could also save money and time.
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Affiliation(s)
- I-Cheng Lu
- Department of Family Medicine, E-Da Hospital
- I-Shou University
- Department of Occupational Medicine, E-Da Hospital
- Kaohsiung Medical University
| | - Mei-Chu Yen Jean
- Department of Family Medicine, E-Da Hospital
- I-Shou University
- Department of Occupational Medicine, E-Da Hospital
| | - Chi-Wei Lin
- Department of Family Medicine, E-Da Hospital
- I-Shou University
| | - Wei-Hung Chen
- I-Shou University
- Kaohsiung Medical University
- Department of Anesthesia, E-Da Hospital
| | - Daw-Shyong Perng
- I-Shou University
- Kaohsiung Medical University
- Department of Hepatology and Gastroenterology Medicine, E-Da Hospital
| | - Chih-Wen Lin
- I-Shou University
- Kaohsiung Medical University
- Department of Hepatology and Gastroenterology Medicine, E-Da Hospital
| | - Hung-Yi Chuang
- Kaohsiung Medical University
- Department of Environmental and Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan ROC
- Correspondence: Hung-Yi Chuang, Department of Public Health, Kaohsiung Medical University, and Department of Environmental and Occupational Medicine, Kaohsiung Medical University Hospital, No.1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City 82445, Taiwan, ROC (e-mail: )
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Makhlouf NA, Farghaly AM, Zaky S, Rashed HAG, Abu Faddan NH, Sayed D, El-Badawy O, Afifi N, Hamza WS, El-Sayed Y. The efficacy of hepatitis B vaccination program in upper Egypt: Flow cytometry and the evaluation of long term immunogenicity. J Med Virol 2016; 88:1567-1575. [PMID: 26910304 DOI: 10.1002/jmv.24506] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2016] [Indexed: 11/11/2022]
Abstract
Anti-HBs levels wanes with time. Many studies discussed the B cell response to HBV vaccine. However, the data about memory T cell response are limited. To evaluate the efficacy of hepatitis B vaccine via evaluating anti-HBs levels and HBsAg specific memory T-lymphocytes through descriptive study. The study was conducted in a tertiary care setting. This study included 440 vaccinated persons during infancy. Group I: 6 to less than 10 years old; Group II: 10 to less than 14 years old; Group III: 14 to less than 17 years old; Group IV: 17 years old. The serum samples were screened for HBV markers. Cytokines secretion by HBsAg-specific memory CD45RO(+) CD4(+) T cells was measured after in vitro culture using flow cytometry. The mean titer of anti-HBs was higher in group I in comparison to others (P-value = 0.000 for each). IFN-γ and IL-4 secreted by memory CD4(+) T cells were positive in all with anti-HBs >100 mIU/ml, while positive in 87% and 75% of participants with anti-HBs <10 mIU/ml and positive in 73% and 32% of participants with absent anti-HBs. The percentage of cells secreting IFN-γ and those secreting IL-4 were higher among participants with serum anti-HBs >100 mIU/ml than those having <10 mIU/ml or absent (P < 0.001 for each). Anti-HBs positivity decreased with time since childhood vaccination. Breakthrough infections are rare in vaccinated persons. Hepatitis-B vaccine is efficient in controlling HBV infection. Flow cytometry is a useful tool to assess the long term persistence of T cell memory after childhood vaccination. J. Med. Virol. 88:1567-1575, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Nahed A Makhlouf
- Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ahlam M Farghaly
- Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Saad Zaky
- Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Hebat-Alla G Rashed
- Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Nagla H Abu Faddan
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Douaa Sayed
- Flow Cytometry Laboratory, Department of Clinical Pathology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Omnia El-Badawy
- Department of Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Noha Afifi
- Department of Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Wafaa S Hamza
- Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Yousseria El-Sayed
- Department of Pediatric Nursing, Faculty of Nursing, Sohag University, Egypt
