Development of Immunity to Hepatitis B Virus Following Hepatitis B Vaccination in Hemodialysis Patient

Background: Hepatitis B infection is common in Dialysis population. Hemodialysis patients have high risk of hepatitis B virus transmission not only due to frequent blood or blood product transmission, decreased response to Hepatitis B vaccine and length on hemodialysis but also due to their immunosuppressed state. Hepatitis B vaccination has the potential to reduce the risk of HBsAg infection in dialysis units. Effective vaccination, blood donor screening, the use of erythropoietin and the isolation of HBV carriers have successfully regulated HBV infection in hemodialysis units (1). This study aims to assess the immunity to HBV & the seroconversion of HBsAg infection in hemodialysis unit. This retrospective observational study evaluated serological markers, hepatitis B vaccination status and co morbidities which can affect the immunity levels of patients undergoing hemodialysis. The patient’s data were collected from laboratory investigations and patient record for analysis. Out of 153 CKD-5D patients on maintenance hemodialysis, 39 patients had anti HBs titer <10U/ml, 30 patients had anti HBs titer between 10-100U/ml, 38 patients had anti HBs titer between100-1000 U/ml, 21 patients had anti HBs titer >1000U/ml and 24 patients didn’t check their titer value. Hypertension was the common co morbidity followed by anaemia and diabetes mellitus.

Causes of delayed vaccination of hepatitis B vaccine and BCG in 1 129 children with special health status in Chongqing / 公共卫生与预防医学

Objective To analyze the status of hepatitis B and BCG vaccination in children with special health status, and analyze the reasons for the delay of vaccination, so as to improve the timely vaccination rate. Methods A total of 1 129 children with special health status who were registered and vaccinated in our hospital from September 1, 2018 to January 23, 2020 were selected. All children were classified according to the major diseases based on the discharge records. The first injection time of hepatitis B and BCG vaccine was extracted, and the children were divided into different groups based on the number of people who delayed vaccination. The comparison between groups was performed by χ2 test. Results A total of 87 children without hepatitis B vaccination and 85 children without BCG vaccination were immediately vaccinated in our hospital after the establishment of the archives in our hospital. None of the 1 129 children with special health status had serious adverse reactions after vaccination. The most common diseases in the delayed hepatitis B vaccination children were premature infants, cardiovascular diseases, and nervous system diseases. The most common diseases in the delayed BCG vaccination children were premature infants, cardiovascular diseases, and neonatal disease. There was a significant difference between the number of delayed hepatitis B vaccination and the number of delayed BCG vaccination, with the number of delayed BCG vaccination being more (χ2=278.24, P<0.00). Conclusion Delayed vaccinations are common in children with special health status. Normal vaccination does not increase the incidence of adverse reactions in children with special health status. Medical staff’s understanding of diseases, types of diseases, and types of vaccines are important factors affecting the vaccination of children with special health conditions. Support from social environment, the understanding and cooperation from children's parents and guardians, and the understanding of medical workers on vaccines and diseases are the keys to truly improve the vaccination rate of children..

Seroprevalence of anti-HBs antibodies and the need for booster vaccination in children under 5 years of age born to HBsAg-negative mothers

Objective: To determine the proportion of HBV surface antigen (anti-HBs) antibody positive children under five years of age born to HBsAg-negative mothers and to analyze the possible related factors following implementation of a hepatitis B vaccination program for infants in Indonesia 22 years ago. Methods: Blood samples were taken from children under five years of age born to HBsAg-negative mothers who have completed primary vaccination series. Anti-HBs antibodies were determined by using rapid test. Data of age, gender, nutritional status, vaccination timing or vaccination compliance, and booster vaccination were collected from vaccination card. Results: Ninety children were enrolled, consisting of 47 females and 43 males with a mean age of 2.3 years. Twenty two (24.4%) children received booster vaccine between 18 and 24 months and 55 (61.1%) were anti-HBs positive. Among factors of age, gender, nutritional status, compliance to vaccination and booster vaccine, only administration of booster vaccine was significantly associated with anti-HBs status (OR 5.45, 95% CI 1.45, 20.52). Children who received booster vaccine at age of 18-24 months were 5.45 times more likely to be anti-HBs positive than that of children who did not receive booster vaccine. Conclusions: Booster vaccine rate is low among children under 5 years of age but is associated with anti-HBs positivity. Booster vaccination may be required to improve anti-HBs seropositivity.

