1887

Abstract

. Tunisia is an intermediate hepatitis B virus (HBV) endemic country. The vaccination against hepatitis B was introduced in 1995 including four doses with a first dose administrated at birth. Decreasing the level of antibodies against hepatitis B surface antigen (anti-HBs) over time can be alarming. This study was conducted to explore the anti-HBV immune response among children under 6 years old, vaccinated according to the national vaccination schedule, by evaluating the immunological response to primary vaccination and by exploring the anamnestic immune response to a booster dose.

. We conducted a cross-sectional prospective study from June 2016 to June 2017 (=180), based on voluntary participation. Children were recruited from the public pediatric ward sectors in Sahloul University Hospital of Sousse in Central Tunisia. An anti-HB titre was determined based on electro-chemiluminescence micro-particle immunoassay (ECLIA), using Elecsys Anti-HBs II kit, Roche.

. Mean age at the time of enrollment in the study was 33±14.8 months. The seroprotection rate was 77.2 %. The anti-HB titre differed significantly between the different age groups (=0.002). The predicting variable for having no seroprotective antibody level was older age. Children with anti-HB levels <10 IU l were offered an additional dose of HBV vaccine. Anamnestic response 1 month after the challenge dose was observed in 100 % of subjects. The probability of developing a high antibody response, following the booster dose increased in conjunction with an increased pre-booster antibody level.

. The response to a booster dose suggests the persistence of immune memory in almost all vaccinated individuals. Although a booster dose increases substantially anti-HB titre, the clinical relevance of such an increase remains unknown.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.001086
2019-10-08
2019-10-20
Loading full text...

Full text loading...

