Home⇛The PCMC Journal⇛vol. 15 no. 1 (2019)

Prevalence and factors associated with seroprotection after primary series of Hepatitis B vaccination among children seen in the outpatient setting of Philippine Children’s Medical Center

Adrienne Michelle B. Lu | Maria Estela R. Nolasco | Marilou G. Tan

Discipline: medicine by specialism

 

Abstract:

BACKGROUND: Hepatitis B is a vaccine-preventable condition that could develop into cirrhosis and hepatocellular carcinoma. Identifying patients at risk for Hepatitis B infection despite the universal implementation of Hepatitis B vaccination will help improve the immunization program. OBJECTIVE: To determine the prevalence and factors associated with seroprotection among children 3 months to 18 years old primary Hepatitis B vaccination series. METHODOLOGY: This is a cross-sectional study among children 3 months to 18years old with complete Hepatitis B immunization. Demographic, social and clinical data were correlated with response to HBsAg, Anti-HBs and Total Anti-HBc tests. RESULTS: Among 110 subjects from different age groups, 52% had seroprotective anti-HBs levels (>10 mIU/ml). Seventy four percent seroprotection was seen in subjects with <5 years interval from vaccination, 26% in cases after 5-10 years, and 38% at 10 years after vaccination with significant difference. Other factors such as gender, geographic area, type of vaccine, schedule, age at first dose and place of vaccine were not associated with seroprotection. CONCLUSION: Fifty two percent seroprotection from Hepatitis B infection among different age groups was demonstrated in our study. Interval year after vaccination was the only factor established to have significant association with seroprotection, with < 50% decline of anti-HBs level at 5 years or more after vaccination. RECOMMENDATIONS: Community studies with larger population are needed. Anti-HBs detection 5 years or more post-vaccination may be considered to identify patients at risk for breakthrough infection. Repeat serologic testing among non-seroprotected subjects is recommended.



References:

  1. Chang YC, Wang JH, et al. Hepatitis B virus vaccination booster does not provide additional protection in adolescents: A cross-sectional school-based study. BMC Public Health. 2014;14:991.
  2. Huang LM, et al. Long-term response to hepatitis B vaccination and response to booster in children born to mothers with Hepatitis B e antigen. Hepatology. 1999;29:954-959.
  3. Shepard CW, et al. Hepatitis B Virus Infection: Epidemiology and Vaccination. Epidemiol Rev. 2006;28:112-125.
  4. Wong S, Ong J, et al. Hepatitis B infection among adults in the Philippines: A national seroprevalence study. World J Hepatol. 2013;5(4):214-219.
  5. Lingao AL, et al. Seroepidemiology of hepatitis B virus in the Philippines. Am J Epidemiol. 1986;123(3):473-480.
  6. Implementing Guidelines on Hepatitis B Immunization for Infants. Administrative Order No. 2006-0015. Republic of the Philippines. Department of Health, June 2006.
  7. Mendoza B, Chan V, et al. Detection of anti-HBs, anti-HBc and HBsAg among pediatric vaccinees years after primary hepatitis B immunization. Philippine Journal of Science. 2007;136(1):57-63.
  8. Van Herck K, Van Damme P. Benefits of early hepatitis B immunization programs for newborns and infants. Pediatr Infect Dis J. 2008;27:861-869.
  9. Filippelli M, Lionetti E. Hepatitis B vaccine by intradermal route in non-responder patients: An update. World J Gastroenterol. 2014;20(30):10383-10394.
  10. Hamborsky J, Kroger A, Wolfe S, eds. Epidemiology and Prevention of Vaccine-Preventable Diseases. 13th ed. Washington, DC: Public Health Foundation; 2015.
  11. Lu JJY, et al. Hepatitis B immunity in adolescents and necessity for booster vaccination: 23 years after nationwide hepatitis B virus vaccination program in Taiwan. Vaccine. 2009:6613-6618.
  12. Gitlin N. Hepatitis B: Diagnosis, prevention, and treatment. Clin Chem. 1997;43:1500-1506.
  13. Recommended Immunization Schedule for Persons Aged 0 Through 6 Years – United States, 2010. www.aap.org.
  14. Mapandi I. Serologic status of neonates born to hepatitis B-positive mothers and given hepatitis B vaccine at birth in a tertiary government hospital, January 2007–June 2008: A pilot study. PIDSP Journal. 2010;11(2):32-39.
  15. Coppola N, et al. The long-term immunogenicity of recombinant hepatitis B virus (HBV) vaccine: contribution of universal HBV vaccination in Italy. BMC Infect Dis. 2015;15:149.
  16. World Health Organization. Hepatitis B. www.who.int.
  17. Demegillo M, et al. Persistence of protective hepatitis B antibody levels and response to booster immunization of elementary students of West City Central School, 5 to 6 years after primary immunization. 2014. Unpublished.
  18. Balangue-Tundag ME, et al. HBsAg carriage among Filipino preschool children in Lapu-Lapu City, Cebu. 2015. Unpublished.
  19. Dassah S, et al. Seroconversion of hepatitis B vaccine in young children in the Kassena Nankana District of Ghana: A cross-sectional study. PLoS One. 2015;10(12):e0145209.
  20. El-Sayed B, et al. Long-term protection of hepatitis B vaccination among Egyptian children. Egypt J Pediatr Allergy Immunol. 2011;9(1):35-40.
  21. Poorolajal J, et al. Long-term protection provided by hepatitis B vaccine and need for booster dose: A meta-analysis. Vaccine. 2010;28:623-631.
  22. Wu JS, et al. Hepatitis B vaccination in high-risk infants: 10-year follow-up. J Infect Dis. 1999;179:1319-1325.
  23. Rezaei M, et al. Seroprotection after hepatitis B vaccination in children aged 1 to 15 years in central province of Iran, Semnan. J Prev Med Hyg. 2014;55:1-3.
  24. Van Herck K, et al. Benefits of early hepatitis B immunization programs for newborns and infants. Pediatr Infect Dis J. 2008;27:861-869.
  25. He F, et al. The serum anti-HBs level among children who received hepatitis B vaccination during infancy in Mianyang City, China: A cross-sectional study. Viral Immunol. 2015;29(1):1-9.
  26. Su FH, et al. Efficacy of hepatitis B vaccine boosters among neonatally vaccinated university freshmen in Taiwan. J Hepatol. 2013;58:684-689.
  27. Kanda T, et al. Testosterone inhibits immunoglobulin production by human peripheral blood mononuclear cells. Clin Exp Immunol. 1996;106:410-415.
  28. Yang S, et al. Factors influencing immunologic response to hepatitis B vaccine in adults. Sci Rep. 2016;6:27251.
  29. Afzal M, et al. Seroprotection after hepatitis B vaccination in Expanded Programme on Immunization. BJMP. 2011;4(4):a445.
  30. World Health Organization, Western Pacific Region. Hepatitis B vaccination in the Philippines. www.upto.who.int.
  31. Hammitt LL, et al. Hepatitis B immunity in children vaccinated with recombinant hepatitis B vaccine beginning at birth: a follow-up study at 15 years. Vaccine. 2007;25:6958-6964.
  32. Petersen KM, et al. Duration of hepatitis B immunity in low-risk children receiving hepatitis B vaccinations from birth. Pediatr Infect Dis J. 2004;23:650-655.
  33. Mele A, et al. Effectiveness of hepatitis B vaccination in babies born to hepatitis B surface antigen-positive mothers in Italy. J Infect Dis. 2001;184:905-908.
  34. Schonberger K, et al. Determinants of long-term protection after hepatitis B vaccination in infancy: A meta-analysis. Pediatr Infect Dis J. 2013;32(4):307-313.
  35. Mast EE, et al. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. 2005. www.cdc.gov.
  36. Yao J, et al. The response of hepatitis B vaccination on seronegative adults with different vaccination schedules. Hum Vaccin Immunother. 2015;11(5):1102-1107.
  37. Bravo L, et al. The new DTPw-HBV-Hib combination vaccine can be used at the WHO schedule with a monovalent dose of hepatitis B vaccine at birth. Southeast Asian J Trop Med Public Health. 1998;29(4):772-778.
  38. Poovorawan Y, et al. Long-term antibody persistence after booster vaccination with combined tetravalent diphtheria, tetanus, whole-cell Bordetella pertussis and hepatitis B vaccine in healthy infants. Ann Trop Paediatr. 1997;17:301-308.
  39. Luo Z, et al. Impact of the implementation of a vaccination strategy on hepatitis B virus infections in China over a 20-year period. Int J Infect Dis. 2012;16(2):e82-e88.

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