Hepatitis B Vaccination and Factors Related with Unresponsiveness in Healthy Children

ABSTRACT Background: The aim of this study was to assess the effectiveness of hepatitis B vaccination and factors associated with vaccine unresponsiveness in healthy children. Methods: A total of 141 healthy children aged between two and five years were included in the study. All of the cases had received 20 μg of recombinant DNA vaccine for hepatitis B (0, 1 and 6 months). Demographic features and factors such as duration of breastfeeding, exposure to HBsAg-positive family members, administration of concomitant vaccines and exposure to smoke were determined. Hepatitis B vaccination serological markers were evaluated. Post-vaccination serologic evaluation was performed one month after the last dose of primary vaccination, one month after the booster dose. Human leukocyte antigens typing was performed in non-responders. Results: Only 87.9% of the children achieved seroprotection antibodies to hepatitis B surface antigen (anti-HBsAG titers ≥ 10 mIU/ml) one month after primary vaccination. No difference was observed between vaccine responsiveness and age, gender, birthweight, maturity, duration of breastfeeding, exposure to HBsAg-positive family members, and mid-upper arm circumference (p > 0.05). HLA types, DRB 111 (64.7%), B5 (52.9%), DRB 104 (52.9%) and DRB 11001 (47%) were detected at increased frequency in non-responders. The antibody titers were significantly higher in children who breastfed for the first six months and longer and who were vaccinated concomitantly with other common vaccines. Conclusion: The seroprotection antibodies to hepatitis B surface antigen correlated with breast feeding and hepatitis B vaccination concomitant with other common vaccines. HLA types DRB 111, B5, DRB 104 and DRB 11001 had increased frequency in non-responders.

Perception Of Hepatitis B And Adult Hepatitis B Vaccination: A Pilot Study Among Malaysian Households Using Malay Version Questionnaire

@#Hepatitis B (HB) is an upcoming health issue in Malaysia. Even though the Expanded Programme on Immunisation (EPI) for HB vaccination implemented by the Malaysia government in 1989, individuals born before 1989 were not covered under the EPI and should immunised against the HB virus. Examining the Malaysians’ perception of vaccination is very important in order to determine their behaviour regarding HB vaccination. Most of the studies only gave priority to analysing this issue from an occupational risk perspective, consumers’ perceptions of the HB vaccination are still lacking. This study is aimed at assessing the validity and reliability of the Malay version of the perception questionnaire used for Malaysian households. A pilot study involving 300 respondents was conducted in six districts in the Selangor area. Factor analysis constructed four components: perceived sustainability, perceived severity, perceived benefit and perceived barriers loaded on the corresponding component with factor loading of more than 0.5. Principal component analysis of the finalised 13 items explained the instrument of the variance, which was 59.7% in total, 20.3%, 14.5%, 12.5% and 12.4% explained by the four constructs. The Cronbach alpha for the items instruments is 0.5 to 0.8 which shows that moderate internal consistency exists and demonstrates reliability of the questionnaire. The frequency of the four constructs shows that most of the respondents worry about getting infected with HBV, the perceived severity level is high among respondents, they perceived benefit from getting an HB vaccination and perceived low barriers to getting the HB vaccination.

Anti-HBs Antibodies over time in healthcare workers

Background: In developing countries including India only 18 % HCWs are vaccinated against HBV. Inspite of all the recommendations, compliance to vaccination remain poor in majority of health care settings. Aims & Objectives: To estimate serum levels of anti-HBs antibodies in healthcare workers and to correlate the values of Anti-HBs level over time in health care workers. Materials and Methods: This cross-sectional study was conducted on Health care workers of tertiary care hospital. Their demographic details and hepatitis B vaccination history was recorded as per performa. Serum samples of all the subjects were tested for Anti-HBs levels by VIDAS-PC equipment. Results: Out of the 294 HCWs enrolled, 84% (247) were fully vaccinated whereas 16%(47) were partially vaccinated. The vaccination rate was highest among nursing staff (74.9%) followed by doctors (13.8%). 3% of doctors and 12.4% of nurses are still at risk of acquiring HBV infection. On anti -HBs titer estimation, 9.7% of the HCWs had anti-HBs titer < 10 mIU/ml while 90.3% had titre > 10 mIU/ml. Conclusion: This study demonstrated that Hepatitis B immunization must be made compulsory for hospital staff in every health care setting as well as to check their anti HBs titres.

