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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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Objective Study of the rare hepatitis B virus patients model cases which both the hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (HBsAb) were positive, and discussion of its cause and the clinical value. Methods serum markers of hepatitis B virus (HBV-M) was detected by microparticle enzyme immunoassay chemiluminescence (MEIA); HBV-DNA was detected by fluores--cence quantitative PCR method, alanine aminotransferase and aspartate aminotransferase were detected by colorimetric, and all the data were combined with the clinical features of patients for comprehensive analysis. Results 1) HBsAg and HBsAb double positive detection rate was 2.3％ in 15600 cases of hepatitis B patients, there was no significant difference in the positive rate of different sex groups and different age groups (P> 0.05); 2) HBsAg, HBsAb, HBeAb, HBcAb positive mode accounted for the highest proportion in all HBsAg and HBsAb double positive cases, the percentage was 57.9％; 3) the positive rate of HBV DNA in hepatitis B patients with HBeAg positive rate were higher than HBeAg negative group in all HBsAg and HBsAb double positive cases; and the incident rate of double variation nt 1762 A-T/nt 1764 G-A in HBeAg negative group was higher than that in HBeAg positive group. There were significant differences between two groups (P < 0.05); 4) the detection rate of HBsAg and HBsAb double positive in patients with chronic hepatitis B were higher than those of asymptomatic carriers, liver cirrhosis, hepatitis B and hepatitis B hepatocellular carcinoma (P < 0.05). Conclusion The phenomenon of both positive HBsAg and HBsAb does not indicate the elimination of the hepatitis B virus infection, but it is likely suggested the mutation of the virus. It is necessary to prompt clinical detection of serum HBV DNA, so as to determine whether the virus in patients is in the replication status, and it also provide some help for clinical individualized treatment of HBsAg and HBsAb double positive patients.
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Objective@#Many physicians and patients still have concerns about the safety of breastfeeding in mothers infected with hepatitis B virus; we evaluate the safety of the newborn and the women with HBeAg positive and high viral load, who received nucleoside analogues to block maternal to child transmisssion and selected postpartum breastfeeding after drug discontinuance.@*Methods@#This prospective, observational study enrolled 60 HBeAg positive patients and HBV-DNA >2*10E+ 5 IU/ml, all patients started antiviral treatment for blocking maternal to child transmission at 24-28 weeks of pregnancy. All the newborns received the active-passive immunization therapy with hepatitis B immunoglobulin (HBIG) and HBVac. After the delivery, patients with normal liver function discontinued the antiviral drug and selected breastfeeding voluntarily. The safety of breastfeeding were compared with patients selected artificial feedings, they were followed up for 7 months. Primary measurements were the proportion of mothers with abormal liver function after stopping the drug and the level of newborn’s anti-HBs at 6 months of age; secondary measurements were the positive rate of neonatal HBsAg and the HBV-DNA value of the patients at 6 weeks postpartum.@*Results@#From December 1, 2015 to May 1, 2017, 415 patients were enrolled in Beijing You’an Hospital Affiliated to the Capital Medical University and all these patients were born following full-term single-child pregnancy. After the delivery and drug withdrawal, there was no significant difference in the incidence of ALT elevation between the breast fed group and the artificially fed group: 29 /220 versus 30/195, (χ2=0.411, P=0.521). Patients continued to take the antiviral medicines between the breast feeding group and the artificial feeding group: 15 /220 versus 20/195, (χ2=1.487, P=0.223), there were no significant differences between them (P> 0.05). At the month 7, there were no significant difference between the breast fed group and the artificially fed group (747.62±374.08 mlU/ml versus 709.76±374.32 mlU/ml, t-value: 0.309, P-value>0.05). At birth, hepatitis B surface antigen (HBsAg) was detected in 15/220 and 20/195 of newborns in the breast feeding and artificially fed groups, respectively. At month 7, an intention-to-treat analysis indicated 0/220 of HBsAg infants from the breast fed versus 0/195 in the artificially fed group (P>0.05) and no significant difference was found in the rate of positive HBsAg between the two groups. In the breast fed group, the mean HBV DNA at baseline was significantly higher than that of the artificially fed group: (1.17±1.82) E+ 8 IU/ml versus (1.12±0.39)E+ 8 IU/ml, and the difference was statistically significant.@*Conclusions@#We have not found the relationship between the rate of neonatal infection and the increase of maternal abnormal liver function in HBeAg positive and high viral load patients, who chose breastfeeding after drug discontinuance.