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Impact and long-term protection of hepatitis B vaccination: 17 years after universal hepatitis B vaccination in Tunisia. Epidemiol Infect 2016; 144:3365-3375. [PMID: 27535719 DOI: 10.1017/s0950268816001849] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Hepatitis B virus (HBV) vaccination has been part of the Expanded Programme of Immunization (EPI) in Tunisia since 1995. The aim of this study was to evaluate, for the first time, the impact of mass vaccination in Tunisia 17 years after this programme was implemented, and in parallel, assess the long-term persistence of anti-HBs antibody in the vaccinated Tunisian population. A total of 1422 students were recruited (703 vaccinated, 719 non-vaccinated). HBV seromarkers were checked. None of the students from either group had positive HBsAg. The overall prevalence of anti-HBc was 0·8%. A Significantly higher prevalence of anti-HBc was noted in unvaccinated students than in vaccinated (1·4% vs. 0·3%, P = 0·02). The overall seroprotection rate (anti-HBs titre ⩾10 mIU/ml) was 68·9% in vaccinated subjects. Seroprotection rates and geometric mean titres decreased significantly with increasing age, reflecting waning anti-HBs titre over time. No significant difference was detected between seroprotection rates and gender or students' area of origin. Incomplete vaccination was the only factor associated with an anti-HBs titre <10 mIU/ml. This study demonstrates the excellent efficacy of the HBV vaccination programme in Tunisia 17 years after its launch. However, a significant decline of anti-HBs seroprotection has been observed in ⩾15-year-old adolescents which places them at risk of infection. Additional studies are needed in hyperendemic regions in Tunisia.
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Affiliation(s)
- David O Freedman
- From the William C. Gorgas Center for Geographic Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (D.O.F.); the Division of Infectious Diseases, Mount Auburn Hospital, Cambridge, MA (L.H.C.); the Department of Medicine, Harvard Medical School, Boston (L.H.C.); and the Division of Infectious Diseases, Emory University, Atlanta (P.E.K.)
| | - Lin H Chen
- From the William C. Gorgas Center for Geographic Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (D.O.F.); the Division of Infectious Diseases, Mount Auburn Hospital, Cambridge, MA (L.H.C.); the Department of Medicine, Harvard Medical School, Boston (L.H.C.); and the Division of Infectious Diseases, Emory University, Atlanta (P.E.K.)
| | - Phyllis E Kozarsky
- From the William C. Gorgas Center for Geographic Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (D.O.F.); the Division of Infectious Diseases, Mount Auburn Hospital, Cambridge, MA (L.H.C.); the Department of Medicine, Harvard Medical School, Boston (L.H.C.); and the Division of Infectious Diseases, Emory University, Atlanta (P.E.K.)
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Gholami Parizad E, Gholami Parizad E, Khosravi A, Amraei M, Valizadeh A, Davoudian A. Comparing HBV Viral Load in Serum, Cerumen, and Saliva and Correlation With HBeAg Serum Status in Patients With Chronic Hepatitis B Infection. HEPATITIS MONTHLY 2016; 16:e30385. [PMID: 27313632 PMCID: PMC4908613 DOI: 10.5812/hepatmon.30385] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 02/17/2016] [Accepted: 04/06/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Hepatitis B is a disease that is prevalent worldwide and is responsible for 10% of the deaths that occur every year. The virus persists in 5% of infected adults and 90% of infected children and can cause chronic hepatitis. In addition to blood, the virus may also be present in other secretions. Transmission through saliva, sexual fluids, and urine has also been confirmed. OBJECTIVES The main aim of this study was to compare viral DNA copies in the serum, cerumen, and saliva of patients with HBeAg levels in their sera. PATIENTS AND METHODS This was a cross-sectional study and subjects were selected by non-randomized methods. Serum, cerumen, and saliva samples were collected from 50 patients who were diagnosed with chronic hepatitis B about a year prior to the study. Enzyme-linked immunosorbent assay (ELISA) was performed to determine the presence of HBsAg and HBeAg in the gathered specimens. Viral DNA was extracted from specimens by using a Qiagen kit. The number of viral DNA copies was determined using a real-time polymerase chain reaction (PCR) assay. The study was performed in Ilam province in western Iran. RESULTS Twenty-eight percent of the patients were HBeAg positive. The average number of viral copies in serum, cerumen, and saliva was higher in women than in men, and a significant correlation was observed between the gender and average viral copies. However, no significant correlation was observed between viral copies present in the serum and cerumen with the age and gender of patients. In addition, no correlation was observed between serum HBeAg and viral copies present in serum, cerumen, and saliva. The correlation analysis confirmed a direct and definite correlation between viral DNA loads in the patients' serum and cerumen. CONCLUSIONS A significant direct correlation was observed between the viral DNA copies present in patients' cerumen and serum. However, the correlation between saliva viral load with serum and cerumen viral load was very low and inverse. These findings suggest that the presence of the hepatitis B virus (HBV) in non-invasive specimens (such as cerumen and saliva) should also be evaluated when monitoring patients to determine the course of infection and disease.
