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Hepatitis B vaccine （HepB） vaccination is the safest and most effective means of preventing hepatitis B virus （HBV） infection. HepB non-response is influenced by multiple factors， and solving the problem of poor immune response after HepB vaccination is of great significance for controlling HBV infection. Bile acids play an important role in human immune regulation， and whether bile acids have an effect on the HepB immune response has not been definitively studied. This article reviews the correlation between bile acids and HepB immune response， and provides a reference for further clarifying the pathogenesis and immunoprevention of bile acids in vaccine immunity.
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Among chronic hepatitis B patients eligible for treatment, only 5% have received antiviral therapy worldwide. The strictness of treatment criteria in current guidelines is one of the contributing factors for the low treatment rate of patients with chronic hepatitis B, and expanding the treatment criteria for chronic hepatitis B established in current guidelines may reduce disease burden. Universal hepatitis B vaccination, universal screening, and treatment of all HBV DNA-positive patients will help to achieve the goal of HBV elimination by 2030 proposed by the World Health Organization.
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【Objective】 To assess the trend of hepatitis B virus (HBV) prevalence and associated risk factors among voluntary blood donors in Guangzhou area from 2011 to 2020, and to explore the impact of hepatitis B vaccination in neonates on the risk of HBV infection. 【Methods】 Blood samples of 2 624 434 voluntary blood donors from 2011 to 2020 in Guangzhou were tested by HBV surface antigen (HBsAg) enzyme-linked immunosorbent assay (ELISA) reagents twice and nucleic acid test (NAT) reagent once. Samples reactive to ELISA twice, or ELISA once + NAT were considered as HBV infection. The gender, age, ethnicity and region of HBV infected blood donors were collected, and the incidence of HBV infection in blood donors born before and after 1992 (when HBV vaccination was conducted in neonates) was compared. The trend and risk factors of HBV infection in blood donors in Guangzhou from 2011 to 2020 were analyzed. 【Results】 An overall HBV prevalence of 0.75% was found in voluntary blood donors in Guangzhou area from 2010 to 2020, showing an overall downward trend(P0.05), but both were significantly higher than that in Hong Kong, Macao, Taiwan and foreign countries (P<0.05). HBV prevalence in Han nationality donors was significantly higher than the ethnic minority donors (P<0.05). Gender, age, ethnicity and birth vaccination are the main risk factors for HBV infection among blood donors. 【Conclusion】 The overall HBV prevalence among voluntary blood donors in Guangzhou area from 2011 to 2020 has shown a decreasing trend, and differences have been found in gender, age, region, ethnicity and birth vaccination, which is helpful to formulate targeted recruitment strategies, thus reducing the risk of transfusion transmitted HBV.
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Organ transplant recipients are at a high risk of infection with high hospitalization rate, critical rate and fatality, due to low immune function caused by taking immunosuppressants for a period of long time after organ transplantation. Currently, vaccination is recognized as an effective approach to prevent infection. Organ transplant recipients may be vaccinated according to individual conditions. However, the sensitivity to vaccines may decline in organ transplant recipients. The types, methods and timing of vaccination have constantly been the hot spots of clinical trials. In this article, the general principles, specific vaccines and SARS-CoV-2 vaccines of vaccination in organ transplant recipients were briefly reviewed, aiming to provide reference for the vaccination of organ transplant recipients. Moreover, current status of SARS-CoV-2 vaccination for organ transplant recipients was illustrated under the global outbreak of novel coronavirus pneumonia pandemic.