Hepatitis B seroepidemiology and booster vaccination in pre-clinical medical students in a Malaysian university

@#Introduction: Infant hepatitis B vaccination was introduced into the Expanded Programme on Immunisation (EPI) in Malaysia in 1989. This study aimed to investigate seroprevalence of hepatitis B among UKM pre-clinical medical students, born between 1991 and 1995, and had their infant vaccination more than 20 years ago. Materials and Methods: A prospective, cross-sectional study involving 352 students, comprising 109 (31.0%) males and 243 (69.0%) females. Blood specimens were tested for anti-HBs, where levels of ≥10 mIU/mL was considered reactive and protective. Students with non-reactive levels were given a 20 µg HBV vaccine booster. Anti-HBs levels were tested six weeks after the first booster dose. Those with anti-HBs <10 mIU/mL were then given another two booster doses, at least one month apart. Anti-HBs levels were tested six weeks after the third dose. Results: Ninety-seven students (27.6%) had anti-HBs ranging from 10 to >1000 mIU/ mL while 255 (72.4%) had anti-HBs <10 mIU/mL. After one booster dose, 208 (59.1%) mounted anti-HBs ≥10 mIU/mL. Among the remaining 47 (13.3%), all except two students (0.6%) responded following completion of three vaccination doses. They were negative for HBsAg and anti-HBcore antibody, thus regarded as non-responders. Conclusions: Anti-HBs levels waned after 20 years post-vaccination, where more than 70% were within non-reactive levels. For healthcare workers, a booster dose followed by documenting anti-HBs levels of ≥10 mIU/mL may be recommended, to guide the management of post-exposure prophylaxis. Pre-booster anti-HBs testing may not be indicated. Serological surveillance is important in long-term assessment of HBV vaccination programs. No HBV carrier was detected.

Cost-effectiveness of community-based treatment of chronic hepatitis B in China / 中华流行病学杂志

Objective Since eliminating hepatitis B in China would need considerable public health resources,the economics problem of the strategy of community-based antiviral treatment for chronic hepatitis B (CHB) has become an important issue.The cost-effectiveness and affordability of the strategy were evaluated in this study.Methods According to the advocacy on eliminating hepatitis B by WHO and the comprehensive protocol of community based prevention of major infectious diseases and the guideline for CHB prevention and treatment in China,the decision analytic Markov model was constructed with the parameters from national surveys or Meta-analysis.A cohort population aged 20-59 years was used as study subjects.The strategy of CHB antiviral treatment was compared with the strategies of hepatitis B vaccination and non-intervention,respectively.The costs and disability-adjusted life years (QALYs) of the strategies were calculated from the societal and payer perspectives.The incremental cost-effectiveness ratio (ICER) and the cost-effectiveness ratio (CER)were calculated for the comparison of the strategies.One-way and probability sensitivity analysis were performed for uncertainty of the results.And the cost-effectiveness and affordability curves were introduced to estimate the budget impact on the strategies.Results In the Chinese aged 20-59 years,the ICER of CHB antiviral treatment was 37598.6 yuan (RMB) per QALYs and the ICERs were smaller in the low age groups,indicating that the antiviral treatment strategy is cost-effective and low age groups should be the priority population.The ICER of hepatitis B vaccination was-64 000.0 yuan (RMB) per QALYs,indicating that hepatitis B vaccination is cost saving.The CER of CHB antiviral treatment ranged from 731.8 to 1813.3 yuan (RMB) pcr QALYs compared with hepatitis B vaccination,and the CER of CHB antiviral treatment was higher than that of hepatitis B vaccination in all age groups,indicating that hepatitis B vaccination would be more cost-effective than CHB antiviral treatment.The price of antiviral drug,entercavir,can influence the cost effectiveness of CHB antiviral treatment.If the price of entercavir declined half,CHB antiviral treatment would be cost-saving.The probability sensitivity analysis showed that people's willing to pay for CHB antiviral treatment should not be ignored,although the results of economics evaluation of CHB antiviral treatment were reliable.The results of affordability analysis indicated that the antiviral treatment strategy could not be implemented with the budget lower than 30 million yuan (RMB),the probability of implementing the strategy was 42.6％ if the budget reaches 127 million yuan (RMB),and only when the budget reaches 269 million yuan (RMB),the goal of CHB antiviral treatment strategy can be fully realized.Conclusions Although the strategy of CHB antiviral treatment as prevention in Chinese aged 20-59 years is cost-effective,it is not an appropriate public health measure due to the high cost.The cost effectiveness would be higher by conducting hepatitis B vaccination and then antiviral treatment in susceptible population.