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Affiliation(s)
- Elaheh Gholami Parizad
- Clinical Microbiology Research Centre, Ilam University of Medical Sciences, Ilam, IR Iran
| | - Eskandar Gholami Parizad
- Public Health Department, Psychosocial Injuries Prevention Research Centre, Ilam University of Medical Sciences, Ilam, IR Iran
- Corresponding Author: Eskandar Gholami Parizad, Public Health Department, Psychosocial Injuries Prevention Research Centre, Ilam University of Medical Sciences, Ilam, IR Iran. Tel: +98-8432240404, Fax: +98-8432240404, E-mail:
| | - Afra Khosravi
- Clinical Microbiology Research Centre, Ilam University of Medical Sciences, Ilam, IR Iran
| | - Mansour Amraei
- Department of Clinical Physiology, Research Centre, Ilam University of Medical Sciences, Ilam, IR Iran
| | - Azar Valizadeh
- Clinical Microbiology Research Centre, Ilam University of Medical Sciences, Ilam, IR Iran
| | - Abdoullah Davoudian
- Department of Clinical Immunology, Ilam University of Medical Sciences, Ilam, IR Iran
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Tosti ME, Alfonsi V, Lacorte E, Mele A, Galli C, Zanetti AR, Romanò L. Acute Hepatitis B After the Implementation of Universal Vaccination in Italy: Results From 22 Years of Surveillance (1993-2014). Clin Infect Dis 2016; 62:1412-8. [PMID: 27009250 DOI: 10.1093/cid/ciw162] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 03/10/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Hepatitis B vaccination has proven to be very safe and highly effective. This study assessed the proportion of successfully vaccinated individuals among cases with acute hepatitis B, the proportion of preventable cases if individuals were vaccinated as recommended, and the reasons for failures. METHODS We analyzed data reported to the Italian Surveillance System for Acute Viral Hepatitis from 1993 to 2014. RESULTS A total of 362 of 11 311 (3.2%) cases with acute hepatitis B were vaccinated. Of the 277 cases for whom immunization data were available, 50 (18%) received a complete vaccination course according to the correct schedule and before exposure to hepatitis B virus. Molecular characterization of 17 of these cases showed that 6 were infected with S-gene mutants. Among the 10 949 unvaccinated cases, 213 (1.9%) escaped mandatory vaccination and 2821 (25.8%) were not vaccinated despite being at increased risk of infection. Among the latter, the most common risk factors were cohabitation with hepatitis B surface antigen (HBsAg) carriers, intravenous drug use, and homosexual/bisexual practices. Thirty-seven percent of the unvaccinated households with HBsAg carriers were aware of their risk. Lack of trust in the vaccination, negative attitude, and inaccurate beliefs followed by lack of or poor communication and low perceived severity of the disease were the most frequent reasons for vaccine hesitancy. CONCLUSIONS Development of acute disease in successfully vaccinated individuals is a rare event. Further efforts are needed to enhance the vaccine coverage rate in individuals at increased risk of infection.