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Objective@#To investigate the change of hepatitis B surface antibody (HBsAb) titer and its long-term protection and infection rates between 1 and 3-year-old children whose mothers were chronic hepatitis B pregnant woman with HBeAg positive and high viral load after successful blocking of mother-to-child transmission.@*Methods@#One-year-old children whose mothers were hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) positive, with HBV DNA≥106IU/ml were enrolled, then were followed up till 3 years old, and tested the five serological markers of hepatitis B and biochemical parameters at the age of one and three years respectively, and analyzed HBsAb titer, positive rate, negative rate and infection rate of 1 to 3-year-old children without enhanced vaccination; meanwhile, data of HBsAb titers at the age of 7 months were collected HBsAb titer, positive rate, and negative rate were analyzed.@*Results@#Totally 264 1-year-old children were enrolled into the study, including 178 children without enhanced vaccination between seven months and 1 year of age, and 114 children without enhanced vaccination between 1 year and 3 years of age. Our result showed that there were no infected children at the age between 1 and 3 years. HBsAb titer decreased from 7 months to 1 year old and dropped from 1 000 IU/L to 509.43 IU/L (P<0.05), and the antibody was still protective. From 1 year to 3 years old, HBsAb titer dropped from 466.72 IU/L to 67.3 IU/L (P< 0.05); at the age of 3 years, 60.52 % children were either weakly positive or negative, but still protective, but significantly less than those who had the reinforced vaccination. As a result , the children without the enhanced vaccination between 1 and 3 years of age were still at high risk.@*Conclusions@#If the antibody was protective at 7 months, children were not easily infected between 1 year and 3 years of age. At the age of 3, the antibody dropped to low or no responsive levels, and the children were still at high risk. It is necessary to take protective measures and supplement the vaccine.
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Objective To establish detection limit and clinical reportable range for detection of anti-HBs by chemiluminescence method and evaluate by clinical application.Methods Referring to the Clinical and Laboratory Standards Institute (CLSI) relevant documents,the programme of blank limit (LoB),detection limit (LoD),quantitative detection limit (LoQ),analytical range of measurement (AMR),clinical reportable range (CRR) for detection of anti-HBs by chemiluminescence method,were designed and measured.The established clinical reportable range and maximum dilution were used to predict the recovery stage of acute hepatitis B patients and to evaluate the effectiveness of different vaccines.Results LoB,LoD,LoQ,AMR and CRR for detection of anti-HBs by chemiluminescence method were 0.87,1.89,3.0,0～970.50 and 3.0 ～48 525 mIU/ml respectively,and the maximum dilution was 1 ∶ 50.The patient with acute hepatitis B showed elevated anti-HBs at fourth weeks after treatment (CRR).The anti-HBs mean was the highest in the B vaccine of the three vaccines.Conclusion The establishment of detection limit and clinical reportable range for detection of anti-HBs by chemiluminescence method was better meet the requirements of clinical laboratories,provide reliable results for clinical laboratories.
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Objective:To acquire potential HBsAb sequences,we have analyzed the BCR CDR3 repertoire of the peripheral blood with HBsAb titer higher than 10 000 mU/ml,which could provide a data basis for follow-up study.Methods:Genomic DNA of pe-ripheral blood mononuclear cells was extracted from samples with HBsAb titer higher than 10 000 mU/ml.We have adopted Illumina Solexa high-throughput sequencing technology of the Adaptive Biotechnologies ImmunoSEQ platform to acquire sequence data.IMGT/High V-QUEST was used to preliminary analyze our sequence data,including usage of IGHV,IGHJ and IGHD gene subgroups,IGHV-J matching,distribution of CDR3 amino acid (AA) length and usage of total CDR3 AA.And these sequences were compared with the HBsAb sequences from NCBI database.Results:Experimental samples have highly selected gene subgroups IGHV3,IGHV4,IGHJ4, IGHJ6,IGHD3,IGHD6,and IGHV3-J4 pairing,IGHV3-J6 pairing.The AA length distributions of CDR3 region were normal distribution with the length of 14/15 AA as the midline.In the regard to amino acid usage in CDR3 region, each sample prior used Alanine, Tyrosine,Glycine,Alanine,Aspartic acid and Serine.The amino acid usages of 107,108,109,113,114 positions were diversified but 105,106,115,116,117 positions taking conservative amino acids usages.We have found 48 unique sequences that have same IGHV, IGHJ and CDR3 AA length with the HBsAb sequences from NCBI database.Conclusion:There were almost the same characteristics of BCR CDR3 repertoire of the peripheral blood with HBsAb titer higher than 10 000 mU/ml.The 48 unique sequences provided a solid data basis for the follow-up study.