Cost-effectiveness of community-based treatment of chronic hepatitis B in China / 中华流行病学杂志

Objective Since eliminating hepatitis B in China would need considerable public health resources,the economics problem of the strategy of community-based antiviral treatment for chronic hepatitis B (CHB) has become an important issue.The cost-effectiveness and affordability of the strategy were evaluated in this study.Methods According to the advocacy on eliminating hepatitis B by WHO and the comprehensive protocol of community based prevention of major infectious diseases and the guideline for CHB prevention and treatment in China,the decision analytic Markov model was constructed with the parameters from national surveys or Meta-analysis.A cohort population aged 20-59 years was used as study subjects.The strategy of CHB antiviral treatment was compared with the strategies of hepatitis B vaccination and non-intervention,respectively.The costs and disability-adjusted life years (QALYs) of the strategies were calculated from the societal and payer perspectives.The incremental cost-effectiveness ratio (ICER) and the cost-effectiveness ratio (CER)were calculated for the comparison of the strategies.One-way and probability sensitivity analysis were performed for uncertainty of the results.And the cost-effectiveness and affordability curves were introduced to estimate the budget impact on the strategies.Results In the Chinese aged 20-59 years,the ICER of CHB antiviral treatment was 37598.6 yuan (RMB) per QALYs and the ICERs were smaller in the low age groups,indicating that the antiviral treatment strategy is cost-effective and low age groups should be the priority population.The ICER of hepatitis B vaccination was-64 000.0 yuan (RMB) per QALYs,indicating that hepatitis B vaccination is cost saving.The CER of CHB antiviral treatment ranged from 731.8 to 1813.3 yuan (RMB) pcr QALYs compared with hepatitis B vaccination,and the CER of CHB antiviral treatment was higher than that of hepatitis B vaccination in all age groups,indicating that hepatitis B vaccination would be more cost-effective than CHB antiviral treatment.The price of antiviral drug,entercavir,can influence the cost effectiveness of CHB antiviral treatment.If the price of entercavir declined half,CHB antiviral treatment would be cost-saving.The probability sensitivity analysis showed that people's willing to pay for CHB antiviral treatment should not be ignored,although the results of economics evaluation of CHB antiviral treatment were reliable.The results of affordability analysis indicated that the antiviral treatment strategy could not be implemented with the budget lower than 30 million yuan (RMB),the probability of implementing the strategy was 42.6％ if the budget reaches 127 million yuan (RMB),and only when the budget reaches 269 million yuan (RMB),the goal of CHB antiviral treatment strategy can be fully realized.Conclusions Although the strategy of CHB antiviral treatment as prevention in Chinese aged 20-59 years is cost-effective,it is not an appropriate public health measure due to the high cost.The cost effectiveness would be higher by conducting hepatitis B vaccination and then antiviral treatment in susceptible population.

Knowledge and awareness regarding hepatitis B infection among medical and dental students: a comparative cross sectional study.