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Affiliation(s)
- Maria Elena Tosti
- Istituto Superiore di Sanità, Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Rome
| | - Valeria Alfonsi
- Istituto Superiore di Sanità, Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Rome
| | - Eleonora Lacorte
- Istituto Superiore di Sanità, Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Rome
| | - Alfonso Mele
- Istituto Superiore di Sanità, Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Rome
| | - Cristina Galli
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Italy
| | | | - Luisa Romanò
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Italy
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45
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Wang ZZ, Li MQ, Wang P, Yang ZX, Wei L, Zeng Y, Li YP, Yan L, Liu XE, Zhuang H. Comparative immunogenicity of hepatitis B vaccine with different dosages and schedules in healthy young adults in China. Vaccine 2016; 34:1034-9. [DOI: 10.1016/j.vaccine.2016.01.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 12/08/2015] [Accepted: 01/08/2016] [Indexed: 10/22/2022]
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46
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Lao TT. Immune persistence after hepatitis B vaccination in infancy - Fact or fancy? Hum Vaccin Immunother 2016; 12:1172-6. [PMID: 26810256 DOI: 10.1080/21645515.2015.1130195] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The hepatitis B vaccine has been introduced for more than 3 decades. In Hong Kong, excellent vaccine coverage through an efficient public health care system, together with supplemental programmes and easy availability of the vaccine, meant that most young pregnant women, and university students at entrance, should have been protected. Yet significant correlations in the prevalence of HBV infection with age were found in these groups of subjects, increasing from low to high endemicity rates from late teenage to the early twenties. This can only be attributed to vaccine failure, and there is cumulating evidence that several factors are involved, including the failure to respond to a primary series of hepatitis B vaccination in infancy, the waning of antibody titer with age, and loss of anamnestic response in a significant portion of the vaccinees. The duration of protection conferred by hepatitis B vaccination in infancy should be re-examined and remedial measures undertaken if its long term protection is found to be insufficient. Otherwise, the efforts to control HBV infection, especially in high endemicity regions, with universal vaccination in infancy would be rendered futile.
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Affiliation(s)
- Terence T Lao
- a Department of Obstetrics & Gynaecology , The Chinese University of Hong Kong, Prince of Wales Hospital , Shatin , Hong Kong SAR , PRC
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47
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Van Damme P. Long-term Protection After Hepatitis B Vaccine. J Infect Dis 2016; 214:1-3. [PMID: 26802140 DOI: 10.1093/infdis/jiv750] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 12/10/2015] [Indexed: 01/04/2023] Open
Affiliation(s)
- Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, Antwerp University, Belgium
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48
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Salama II, Sami SM, Said ZNA, El-Sayed MH, El Etreby LA, Rabah TM, Elmosalami DM, Abdel Hamid AT, Salama SI, Abdel Mohsen AM, Emam HM, Elserougy SM, Hassanain AI, Abd Alhalim NF, Shaaban FA, Hemeda SA, Ibrahim NA, Metwally AM. Effectiveness of hepatitis B virus vaccination program in Egypt: Multicenter national project. World J Hepatol 2015; 7:2418-2426. [PMID: 26464758 PMCID: PMC4598613 DOI: 10.4254/wjh.v7.i22.2418] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 08/04/2015] [Accepted: 09/10/2015] [Indexed: 02/06/2023] Open
