These authors contributed equally to this work.
Article first published online: 28 DEC 2012
Copyright © 2012 American Association for the Study of Liver Diseases
Volume 57, Issue 1, pages 37–45, January 2013
How to Cite
Wu, T.-W., Lin, H. H. and Wang, L.-Y. (2013), Chronic hepatitis B infection in adolescents who received primary infantile vaccination. Hepatology, 57: 37–45. doi: 10.1002/hep.25988
Potential conflict of interest: Nothing to report.
- Issue published online: 7 JAN 2013
- Article first published online: 28 DEC 2012
- Accepted manuscript online: 1 AUG 2012 07:35AM EST
- Manuscript Accepted: 17 JUL 2012
- Manuscript Received: 25 APR 2012
- National Science Council, Taiwan. Grant Number: NSC97-2314-B-715-001-MY3
- Mackay Medical College, Taiwan. Grant Number: 981B03, 991A01
Hepatitis B virus (HBV) infection is a global health issue. Universal infantile hepatitis B (HB) vaccination is very efficacious. However, HBV infections among those immunized subjects have been reported. The long-term efficacy of postnatal passive-active HB vaccination in high-risk subjects is not well explored. A total of 8,733 senior high school students who were born after July 1987 were assayed for hepatitis B surface antigen (HBsAg) and antibodies to HBsAg (anti-HBs). The overall HBsAg and anti-HBs-positive rates were 1.9% and 48.3%, respectively. The HBsAg-positive rate was 15% in HB immunoglobulin (HBIG) recipients (adjusted odds ratio [OR]: 15.63; 95% confidence interval [CI]: 10.99-22.22). Among students who did not receive HBIG, there was a significantly negative association between HB vaccination dosage and HBsAg-positive rate (P for trend = 0.011). Adjusted ORs for those who received 4, 3, and 1 to 2 doses were 1.00, 1.52 (95% CI: 0.91-2.53), and 2.85 (95% CI: 1.39-5.81), respectively. Among HBIG recipients, the HBsAg-positive rate was significantly higher in subjects with maternal hepatitis B e antigen (HBeAg) positivity and who received HBIG off-schedule. A booster dose of HB vaccination was administered to 1974 HBsAg- and anti-HBs-negative subjects. Prebooster and a postbooster blood samples were drawn for anti-HBs quantification. The proportions of postbooster anti-HBs titer <10 mIU/mL was 27.9%. Subjects with prebooster anti-HBs titers of 1.0-9.9 mIU/mL had significantly higher postbooster anti-HBs titers than those with prebooster anti-HBs titers of <1.0 mIU/mL (P < 0.0001). Conclusion: Having maternal HBeAg positivity is the most important determinant for HBsAg positivity in adolescents who received postnatal passive-active HB vaccination 15 years before. A significant proportion of complete vaccinees may have lost their immunological memories against HBsAg. (HEPATOLOGY 2013)