Background: Healthcare workers have a high risk of exposure to various infections like HIV, hepatitis B and C. Among these, the risk of exposure and infectivity is highest with hepatitis B. Sadly, among a majority of healthcare workers, awareness regarding this serious disease which is also preventable by vaccination, is lacking. This study was conducted with the objective of assessing the level of awareness and attitudes among medical and dental students regarding hepatitis B infection. Methods: This was a self-reported questionnaire-based study conducted among randomly selected medical and dental college students. The questionnaire included questions regarding hepatitis B infection, modes of transmission, vaccination schedule and attitudes towards hepatitis B patients in clinical practice. Results: A total of 246 students were interviewed of whom 144 (59%) and 102 (41%) were medical and dental students respectively. Overall, awareness levels were higher among medical students than dental students. We also found that female students were more knowledgeable than male students among both medical and dental student groups, with regard to awareness of hepatitis B infection as well as knowing the vaccination schedule, life-threatening complications and treatment and practice aspects. Approximately 60% of the dental students and less than 1% of the medical students were not vaccinated against hepatitis B. Conclusions: This study showed that overall awareness regarding hepatitis B is at a very basic level among the health care providers of the future and measures need to be taken to create complete awareness.

Association of the immune response to hepatitis B vaccination with HLA-DRB1 * 12 allele as well as the expression level of IL-4 and IFN-γ cytokines / 中华微生物学和免疫学杂志

ObjectiveTo elucidate the association of immune response to hepatitis B vaccination with HLA-DRB1 * 12 allele as well as the level of IL-4 and IFN-γ.MethodsSeventy-four healthy college students from Guangxi province who had non- or hypor -response to recombinant hepatitis B vaccination and 64 medium- or hyper-responders with the conditions of similar were selected randomly and involved in this study.HLA-DRB1 * 12 was detected by PCR-SSP,the level of IFN-γ and IL-4 cytokines were examined by ELISA.Results(1)The allelic frequencies of HLA-DRB1 * 12 was lower in the non- or hypor-responders than that in the medium- or hyper-responders ( 10.8％ vs 32.8％,P=0.002) ; (2)The expression level of IFN-γ in the non- or hypor-responders ( 7.21±7.92 ) ng/ml was much less than that of the medium- or hyper- responders ( 16.36± 11.00) ng/ml ( P=0.000).(3) The expression level of IL-4 in the non- or hyporresponders (3.18±4.45) ng/ml was much less than that of the medium- or hyper- responders (7.76±5.71 ) ng/ml(P=0.000).(4)No significant differences was seen between the expression level of IFN-γ in the HLA-DRB1 * 12 positive ( 13.18± 11.24) ng/ml and the negative ( 11.00± 10.29 ) ng/ml ( P =0.349 ).(5)No significant differences was seen between the expression level of IL-4 in the HLA-DRB1 * 12 positive (5.947±4.530) ng/ml and the negative (5.132±5.800) ng/ml (P=0.423).ConclusionHLA-DRB1 * 12 might be the allele enhanced immune response to hepatitis B vaccination.The expression levels of IFN-γand IL-4 correlating to Thl/Th2 cells might affect on the immune response to hepatitis B vaccination.

Efficacy of the intervention with anti-HBV immunoglobulin and hepatitis B vaccination within 24 hours after birth for neonates in Hanoi

Background: Previous studies showed that B hepatitis prevalence in Vietnam was very high and the rate of mother-to-child transmission was range from 44.7% to 45.2%. Objectives: Study on the efficacies of the interventional methods with anti-HBV immunoglobulin and hepatitis B vaccination within 24 hours after birth for neonates in Hanoi. Subjects and method: This interventional study was carried out on 163 neonates of positive-HBsAg mothers who were admitted to Hanoi Obstetrical Hospital from 6/2005 to 3/2007. These neonates received anti-HBV immunoglobulin and hepatitis B vaccination within 24 hours after birth, then were followed up for 11 to 18 months. Results: Among these 163 neonates that received interventions, there were 135 neonates that underwent HBsAg tests after 11 to 18 months. The results showed that only one newborn baby had positive HBsAg (0.74%) and 134 neonates with non-HBV (99.26%). 81.5% of neonates had hepatitis B surface antibody that can protect against HBV. Conclusion: Early interventions with anti-HBV immunoglobulin and HBV vaccination were effective in preventing HBV for neonates of positive-HBsAg mothers.