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Objective To analyze the conformance between the quantitative and qualitative tests of hepatitis B surface antibody (anti-HBs).Methods The chemiluminecence microparticle enzyme immunoassay(CMIA)was adopted to quantitatively detect anti-HBs and the enzyme linked immunosorbent assay(ELISA)was adopted to qualitatively detect anti-HBs.Results With the CMIA as the reference experiment,Se ,Sp ,J ,PV+ and PV-of anti-HBs detected by ELISA were 0.95,0.53,0.48,0.74 and 0.88 respec-tively,k=0.51;when the absorbance was 0.400 9,Se ,Sp ,J ,PV+ and PV-were 0.50,0.95,0.45,0.93 and 0.43 respectively;for the samples exceeding the absorbance range of 0.104 3 -0.400 9,Se ,Sp ,J ,PV+ and PV-qualitatively detected by ELISA were 0.90,0.91,0.81,0.93 and 0.88 respectively,k =0.81.Conclusion Determining cutoff value with the absorbance value 0.105 as the ELISA detection result has the good detection sensitivity(Se =0.95)and the better negative prediction value(PV-=0.88),the negative anti-HBs detected by ELISA may be considered that the anti-HBs concentration was less than 10 mIU/mL without the conservation value;when the sample absorbance ≥0.400 9,the anti-HBs concentration is ≥10 mIU/mL,which may be considered to have the conservation value;the gray area range of anti-HBs detected by ELISA is mainly the absorbance of 0.105-0.400 9,the true anti-HBs level should be quantitatively detected.
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BACKGROUND: The aim of this study was to report the first experience of using tests of antibody to hepatitis B core antigen (anti-HBc) and antibody to hepatitis B surface antigen (anti-HBs) for the selection of blood donors in a tertiary hospital blood center in Korea. METHODS: From January 2005 to December 2007, the data of all eligible donors according to the Korean Blood Regulation Law were analyzed. Anti-HBc testing was performed in all donors, but anti-HBs was tested only in anti-HBc seropositive donors. Anti-HBs negative but anti-HBc positive donors were regarded as ineligible for blood donation. Cost for donor testing was calculated based on Korean health insurance payment schedule from 2005 to 2007. RESULTS: The seroprevalence of anti-HBc in blood donors was 23.2% (162/699) and increased with increasing age. The proportion of ineligible donors for blood collection was 2.7% (19/699) of total donors and 11.6% (19/162) of anti-HBc seropositive donors. The cost of testing for anti-HBc and anti-HBs was estimated to be about 40% of the total screening cost. CONCLUSIONS: Although additional donor screening tests for anti-HBc and anti-HBs requires increased cost and relatively small number of donors are additionally excluded by these tests, they are considered to be helpful for the safety of blood products, because our blood center has characteristics with small number of donors and relatively high percentage of donors in the age group of thirties and older.
Subject(s)
Adolescent , Adult , Humans , Middle Aged , Age Factors , Blood Banks , Blood Donors , Hepatitis B/diagnosis , Hepatitis B Antibodies/blood , Hepatitis B Core Antigens/immunology , Hepatitis B Surface Antigens/immunology , Korea , Laboratories, Hospital , Seroepidemiologic Studies , Serologic Tests/economicsABSTRACT
PURPOSE: Hypogammaglobulinemia has been observed in nephrotic syndrome, but its pathophysiology remains unknown. We evaluated serum immunoglobulins, IgG subclasses, and vaccine-induced viral antibodies(anti-hepatitis B surface IgG and anti-measles IgG) in children with minimal change nephrotic syndrome(MCNS). METHODS: Using the stored sera, the levels of immunoglobulin(IgG, IgM, IgA, and IgE) and IgG subclasses(IgG 1, 2, 3, and 4), anti-HBs Ab and anti-measles IgG of 21 children with MCNS were analyzed and compared to those of 25 age-matched healthy children. RESULTS: The mean values of IgG and IgG1 were 390+/-187 mg/dL and 287+/-120 mg/dL in nephrotic children, and 1,025+/-284 mg/dL and 785+/-19 mg/dL in control children, respectively. The values of the total IgG and the 4 IgG subclasses in nephrotic children were all significantly depressed(P<0.001), but the IgM(251+/-183 mg/dL vs. 153+/-55 mg/dL, P=0.02) and IgE values(P=0.01) were elevated, and the IgA values were not changed. The seropositivity of anti-HBs IgG was 42.9%(9 of 21 cases) in the MCNS group and 52%(13/25) in the control group, and that of anti-measles IgG was 76%(16/21) and 92%(23/25), respectively, but there was no statistical difference between the two groups. CONCLUSION: IgG and IgG subclass levels in MCNS children are all depressed without significant seronegativity of the vaccine-induced viral antibodies. Further studies are needed to resolve the cause of hypogammaglobulinemia in MCNS.