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Objective:To investigate the appropriate age for booster doses of hepatitis B vaccine in children aged 0-14.Methods:Retrospective study.A total of 3 118 children aged 0-14 years who underwent quantitative serological marker testing for hepatitis B virus at the Affiliated Hospital of Hangzhou Normal University from January 2015 to October 2021 were recruited in this analysis.There were 1 702 males and 1 416 females, with a male to female ratio of 1.20∶1.00.Children were divided into 15 groups according to their age, and the classifying interval was 1 year.The hepatitis B virus surface antibody (Anti-HBs) titer was quantified by chemiluminescent microparticle immunoassay.The Anti-HBs positivity rates and hepatitis B immune response among groups of different sexes and age were compared by the chi- square test and rank- sum test, respectively. Results:A total of 3 118 children were investigated.The titer and effective response rate of Anti-HBs decreased gradually with age.The difference in the titer and effective response rate of Anti-HBs was statistically significant among groups of different age (all P<0.01), but not significant between males and females (all P>0.05). The median titer of Anti-HBs in children aged above 3 years was 58.49 IU/L(0-1 001.00 IU/L). About 59.1% (1 477/2 497 cases) of children aged 3 years and above had no immune response or low immune response (i.e., the titer of Anti-HBs was below 100 IU/L). Conclusions:The immune protective effect of the hepatitis B vaccine decreases year by year in children who have received the standardized vaccine, and the vaccine has poor protective effect on most children aged 3 years and above.Therefore, booster dose vaccination for preventing hepatitis B is necessary for children aged 3 and above.
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Recently, the Society of Infectious Diseases of Chinese Medical Association and Chinese GRADE Center jointly released the “2019 Chinese practice guideline for the prevention and treatment of hepatitis B virus mothertochild transmission”. We concerned several issues in the Guideline, including the improper citation of some references, no recommendations for some key strategies for the prevention of hepatitis B virus mothertochild transmission, insufficient or even lack of evidence for some recommendations and others. Based on the principle of academic contention, we present in this article our comments on the Guideline to discuss these issues with the Guideline’s authors and readers.
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Background@#Healthcare works are high risk of infection through occupational exposure that contact with blood and other body fluids, including infected person, uses needles, syringes, equipment or exposures to sharp instruments. The World Health Organization (WHO) estimates, approximately 66,000 health workers are infected with the hepatitis B virus (HBV) and 200-5000 workers arc infected with human immunodeficiency virus (HIV) each year due to carelessness. HBV infection is a global health problem that remains to preventive. Hepatitis B can be prevented by vaccines that are safe, available and effective. In our country, which has a high prevalence of hepatitis B virus infection, it has been concluded that the coverage of hepatitis B vaccination and the level of immunity of health workers are insufficient.@*Aim@#To evaluate post vaccination immunity against HBV in the staff of National center for transfusion medicine @*Methods@#63 workers with negative surface antigen of hepatitis B (HBsAg) and absent anamnesis of infection were selected for this study. In 2019 and 2020 all 63 workers were evaluated post vaccination immunity against HBV. Analysis done by Sysmex HSCL800 that is an automated immune assay system. @*Results and discussion@#This center was begun to conduct the vaccination of workers from 2011. Among total 63 individuals involved in this study 53 (84.1%) were vaccinated against hepatitis B and 10 (15.9%) were not vaccinated. From the vaccinated 53 workers, 47 (88,7%) have immunized (anti-H Bs > 1 Ou/ml) but 6 (11.3%) of them were not immunized (anti-HBs <1 Ou/ml).</br> Therefore 1(1,9%) worker of them received just first dose, 14 (26.4%) workers were injected second dose, whereas 38 (71.7%) workers were vaccinated with third dose. The study shows that 12 (85.7%) workers after second dose and 34 (89.5%) workers after third dose were immunized.@*Conclutions@#As a result of hepatitis B vaccination, 88.7% of workers of the NCTM have had immunized against HBV. The final evaluation shows that 36 (57%) of workers had stable, 17 (27%) increased, and 10(16%) decreased level of immunization than the previous year.