References

  1. World Health Organization null Hepatitis B vaccines: WHO position paper, July 2017 - Recommendations. Vaccine 2017;Jul 22:
    [Google Scholar]
  2. Hepatitis B vaccines. Releve Epidemiol Hebd 2009;84:405–419
    [Google Scholar]
  3. Chien Y-C, Jan CF, Kuo HS, Chen CJ. Nationwide hepatitis B vaccination program in Taiwan: effectiveness in the 20 years after it was launched. Epidemiol Rev 2006;28:126–135 [CrossRef]
    [Google Scholar]
  4. Beasley RP. Rocks along the road to the control of HBV and HCC. Ann Epidemiol 2009;19:231–234 [CrossRef]
    [Google Scholar]
  5. Hou J, Liu Z, Gu F. Epidemiology and prevention of hepatitis B virus infection. Int J Med Sci 2005;2:50–57 [CrossRef]
    [Google Scholar]
  6. Ben-Alaya-Bouafif N, Bahri O, Chlif S, Bettaieb J, Toumi A et al. Heterogeneity of hepatitis B transmission in Tunisia: risk factors for infection and chronic carriage before the introduction of a universal vaccine program. Vaccine 2010;28:3301–3307 [CrossRef]
    [Google Scholar]
  7. Vaccine price data In: UNICEF [website] Copenhagen: United Nations Children’s Fund;http://www.unicef.org/supply/index_57476.html 2015
    [Google Scholar]
  8. Sun Z, Ming L, Zhu X, Lu J. Prevention and control of hepatitis B in China. J Med Virol 2002;67:447–450 [CrossRef]
    [Google Scholar]
  9. Fitzsimons D, François G, Hall A, McMahon B, Meheus A et al. Long-Term efficacy of hepatitis B vaccine, booster policy, and impact of hepatitis B virus mutants. Vaccine 2005;23:4158–4166 [CrossRef]
    [Google Scholar]
  10. Wang L-Y, Lin HH. Short-Term response to a booster dose of hepatitis B vaccine in anti-HBs negative adolescents who had received primary vaccination 16 years ago. Vaccine 2007;25:7160–7167 [CrossRef]
    [Google Scholar]
  11. McMahon BJ, Bruden DL, Petersen KM, Bulkow LR, Parkinson AJ et al. Antibody levels and protection after hepatitis B vaccination: results of a 15-year follow-up. Ann Intern Med 2005;142:333–341 [CrossRef]
    [Google Scholar]
  12. Dentinger CM, McMahon BJ, Butler JC, Dunaway CE, Zanis CL et al. Persistence of antibody to hepatitis B and protection from disease among Alaska natives immunized at birth. Pediatr Infect Dis J 2005;24:786–792 [CrossRef]
    [Google Scholar]
  13. McMahon BJ, Dentinger CM, Bruden D, Zanis C, Peters H et al. Antibody levels and protection after hepatitis B vaccine: results of a 22-year follow-up study and response to a booster dose. J Infect Dis 2009;200:1390–1396 [CrossRef]
    [Google Scholar]
  14. C-Y L, Y-H N, Chiang B-L, Chen P-J, Chang M-H et al. Humoral and cellular immune responses to a hepatitis B vaccine booster 15–18 years after neonatal immunization. 2008;1971419 p
  15. Carollo M, Palazzo R, Bianco M, Pandolfi E, Chionne P et al. Hepatitis B specific T cell immunity induced by primary vaccination persists independently of the protective serum antibody level. Vaccine 2013;31:506–513 [CrossRef]
    [Google Scholar]
  16. Chaouch H, Hachfi W, Fodha I, Kallala O, Saadi S et al. Impact and long-term protection of hepatitis B vaccination: 17 years after universal hepatitis B vaccination in Tunisia. Epidemiol Infect 2016;144:3365–3375 [CrossRef]
    [Google Scholar]
  17. World Health Organization Hepatitis B vaccines who position paper. Releve Epidemiologique Hebdomadaire 2004;No 28:9 JUILLET
    [Google Scholar]
  18. Schönberger K, Riedel C, Rückinger S, Mansmann U, Jilg W et al. Determinants of long-term protection after hepatitis B vaccination in infancy: a meta-analysis. Pediatr Infect Dis J 2013;32:307–313 [CrossRef]
    [Google Scholar]
  19. Rezaei M, Nooripoor S, Ghorbani R, Ramezanshams F, Mamishi S 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
    [Google Scholar]
  20. Afzal MF, Sultan MA, Saleemi AI. Immune response and anamnestic immune response in children after a 3-Dose primary hepatitis B vaccination. J Ayub Med Coll Abbottabad JAMC 2016;28:7
    [Google Scholar]
  21. Chen Y-S, Chu C-H, Wang J-H, Lin J-S, Chang Y-C. Predictors of booster response to hepatitis B vaccine at 15 years of age: a cross-sectional school-based study. Pediatr Neonatol 2016;57:302–309 [CrossRef]
    [Google Scholar]
  22. Anderson CL, Remschmidt C, Drobnitzky F-P, Falkenhorst G, Zimmermann R et al. Hepatitis B immune status in adolescents vaccinated during infancy: a retrospective cohort study from a pediatric practice in Germany. Hum Vaccin Immunother 2016;12:779–784 [CrossRef]
    [Google Scholar]
  23. Filippelli M et al. Hepatitis B vaccine by intradermal route in non Responder patients: an update. World J Gastroenterol 2014;20:10383–10394 [CrossRef]
    [Google Scholar]