Abstract
AIM To assess the effectiveness of hepatitis B virus (HBV) vaccination program among fully vaccinated children. METHODS A national community based cross-sectional study was carried out in 6 governorates representing Egypt. A total of 3600 children aged from 9 mo to 16 years who were fully vaccinated with HBV vaccine during infancy were recruited. Face to face interviews were carried out and sera were evaluated for hepatitis B surface antigen (HBsAg), anti-HBV core antibodies (total) and quantitative detection of hepatitis B surface antibody using enzyme linked immunoassays techniques. Samples positive to HBsAg/anti-HBV core antibodies were subjected to quantitative HBV-DNA detection by real time polymerase chain reaction with 3.8 IU/L detection limit. RESULTS Sero-protection was detected among 2059 children (57.2%) with geometric mean titers 75.4 ± 3.6 IU/L compared to 3.1 ± 2.1 IU/L among non-seroprotected children. Multivariate logistic analysis revealed that older age and female gender were the significant predicting variables for having non sero-protective level, with adjusted odds ratio 3.3, 9.1 and 14.2 among children aged 5 to < 10, 10 to < 15 and ≥ 15 years respectively compared to those < 5 years and 1.1 among girls compared to boys with P < 0.01. HBsAg was positive in 0.11% and breakthrough infection was 0.36% and 0.39% depending on positivity of anti-HBc and DNA detection respectively. The prevalence of HBV infection was significantly higher among children aged ≥ 7 years (0.59%) compared to 0.07% among younger children with odds ratio equal to 8.4 (95%CI: 1.1-64.2) and P < 0.01.The prevalence was higher among girls (0.48%) than boys (0.29%) with P > 0.05. CONCLUSION The Egyptian compulsory HBV vaccination program provides adequate protection. Occult HBV infection exists among apparently healthy vaccinated children. Adherence to infection control measures is mandatory.
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Affiliation(s)
- Iman I Salama
- Iman I Salama, Lobna A El Etreby, Thanaa M Rabah, Dalia M Elmosalami, Amany T Abdel Hamid, Somaia I Salama, Aida M Abdel Mohsen, Samia A Hemeda, Nihad A Ibrahim, Ammal M Metwally, Community Medicine Research Department, National Research Center, Cairo 12311, Egypt
| | - Samia M Sami
- Iman I Salama, Lobna A El Etreby, Thanaa M Rabah, Dalia M Elmosalami, Amany T Abdel Hamid, Somaia I Salama, Aida M Abdel Mohsen, Samia A Hemeda, Nihad A Ibrahim, Ammal M Metwally, Community Medicine Research Department, National Research Center, Cairo 12311, Egypt
| | - Zeinab Nabil Ahmed Said
- Iman I Salama, Lobna A El Etreby, Thanaa M Rabah, Dalia M Elmosalami, Amany T Abdel Hamid, Somaia I Salama, Aida M Abdel Mohsen, Samia A Hemeda, Nihad A Ibrahim, Ammal M Metwally, Community Medicine Research Department, National Research Center, Cairo 12311, Egypt
| | - Manal H El-Sayed
- Iman I Salama, Lobna A El Etreby, Thanaa M Rabah, Dalia M Elmosalami, Amany T Abdel Hamid, Somaia I Salama, Aida M Abdel Mohsen, Samia A Hemeda, Nihad A Ibrahim, Ammal M Metwally, Community Medicine Research Department, National Research Center, Cairo 12311, Egypt
| | - Lobna A El Etreby
- Iman I Salama, Lobna A El Etreby, Thanaa M Rabah, Dalia M Elmosalami, Amany T Abdel Hamid, Somaia I Salama, Aida M Abdel Mohsen, Samia A Hemeda, Nihad A Ibrahim, Ammal M Metwally, Community Medicine Research Department, National Research Center, Cairo 12311, Egypt
| | - Thanaa M Rabah