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Background: Hepatitis B is a major contributor to the burden of infectious diseases worldwide. Many preventive measures havebeen employed, however, active immunization with hepatitis B vaccine remains the single most important hepatitis B preventionmeasure. WHO recommends that all health care workers (HCWs) should be vaccinated against HBV. However, proportions ofindividuals do not respond to the recommended standard three dose of HBV vaccination and remain susceptible to theinfection.Objectives: This study was to assess the response rate to vaccination against HBV among health care workers and todetermine predictors of non-response to HBV vaccine in HCWs. Methods and Materials: A prospective study carried out at theSaint Dominic Hospital, Akwatia, involving 100 HCWs from 29th August, 2018 to 4th June, 2019. All the participants received thestandard protocol of 3 intramuscular injections of HBV vaccine (Engerix B) at 0, 1, and 6 months. Qualitative and quantitativeserum anti-HBs was determined 1-2 months after the last injection in order to detect the responders and non-responders.Results:Majority (54.0%) of the participants were males. The Median age of the study participants was 35 (29, 47) with age range of 20-65 years. Out of the 100 HCWs 90 (90%) were responders and 10 (10%) were non-responders to hepatitis B vaccine. Nonresponders had increased odds of being female, though this was not statistically significant (COR=1.47 (0.42 - 5.17).Conclusion:All HCWs should undergo confirmatory testing of immune response after completion of scheduled standard HBV immunization.This will ensure safety of all HCWs against HBV infection.
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Abstract Introduction: Hepatitis B virus (HepB) infection is a global health problem with increasing cause of morbidity and mortality.Hemodialysis patients are especially vulnerable to HepB infection due to uremia-related immune dysfunction, frequent interventions they exposed, and health-care personnel's unsafe care. The vaccination against HepB confers the primary preventive measure. However, unresponsiveness to vaccination constitutes a major problem. Several factors can influence the immune response to vaccines but human genetic variations are thought to strongly militate the variability in vaccine responsiveness. We aimed to determine the association with specific HLA alleles and response to HepB vaccination in hemodialysis patients. Methods: The study included in-center hemodialysis patients. We retrospectively collected data regarding demographic, clinical, and laboratory features including anti-HBs antibody, antibody to hepatitis C (anti-HCV), anti-HIV, and specific HLA class I and II alleles (HLA-A, HLB, HLA-DR) from electronical medical record system. The frequencies of HLA class I and II antigens in nonresponders and responders were analyzed. Results: The most commonly observed HLA alleles in patients were DQA1*01 (%73.7), DQA1*05 (%57.9), DQB1*03 (%53.8), DQB1*05 (%38.5), and DRB1*11 (%37.3), respectively. The frequency of HLA-B40 allel was significantly higher in nonresponders (p=0.02, OR=6.25, 95%CI =1.33-29.3). HLA-DQA1*01 and HLA-DQB1*05 alleles were observed significantly more in responders (p=0.019, OR =6.9, 95% CI=1.40-33.91, andp=0.028, OR =10, 95% CI=1.12-88.91, respectively). Conclusion: This is the first study to our knowledge demonstratingthe association between antibody response to HBsAg and HLA-B40, HLA-DQA1*01, and HLA-DQB1*05 alleles in Turkish hemodialysis patients.