  24. Alssamei FAA, Al-Sonboli NA, Alkumaim FA, Alsayaad NS, Al-Ahdal MS et al. Assessment of immunization to hepatitis B vaccine among children under five years in rural areas of Taiz, Yemen. Hepat Res Treat 2017;2017:1–6 [CrossRef]
    [Google Scholar]
  25. Qawasmi M, Samuh M, Glebe D, Gerlich WH, Azzeh M. Age-dependentdecrease of anti-HBs titers and effect of booster doses using 2 differentvaccines in Palestinian children vaccinated in early childhood. HumVaccin Immunother 2015;11:1717–1724
    [Google Scholar]
  26. Al-Shamahy HA, Hanash SH, Rabbad IA, Al-Madhaji NM, Naser SM. Hepatitis B vaccine coverage and the immune response in children under ten years old in Sana'a, Yemen. Sultan Qaboos Univ Med J 2011;11:77–82
    [Google Scholar]
  27. Poovorawan Y, Chongsrisawat V, Theamboonlers A, Bock HL, Leyssen M et al. Persistence of antibodies and immune memory to hepatitis B vaccine 20 years after infant vaccination in Thailand. Vaccine 2010;28:730–736 [CrossRef]
    [Google Scholar]
  28. Bose D, Chandra J, Dutta R, Jais M, Ray S et al. Immune response to double dose hepatitis-B vaccine using four dose schedule in HIV infected children. Indian J Pediatr 2016;83:772–776 [CrossRef]
    [Google Scholar]
  29. Whittle H, Jaffar S, Wansbrough M, Mendy M, Dumpis U et al. Observational study of vaccine efficacy 14 years after trial of hepatitis B vaccination in Gambian children. BMJ 2002;325:569 [CrossRef]
    [Google Scholar]
  30. Xu L, Wei Y, Chen T, Lu J, Zhu C-L et al. Occult HBV infection in anti-HBs-positive young adults after neonatal Hb vaccination. Vaccine 2010;28:5986–5992 [CrossRef]
    [Google Scholar]
  31. Whittle HC, Inskip H, Hall AJ, Mendy M, Downes R et al. Vaccination against hepatitis B and protection against chronic viral carriage in the Gambia. Lancet 1991;337:747–750 [CrossRef]
    [Google Scholar]
  32. Impfkommission S. Empfehlungen Der Ständigen Impfkommission (STIKO) am Robert Koch-Institut/Stand: Juli 2012. Epidemiologisches Bulletin 2012;30:290–291
    [Google Scholar]
  33. Department of health Immunisation against infectious disease UK: Department of Health L; 2006
  34. Samandari T, Fiore AE, Negus S, Williams JL, Kuhnert W et al. Differences in response to a hepatitis B vaccine booster dose among Alaskan children and adolescents vaccinated during infancy. Pediatrics 2007;120:e373–e381 [CrossRef]
    [Google Scholar]
  35. van der Sande MAB, Waight PA, Mendy M, Zaman S, Kaye S et al. Long-Term protection against HBV chronic carriage of Gambian adolescents vaccinated in infancy and immune response in HBV booster trial in adolescence. PLoS One 2007;2:e753 [CrossRef]
    [Google Scholar]
  36. Bréchot C, Degos F, Lugassy C, Thiers V, Zafrani S et al. Hepatitis B virus DNA in patients with chronic liver disease and negative tests for hepatitis B surface antigen. N Engl J Med 1985;312:270–276 [CrossRef]
    [Google Scholar]
  37. Salama II, Sami SM, Salama SI, Rabah TM, El Etreby LA et al. Immune response to second vaccination series of hepatitis B virus among booster dose non-responders. Vaccine 2016;34:1904–1908 [CrossRef]
    [Google Scholar]
  38. Chiara F, Bartolucci GB, Cattai M, Piazza A, Nicolli A et al. Hepatitis B vaccination of adolescents: significance of non-protective antibodies. Vaccine 2013;32:62–68 [CrossRef]
    [Google Scholar]
  39. Gilca V, De Serres G, Boulianne N, Murphy D, De Wals P et al. Antibody persistence and the effect of a booster dose given 5, 10 or 15 years after vaccinating preadolescents with a recombinant hepatitis B vaccine. Vaccine 2013;31:448–451 [CrossRef]
    [Google Scholar]
  40. Sami SM, Salama II, Abdel-Latif GA, El Etreby LA, Metwally AI et al. Hepatitis B Seroprotection and the response to a challenging dose among vaccinated children in red sea Governorate. Open Access Maced J Med Sci 2016;4:219–225 [CrossRef]
    [Google Scholar]
  41. Carmody E. Time to re-evaluate the effect of the adolescent booster of hepatitis B vaccine. Int J Infect Dis 2017;60:88–90 [CrossRef]
    [Google Scholar]
  42. Weber DJ, Rutala WA, Samsa GP, Santimaw JE, Lemon SM. Obesity as a predictor of poor antibody response to hepatitis B plasma vaccine. JAMA 1985;254:3187–3189 [CrossRef]
    [Google Scholar]
  43. Wood RC, MacDonald KL, White KE, Hedberg CW, Hanson M et al. Risk factors for lack of detectable antibody following hepatitis B vaccination of Minnesota health care workers. JAMA 1993;270:2935–2939 [CrossRef]
    [Google Scholar]
  44. Alper CA, Kruskall MS, Marcus-Bagley D, Craven DE, Katz AJ et al. Genetic prediction of nonresponse to hepatitis B vaccine. N Engl J Med Overseas Ed 1989;321:708–712 [CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.001086
Loading
/content/journal/jmm/10.1099/jmm.0.001086
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error