- Iman I Salama, Lobna A El Etreby, Thanaa M Rabah, Dalia M Elmosalami, Amany T Abdel Hamid, Somaia I Salama, Aida M Abdel Mohsen, Samia A Hemeda, Nihad A Ibrahim, Ammal M Metwally, Community Medicine Research Department, National Research Center, Cairo 12311, Egypt
| | - Dalia M Elmosalami
- Iman I Salama, Lobna A El Etreby, Thanaa M Rabah, Dalia M Elmosalami, Amany T Abdel Hamid, Somaia I Salama, Aida M Abdel Mohsen, Samia A Hemeda, Nihad A Ibrahim, Ammal M Metwally, Community Medicine Research Department, National Research Center, Cairo 12311, Egypt
| | - Amany T Abdel Hamid
- Iman I Salama, Lobna A El Etreby, Thanaa M Rabah, Dalia M Elmosalami, Amany T Abdel Hamid, Somaia I Salama, Aida M Abdel Mohsen, Samia A Hemeda, Nihad A Ibrahim, Ammal M Metwally, Community Medicine Research Department, National Research Center, Cairo 12311, Egypt
| | - Somaia I Salama
- Iman I Salama, Lobna A El Etreby, Thanaa M Rabah, Dalia M Elmosalami, Amany T Abdel Hamid, Somaia I Salama, Aida M Abdel Mohsen, Samia A Hemeda, Nihad A Ibrahim, Ammal M Metwally, Community Medicine Research Department, National Research Center, Cairo 12311, Egypt
| | - Aida M Abdel Mohsen
- Iman I Salama, Lobna A El Etreby, Thanaa M Rabah, Dalia M Elmosalami, Amany T Abdel Hamid, Somaia I Salama, Aida M Abdel Mohsen, Samia A Hemeda, Nihad A Ibrahim, Ammal M Metwally, Community Medicine Research Department, National Research Center, Cairo 12311, Egypt
| | - Hanaa M Emam
- Iman I Salama, Lobna A El Etreby, Thanaa M Rabah, Dalia M Elmosalami, Amany T Abdel Hamid, Somaia I Salama, Aida M Abdel Mohsen, Samia A Hemeda, Nihad A Ibrahim, Ammal M Metwally, Community Medicine Research Department, National Research Center, Cairo 12311, Egypt
| | - Safaa M Elserougy
- Iman I Salama, Lobna A El Etreby, Thanaa M Rabah, Dalia M Elmosalami, Amany T Abdel Hamid, Somaia I Salama, Aida M Abdel Mohsen, Samia A Hemeda, Nihad A Ibrahim, Ammal M Metwally, Community Medicine Research Department, National Research Center, Cairo 12311, Egypt
| | - Amal I Hassanain
- Iman I Salama, Lobna A El Etreby, Thanaa M Rabah, Dalia M Elmosalami, Amany T Abdel Hamid, Somaia I Salama, Aida M Abdel Mohsen, Samia A Hemeda, Nihad A Ibrahim, Ammal M Metwally, Community Medicine Research Department, National Research Center, Cairo 12311, Egypt
| | - Naglaa F Abd Alhalim
- Iman I Salama, Lobna A El Etreby, Thanaa M Rabah, Dalia M Elmosalami, Amany T Abdel Hamid, Somaia I Salama, Aida M Abdel Mohsen, Samia A Hemeda, Nihad A Ibrahim, Ammal M Metwally, Community Medicine Research Department, National Research Center, Cairo 12311, Egypt
| | - Fatma A Shaaban
- Iman I Salama, Lobna A El Etreby, Thanaa M Rabah, Dalia M Elmosalami, Amany T Abdel Hamid, Somaia I Salama, Aida M Abdel Mohsen, Samia A Hemeda, Nihad A Ibrahim, Ammal M Metwally, Community Medicine Research Department, National Research Center, Cairo 12311, Egypt
| | - Samia A Hemeda
- Iman I Salama, Lobna A El Etreby, Thanaa M Rabah, Dalia M Elmosalami, Amany T Abdel Hamid, Somaia I Salama, Aida M Abdel Mohsen, Samia A Hemeda, Nihad A Ibrahim, Ammal M Metwally, Community Medicine Research Department, National Research Center, Cairo 12311, Egypt
| | - Nihad A Ibrahim
- Iman I Salama, Lobna A El Etreby, Thanaa M Rabah, Dalia M Elmosalami, Amany T Abdel Hamid, Somaia I Salama, Aida M Abdel Mohsen, Samia A Hemeda, Nihad A Ibrahim, Ammal M Metwally, Community Medicine Research Department, National Research Center, Cairo 12311, Egypt
| | - Ammal M Metwally
- Iman I Salama, Lobna A El Etreby, Thanaa M Rabah, Dalia M Elmosalami, Amany T Abdel Hamid, Somaia I Salama, Aida M Abdel Mohsen, Samia A Hemeda, Nihad A Ibrahim, Ammal M Metwally, Community Medicine Research Department, National Research Center, Cairo 12311, Egypt
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49