Resumen Introducción: La infección por el virus de la hepatitis b (VHB) constituye un problema de salud mundial con una morbimortalidad cada vez mayor.Los pacientes que reciben hemodiálisis están particularmente expuestos a una infección por el virus de la hepatitis b debido a una disfunción del sistema inmunitario relacionada con la uremia, las intervenciones a las que se someten frecuentemente y prácticas poco seguras por parte del personal de salud. La vacuna contra el VHB constituye la medida preventiva principal. Sin embargo, la falta de respuesta a la vacuna supone un gran problema. Existen varios factores que pueden influir sobre la respuesta inmunitaria a la vacuna, pero se cree que las variaciones genéticas humanas tienen una gran incidencia sobre la variación en la respuesta a la vacuna. El objetivo de este trabajo fue determinar la relación entre alelos HLA específicos y la respuesta a la vacuna contra el VHB en pacientes que reciben hemodiálisis. Material y métodos: El estudio incluyó pacientes en hemodiálisis hospitalaria. Se recopilaron datos retrospectivamente del sistema electrónico de registros médicos sobre características demográficas, clínicas y de laboratorio, incluidos anticuerpos anti-HBs, anticuerpos contra la hepatitis C (anti-VHC), anti-VIH y alelos HLA específicos de clase I y II (HLA-A, HLA-B, HLA-DR). Se analizaron las frecuencias de los antígenos HLA clase I y II en pacientes que no respondían y en aquellos que sí lo hacían. Resultados: Los alelos HLA más comúnmente observados en pacientes fueron DQA1 * 01 (73,7%); DQA1 * 05 (57,9%); DQB1 * 03 (53,8%); DQB1 * 05 (38,5%), y DRB1 * 11 (37.3%), respectivamente. La frecuencia del alelo HLA-B40 fue significativamente mayor en los que no respondieron (p=0,02; OR = 6,25; IC 95% = 1,33-29,3). Se observó que los alelos HLA-DQA1*01 y HLA-DQB1*05 aparecían mayormente en los pacientes que respomdían (p=0,019; OR = 6,9; IC 95% = 1,40-33,91, y p=0,028; OR=10; IC 95% = 1,12- 88,91, respectivamente). Conclusión: Este es el primer estudio que conocemos que demuestra la asociación entre la respuesta de anticuerpos a HBsAg y a alelos HLA-B40, HLA-DQA1*01 y HLA-DQB1*05 en pacientes turcos en hemodiálisis.
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Objectives: To study the prevalence of Hepatitis B seroprotection in children (>1 y) withnephrotic syndrome vaccinated against Hepatitis B vaccine as per the UniversalImmunization Program schedule (0,6,10,14 wk); to compare the Hepatitis B seroprotectionrates and anti-HBs titers among different phenotypes of nephrotic syndrome; to evaluate theassociation between Hepatitis B seroprotection status and the immunosuppressive agents;and to study the correlation between anti-HBs titres and proteinuria. Methods: Hepatitis Bserology and anti-HBs titers were analyzed in 100 children (age-1-18 y) with different clinicalphenotypes of nephrotic syndrome (cases) and 100 healthy controls. Results: Theproportion of seroprotected children among the cases and controls was 37% (n=37) and 61%(n=61), respectively (P<0.04). The median (IQR) anti- HBs antibodies titers among the caseswas 75 (62.5, 81) mIU/mL and 112 (56, 367) mIU/mL among the controls (P=0.001). Theproportion of seroprotected children among the steroid sensitive nephrotic syndrome, steroid-resistant nephrotic syndrome and controls was 40% (n=28), 30% (n=9) and 61% (n=61),respectively (P<0.01). No differences in the anti-HBs titers between children receivingsteroids versus steroids along with other immunosuppressants were found. Weak negativecorrelation was noted between proteinuria and protective titers (r = -0.155; P=0.039).Conclusion: Children with nephrotic syndrome, in general, and steroid-resistant nephroticsyndrome in particular, show poor seroprotection with Hepatitis B vaccination.