Economic effect of 2 hepatitis B vaccination methods in medical center and working place in HoChiMinh city, 2003

The economic effectiveness of two model of B hepatitis immunization for the group of 20-29 years old living in Ho Chi Minh city was analyzed in the year 2003. The related parameters were: HBV incidence, the protecting effect the vaccin, the complicance of immunization schedule, the cost of vaccin and of laboratory assay, the travelling cost, the income loss, service fee devoted for health staff. Result showed that the model of supplies of vaccin in living and working fields for users had had absolute predominance with 1 diminutrition of 7.345.000 VND for 100 cases of preventive vaccination

Effect of Simultaneous Administration of Hepatitis B Vaccine with DPT and Oral Polio Vaccine

PURPOSE: The universal vaccination against hepatitis B during early infancy is the only effective way to control hepatitis B infection in highly endemic areas in Korea. The purpose of this study was to assess the effectiveness of simultaneous hepatitis B vaccination with DPT and oral polio at 2, 4, 6 months of age in babies of HBs antigen negative mothers. METHODS: One hundred and eighty-one infants who were admitted to the Neonatal Intensive Care Unit (NICU), Chonnam University Hospital from August, 1994 to December, 1995 were enrolled in this study. Infants received Hepavax-B 0.5ml (10 microgram) at contralateral thigh intramuscularly, simultaneously with DPT vaccination. Antibody was assessed by MEIA (microparticle enzyme immunoassay) at seven to nine months of age. RESULTS: The seroconversion rate of Hepatitis B after vaccination was 98.3%. There were no significant differences in positive rate of antibody according to gestational age, birth weight and sex. Seroconversion rate to hepatitis B in twins was lower than in singlets. Twenty-two infants among 23 infants, who were able to assess antibody titer, showed effective antibody titer, above 100mIU/ml. CONCLUSION: The results suggest that the simultaneous administration of hepatitis B vaccine with DPT/TOPV is very effective and simplifies schedule. Moreover, this schedule will improve the compliance of vaccination.

The risk factors of the nonresponders after hepatitis B vaceinatio and the immunogenecity after a double-dose revaccination in the nonresponders

BACKGROUND: Korea is an endemic area of viral hepatitis B with a rate of 5~10% carrier state. Therefore, hepatitis B vaccination is performed nationwide. But 5~15% of healthy individuals fail to respond adequately to the vaccine and an approved guideline for the nonresponders has not been developed yet. This study is designed to identify risk factors for those who lack anti-HBs after hepatitis B vaccination and to document the results of a double-dose revaccination in such nonresponders to the primary vaccination. METHODS: From Feb. 1996 to Aug, 1997, we assessed 51 healthy subjects(HBs Ag negative, anti-HBs negative, anti-HBc negative and a normal LFT). All subjects were vaccinated with Hepavax- B, 1.0ml, 24 by a rapid schedule(0, 1, and 2 months) and 27 by a standard schedule(0, 1, and 6 months). Anti-HBs titers were evaluated 3 months after the third vaccine and assessed the nonre-sponders (anti-HBs titer<2mIu/ml) and the hyporesponders(2~10mK/ml). All 13 nonresponders were revaccinated with 2ml of Hepavax-B 3 months after the primary vaccination. Anti-HBs titers were evaluated 1 month later. RESULTS: The differences in age(p<0.01) and smoking amount(p<0.05) between the responders and the hypo and the nonresponders were statistically significant. There were more males and higher body mass index in the hypo and the nonresponders but not statistically significant. The seroconversion rate after the double-dose vaccination was 92.3%(12/13) with an average titer of 5K08mlU/ ml(1-132.4mIU/ml). CONCLUSIONS: Increase in age and smoking amount were the risk factors of the nonresponders after the primary vaccination. Most of the hypo and the nonresponders to the primary vaccination responded adequately to the double-dose revaccination.