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Meireles LC, Marinho RT, Van Damme P. Three decades of hepatitis B control with vaccination. World J Hepatol 2015; 7:2127-2132. [PMID: 26328023 PMCID: PMC4550866 DOI: 10.4254/wjh.v7.i18.2127] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Revised: 07/23/2015] [Accepted: 08/03/2015] [Indexed: 02/06/2023] Open
Abstract
Hepatitis B virus (HBV) continues to represent a major health problem and can lead to acute liver failure, acute hepatitis, chronic carriership, chronic hepatitis of HBV, liver cirrhosis, liver cancer, liver transplantation and death. There is a marked difference in the geographic distribution of carriers. More than 240 million people worldwide are chronic HBV carriers. Mother-to-child transmission remains the most important mechanism of infection in countries with a high prevalence of HBV. Percutaneous/parenteral transmission and unsafe sexual practices are important mode of spread transmission of HBV in other countries. Vaccination against HBV is the gold measure for primary prevention and control of the disease. Currently, 179 countries have added HBV vaccination to their routine vaccination programs with great results. Neonatal immunization with HBV vaccine has been one of the most highly effective measures in public health and the first anti-cancer program to be launched. In this paper we review the achievements for the last three decades.
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50
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Schinzari V, Barnaba V, Piconese S. Chronic hepatitis B virus and hepatitis C virus infections and cancer: synergy between viral and host factors. Clin Microbiol Infect 2015; 21:969-74. [PMID: 26163104 DOI: 10.1016/j.cmi.2015.06.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 06/12/2015] [Accepted: 06/16/2015] [Indexed: 02/07/2023]
Abstract
Hepatitis B virus (HBV) or hepatitis C virus (HCV) infections represent major causes of chronic liver disease and hepatocellular carcinoma. Despite inducing shared pathological events leading to oncogenic transformation, these two viruses present profound differences in their molecular features, life cycle and interplay with host factors, which significantly differentiate the prognostic and therapeutic approach to the related diseases. In the present review, we report the main mechanisms involved in the multistep process leading from HCV/HBV infection and cancer development, discussing side-by-side the analogies and differences between the two viruses. Such events can be broadly categorized into (a) direct oncogenic effects, involving integration in the host genome (in the case of HBV) and chromosomal instability, interference with oncosuppressor pathways, induction of oxidative stress, promotion of angiogenesis, epithelial-mesenchymal transition, alterations in the epigenetic asset and interaction with non-coding RNAs; and (b) indirect activities mostly mediated by host events, including chronic inflammation sustained by peculiar cytokine networks (such as interleukin-6 and lymphotoxins), metabolic dysfunctions promoted by steatohepatitis, interplay with gut microbiota and fibrotic events (mainly in HCV infection). This scenario suggests that the integrated study of viral and host factors may lead to the successful development of novel biomarkers and targets for therapy.
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Affiliation(s)
- V Schinzari
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy
| | - V Barnaba
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy; Istituto Pasteur-Fondazione Cenci Bolognetti, Rome, Italy.
| | - S Piconese
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy; Istituto Pasteur-Fondazione Cenci Bolognetti, Rome, Italy
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