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Background:Hepatitis B vaccine has been introduced in Nigeria for over a decade now, yet, data on sero-conversion status of the immunized cohort in the population are scarce. Such data are important for objective evaluation of the impact and effectiveness of the HBV vaccination program This study therefore aims at determining the sero-conversion status and the prevalence of HBV infection among immunized cohort of children in Ekiti state, Nigeria.Methodology:This cross-sectional study was conducted across the three senatorial districts of Ekiti state, between October and December, 2017. A total of 441 children consisting of 226 males and 215 females (Male to female ratio= 1.1:1).Immunization was confirmed by immunization cards. Multistage sampling technique was used. Questionaire were administered after caregiver’s consentand assent from subjects, 2 to 5mls of blood samples were then collected and tested for the various hepatitis B viral markers (HBeAg, HBeAb, HBcAb, HBsAb and HBsAg) using Hepatitis B combo kit manufactured by Innovita Biological Technology. Very low levels antibody titres which may not be detectable by qualitative detection method used is a limitation to this study.Results:Subjects were between 5 to 10 years. All subjects had 3 full doses of hepatitis B vaccination before the age of 1 year and all subjects were negative for HBsAg, HBeAg, HBeAB and HBcAb. However, only 47 (10.7%) had detectable HBsAb. Among HBsAb positive patients 22 were males while 25 were females. Our findings showed zero prevalence of hepatitis B but minimal seroconversion rate among vaccinated children in Ekiti state, Nigeria.Conclusion:Hepatitis B vaccination protects children against HBV in the study population. However, seroconversion rate showed that majority of the children may be at risk of HBV infection at a later age. We recommend a booster dose of HBV vaccination
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Hepatitis B vaccination and blocking mother-to-child transmission of HBV are of great significance in the prevention and control of HBV infection. Hepatitis B vaccination is the most effective way to prevent HBV infection. Mother-tochild transmission of HBV can be greatly reduced by these measures, which include strengthening the screening of HBV in women of childbearing age, antiviral treatment in pregnant women with high viral load, and combined immunization of hepatitis B vaccine and hepatitis B immunoglobulin for newborns of HBsAg positive mothers. In the recent 30 years, remarkable achievements have been made in the prevention and control of HBV infection in China.
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Objective@#To estimate the immune memory at 12 years after hepatitis B vaccination and its risk factors among adults.@*Methods@#The study was conducted in 20 villages of Qudi town in Jiyang county, Shandong province, China in 2003. Hepatitis B surface antigen (HBsAg), antibody against HBsAg (anti-HBs) and antibody against hepatitis B core antigen (anti-HBc) were tested for all healthy residents aged 15-40 years in these villages. Those who had no history of hepatitis B vaccination and were negative for all three indicators were divided into two groups randomly. Hepatitis B vaccine (HepB) was administrated to them on 0-6 month schedule or 0-1-6 month schedule respectively. Blood samples were obtained at one month after the last dose for each receipt and were quantitatively detected for anti-HBs. Finally a total of 629 participants completed HepB vaccination and anti-HBs testing, including 288 of two-dose group and 341 of three-dose group respectively. In 2015, an additional dose of HepB (challenge dose) was administrated to those who were negative for anti-HBs at follow-up (anti-HBs <10 mIU/ml) to evaluate the immune memory. A total of 93 blood samples, including 50 of two-dose group and 43 of three-dose group respectively, were drawn at 14 days after the challenge dose and anti-HBs was quantitatively detected. The anti-HBs geometric mean concentrations (GMCs) after the challenge dose were compared between the two groups. Multivariate linear regression model was built to find the independent risk factors associated with immune memory response (anti-HBs GMC after the challenge dose).@*Results@#The challenge dose of HepB and post-challenge anti-HBs detection were completed among 93 participants. Totally 92 (98.92%, 92/93) participants were found holding immune memory (anti-HBs after the challenge dose was ≥10 mIU/ml). The immune memory positive rates were 100% (50/50) and 97.67% (42/43) in the two-dose group and three-dose group respectively and the corresponding anti-HBs GMC after challenge dose were 2 684.30 (95%CI: 1 721.71-4 185.08) mIU/ml and 3 527.48 (95%CI: 2 145.15-5 800.58) mIU/ml (P=0.410). The anti-HBs GMC after the challenge dose were 1 908.33 (95%CI: 1 190.01-3 060.27) mIU/ml, 4 004.20 (95%CI: 2 257.90-7 101.12) mIU/ml and 8 682.16 (95%CI: 5 813.94-12 965.36) mIU/ml among the participants whose anti-HBs titer was<4, 4-6 and 7-9 mIU/ml at follow-up, respectively (P=0.002). There was no correlation between immune schedule and anti-HBs GMC after the challenge dose; β (95%CI) was -0.07 (-0.34-0.20), P=0.601.@*Conclusion@#The immune memory after primary hepatitis B vaccination lasted for at least 12 years among adults. The immune memory response was independently associated with ant-HBs titer at follow-up, but might be similar between 0-6 month schedule and 0-1-6 month schedule.