Serum HBsAg and Anti-HBs Positive Rate among a City Health Center Visitors / 예방의학회지

Hepatitis B virus(HBV) infection is one of the major health problems in Korea and HBsAg positive rate was known to be about 5~15% in general population. This study was conducted to identify the positive rates of serum HBsAg and anti-HBs among community population regared as having high HBV vaccination rate than in previous decade, using EIA(Enzyme immunoassay) method, in Seo-Gu, Taegu, Korea. The study subjects were 1,160 who visited Seo-Gu Health Center for check-up serologic markers of hepatitis B. The data were obtained from the serologic test for hepatitis markers and questionnaire survey was conducted to obtain the general characteristics, vaccination history, past history of hepatitis and other liver disease , and exposure history to risk factors of hepatitis of the study subjects. The positive rates of HBsAg and anti-HBs were 5.2% and 62.4% respectively. The positive rates of HBsAg for male and female were 6.6% and 4.3% respectively. The age was divided into two groups as group I(less than 15 years old), group II(more than 16years old) according to the hypothesis that these two groups might be different in HBV vaccination rate. HBV vaccination rates for group I and II were 83.1% and 52.3%. The positive rates of HBsAg for group I and II were 2.6% and 6.5%. The positive rates of HBsAg for the vaccinated people of the group I and II were 2.2% and 3.5%, the positive rates of anti-HBs for the vaccinated people of the group I and II were 70.1% and 71.1% respectively. The most significant factor in positive rate of HBsAg was 'hepatitis carrier in family'. Multiple logistic regression analysis revealed that 'hepatitis history' and 'hepatitis carrier in family' were significant variables for positivity of HBsAg, and 'hepatitis B vaccination' was only a significant variable for positivity of anti-HBs.

Recent Changes in Prevalence of Hepatitis B Viral Markers in Preschool Children in Seoul,1995

PURPOSE: A nationwide hepatitis B vaccination publicity campaign and program was launched in 1988 in Korea. This survey was designed to evaluate the recent changes of the positive rates of hepatitis B surface antigen and antibody in sampled preschool children living in Seoul, 1995. METHODS: Study population consisted of 218 preschool children aged 2 to 5 years. Most of them had been immunized against hepatitis B in accordance with the schedule in early infancy. Blood samples were tested for HBsAg, HBsAb and HBcAb by radioimmunoassay. RESULTS: Of 218 children, 214(98.2%) had received hepatitis B vaccination. Two of 218(0.9%) was surface antigen positive. The positive rates of HBsAb in age groups were 68.2, 73.6, 71.6, and 66.7% from 2 to 5 years, respectively (mean 70.6%). They showed no significant difference with aging. One(0.6%) of 154 who were HBsAb positive was HBcAb positive. CONCLUSIONS: Most of the children who were HBsAb positive acquired the antibodies by immunization, and vertical transmission is rare recently. Our findings suggest that the effective administration of vaccination with the help of publicity campaign lowers HBV transmission and increases positive rate of HBsAb.

Experience in hepatitis B vaccination in general population.

There were 1,544 healthy people requested for hepatitis B vaccinations and blood testing from the Health Service Unit in the Siriraj Hospital’s Centennial Anniversary Fair from April 27, to May 7, 1988. The ages of those 689 people ranged from 1-70 years received hepatitis B vaccination. 52.8% were children under 10 years of age. The prevalence of hepatitis B infection among 1,214 people of 6-82 years were studies. HBs Ag and anti-HBc positive were found in 9.3% of the population studied 13.7% in male, and 6% in female. Only 31.2% of this group was immuned (anti-HBs and anti-HBc positive). The discrepant markers were found as followings: 9.6% had anti-HBc positive solely, 3.6% had anti-HBc positive solely and 0.3% were positive for all 3 markers. The percentage among those with neither antigen nor antibody was 45.9%.

FURTHER STUDY ON HEPATITIS B VACCINATION STRATEGY / 西安交通大学学报(医学版)

With decision tree model, both net utility and cost-benefit were analysed to comprehensively assess hepatitis B vaccination strategy in China. The result showed that neonates shoulUbe taken as the most favourable vaccinated population, infants aged 0～3 years the next, and immediate vaccination scheme was recommended. Although vaccination would result in negative benefit in the population aged 7 and over, certain net utility was also gained, Therefore we suggest that the subjects to be vaccinated be extended in due course.