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Objective@#Safety and immunogenicity regarding simultaneous vaccination on both hepatitis E and hepatitis B vaccines were studied.@*Methods@#A total of 600 healthy subjects aged 18-60 were recruited in Chaoyang district of Beijing city, from September 2015 to December 2016. Subjects meeting the inclusion and exclusion criteria were randomly divided into 3 groups: the simultaneous vaccination group of hepatitis E and hepatitis B, the hepatitis B vaccination group and the hepatitis E vaccination group. Members of the 3 groups were all inoculated according to the procedure of '0, 1 and 6 months’. Safety and immunogenicity of the simultaneous vaccination group was compared with the individual vaccination groups.@*Results@#Vaccination groups had 601 subjects, involved with having 150 subjects of hepatitis E vaccination group, 159 subjects of hepatitis B vaccination group, and 292 subjects of simultaneous vaccination of hepatitis E and hepatitis B. Local adverse reactions that mostly common seen, would include pain (25.0%, 73/292), redness (12.7%, 37/292), pruritus (9.2%, 27/292), callus (8.9%, 26/292), swelling (8.2%, 24/292) at the inoculation sites. Systemic adverse reactions would include fever (7.2%, 21/292), headache (5.8%, 17/292), muscle pain (5.5%, 16/292) and fatigue (3.4%, 10/292). No serious adverse reactions associated with vaccination were seen. In addition to the higher incidence of pain at the inoculation sites, rest of the adverse reactions was similar to the simultaneous vaccination group or the individual vaccination groups. One month after the completed immunization process, positive rate and geometric mean concentration(GMC) of the HBsAb were not inferior to that of the hepatitis B vaccine group (94.2% vs. 93.8%, 611.6 WU/ml vs. 745.1 WU/ml). Positive rate and GMC of the HEV IgG were not inferior to that of the hepatitis E vaccinated group (98.8% vs. 100.0%, 11.0 WU/ml vs. 18.0 WU/ml).@*Conclusions@#Simultaneous vaccination strategy on hepatitis E and hepatitis B vaccines showed good safety and immunogenicity. It is recommended that hepatitis E and hepatitis B vaccines should be administered to the susceptible population at the same time, in order to protect the liver functions.
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Objective@#To investigate the role of HBsAg status and content in neonatal venous blood to predict HBV mother-to-children transmission.@*Methods@#The study candidates from a prospective study about HBV mother-to-children transmission blocking who were hepatitis B surface antigen (HBsAg) positivity, hepatitis B e antigen (HBeAg) positivity, and HBV DNA levels >105 IU/ml.All of their infants were enrolled.200 IU of hepatitis B immunoglobulin (HBIG)was injected within 6 hours after birth, and 200 IU HBIG was voluntarily selected 1 month after birth.All infants according to 0-1-6 month standard procedure were given 10 or 20 μg of hepatitis B vaccine. Pregnancy women before birth, and infants at the time of birth, 1-month and 7-month after birth, venous blood was tested for HBV virus and serological markers to assess the association with success of mother-to-children transmission blocking.@*Results@#530 pregnant women and 530 neonates were enrolled. 60.75% at birth and 86.02% at birth for one month children were HBsAg-negative. The successful transmission in HBsAg-negative neonates was 100.00%. According to the receiver operating characteristic curve, the AUC of HBsAg content≥0.35 IU/ml at birth predicted to block failure was 0.979. The sensitivity was 85.60%, and the specificity was 100.00%. The AUC of HBsAg content≥0.18 IU/ ml at one month after birth predicted to block failure was 0.988, the sensitivity was 89.40%, and the specificity was 100.00%.@*Conclusions@#The HBsAg level in venous blood at birth and 1 month after birth can predict the failure of HBV mother-to-children transmission, and the neonates with HBsAg positivity in venous blood are a high-risk group that may block failure.
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BACKGROUND@#Two types of recombinant hepatitis B virus (HBV) vaccines are available in Japan. One type uses the antigen from genotype A (Heptavax-II®) and the other uses the antigen from genotype C (Bimmugen®). Potential differences in productivity of the hepatitis B virus surface (HBs) antibody between vaccines have not been studied in detail. We investigated the acquired level of immunity against HBV in association with two vaccines, their administration routes, and patient sex. We present the appropriate inoculation method based on the characteristics of each vaccine.@*METHODS@#Data of 1135 medical and nursing students (481 men and 651 women) were used, each of whom was unvaccinated prior to recruitment and subsequently vaccinated three times prior to the study. The vaccine type and administration route differed according to the university department and enrolling year. The students were categorized into the following three groups: Bimmugen®-subcutaneous group, Heptavax-II®-subcutaneous group, and Heptavax-II®-intramuscular group. The total and sex-segregated positive rates of the HBs antibody among the three groups were compared using Pearson's chi-square test. The effect of time between the HBs antibody test and vaccine administration on the HBs antibody level was also analyzed similarly.@*RESULTS@#The Bimmugen®-subcutaneous group showed the highest positive HBs antibody rate (92.0%) among the three groups. In the Heptavax-II® group, the positive rate was 66.3% in the subcutaneous injection group and 89.1% in the intramuscular injection group. There was a significant difference among these three groups. In terms of sex, women showed a significantly higher average positive rate than men in each group. In terms of effect of time between the HBs antibody test and vaccine administration, no significant differences were observed.@*CONCLUSIONS@#Bimmugen® is associated with more effective HBs antibody production than Heptavax-II® in Japanese students. However, the Heptavax-II® vaccine is an appropriate choice for HBV vaccination in areas where HB is caused predominantly by HBV genotype C. With both vaccines, women tended to acquire more immunogenicity than men. Intramuscular injection may be the preferred administration route due to the possibility of local reactions.
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Objective To explore the association between Toll-like receptors(TLR) gene polymorphisms and the primary immune response level to Hepatitis B Vaccine in Han children in Guangxi. Methods A total of 513 Han children aged 8-9 months were collected from the department of pediatrics in the Maternal and Child Hospital of Guangxi Zhuang Autonomous Region and Nanning Maternal and Child Health Hospital from 2014 to 2016. Peripheral venous blood of each study object was collected to detect HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc and HBV DNA. The polymorphisms of 10 sites of TLR gene were detected by SNPscanTM multiple SNP typing techniques. The association between allele, genotype of TLR gene and anti-HBs levels were analyzed by non-conditional logistic regression. Results The genetic polymorphism of TLR3 gene rs13126816 was related to immune response after primary Hepatitis B immunization in Han children in Guangxi (OR=1.79，95% CI: 1.11-2.89, P=0.018). The anti-HBs level of children with A/A genotype［238.04(519.75) mIU/L］and G/A genotype［347.96(619.68) mIU/L］were significantly lower than those with G/G genotype［489.08(854.76) mIU/L］, and the differences were statistically significant (all P0.05). Conclusions The allele A of TLR3 gene rs13126816 may be the influencing factor for the low response of primary immune response to Hepatitis B Vaccine in Han children.
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Objective To explore the influence of risk attitude to hepatitis B vaccination behavior of residents in suburban areas, and provide evidence for improvement of health education. Methods A total of 1 031 adults aged 16-60 years old were selected from 6 villages in Ninghe county and Jinghai county. A questionnaire was used to investigate them. Results Logistic regression analysis showed that respondents’ hepatitis B vaccination behavior was affected by their risk attitude when controlling other factors. The younger (OR=0.94, 95% CI:0.93-0.96, P＜0.001), unmarried (OR=8.24, 95% CI:2.89-23.60, P＜0.001), low self-rated health (OR=1.78, 95% CI:1.53-3.49, P=0.008), the formal sector workers (OR=7.18, 95% CI:2.29-22.54, P=0.001), covered by health insurance (OR=8.46, 95% CI:2.31-30.86, P=0.001), risk aversion (OR=1.65, 95% CI:1.06-2.57, P=0.026) and risk neutral (OR=1.50, 95% CI:1.03-2.17, P=0.032) were more likely to choose hepatitis B vaccination. Conclusions For the risk aversion and risk neutral, health education on disease symptoms and disease economic burden should be enhanced; for the risk seeking, more knowledge on prevalence trend and transmission route need to be improved.
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@# Objective To evaluate the risk of hepatitis B virus(HBV) infection among preschool children who were the non-responders to hepatitis B vaccine in future. Methods A prospective cohort study was conducted. Children aged 2 to 5 years were selected from 64 kindergartens.These children were inoculated three doses of hepatitis b vaccine at 0, 1 and 6 months after birth. Hepatitis B surface antigen (HBsAg)and Hepatitis B surface antibody (anti-HBs)were detected during the period from March to May 2015. The children who were HBsAg negative were enrolled in the study. The subjects were divided into exposure group (anti-HBs negative) and control group (anti-HBs positive) . The follow-up began on June 1, 2015 and ended on June 1, 2016. Serum HBsAg of children in the cohort was then collected and detected from June 1 to 30, 2016. At the end of the study, the HBsAg positive rates between two groups were compared. Results 83 children who received hepatitis B vaccine again during the follow-up period were excluded from 1 907 non-responders. The actual number in non-responders group was 1 824. 151 children were lost at the end of the study. The actual number of follow-up was 1 673 and 5 children were found to be positive for HBsAg and the infection rate was 0.30% (5/1673). In the respondent goup, 2 054 were enrolled and followed. Finally, 140 children were lost and none of the remaining 1 914 people were HBsAg positive at the end of the study. HBsAg positive rate was higher in the non-responder group than in the responder group (P=0.023). Conclusion There is a risk of HBV infection in the children who are non-responders to hepatitis B vaccine in future.
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Objective: To compare anti-HBs titers between term low birthweight (1800-2499 g) infants and normal birthweight infants, 6weeks after last dose of primary immunization with pentavalentvaccine, and to study adverse events following immunization(AEFI) with pentavalent vaccine.Design: Cohort study.Setting: Tertiary-care hospital predominantly catering to urbanpoor population of East Delhi.Participants: 265 low birthweight (1800-2499 g) and 265 normalbirthweight (2500-4000 g) infants. Monovalent Hepatitis B vaccinewas administered within 24 hours of birth followed by three primarydoses of pentavalent vaccine at 6, 10 and 14 weeks. Anti-HBstiters were estimated after 6 weeks of third dose of pentavalentvaccine. Adverse events following immunization (AEFI) monthwere observed for a month after each dose of pentavalent vaccine.Main outcome measures: Anti HBs antibody titers after 6 weeksof primary immunization, and AEFI.Result: 443 (83.5%) infants (225 low birthweight and 218 normalbirthweight infants) completed the follow-up. Seroprotectionagainst hepatitis B virus was achieved in both groups afterpentavalent vaccine administration. Anti HBs GMTs in lowbirthweight infants (194.8 mIU/mL) and normal birthweight infants(204.2 mIU/mL) were comparable (P = 0.17). No serious adverseevents were observed in either group.Conclusion: Three primary doses of pentavalent vaccineadministered along with zero dose of Hepatitis B vaccine at birthprovide good seroprotection. The vaccine appears to be safe inboth low birth weight and normal birthweight infants born at term.