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Published on: September 25, 2019
[Follow-up on hepatitis B immunized neonates born to HBsAg positive mothers]
Insights
Hepatitis B (HB) immunization in neonates born to infected mothers provides over 90% antibody protection for six years. A booster dose appears unnecessary within this timeframe, as no chronic carriers were detected.
Area of Science:
- Immunology
- Vaccinology
- Hepatology
Context:
- Neonates born to mothers positive for hepatitis B surface antigen (HBsAg) are at high risk of vertical transmission.
- Timely and effective immunization strategies are crucial for preventing chronic hepatitis B virus (HBV) infection.
Purpose:
- To evaluate the long-term immune persistence of antibodies against HBsAg (anti-HBs) in neonates born to HBsAg-positive mothers following different HB vaccine schedules.
- To assess the carriage status of HBsAg in these children over a six-year follow-up period.
Summary:
- Two hundred and three neonates received HB vaccine at birth with varying schedules and doses.
- Antibody prevalence against HBsAg remained above 90% for six years, peaking between 7-12 months and stabilizing after age two.
- No chronic HBsAg carriers were identified, and antibody conversion to negative did not result in infection or sustained loss of immunity.
Impact:
- The findings suggest that current primary immunization schedules provide robust and sustained protection against HBV infection in high-risk neonates.
- A booster dose of HB vaccine may not be required for children up to ten years post-primary immunization, potentially optimizing vaccination strategies and reducing healthcare costs.
Objective:
To determine the immune persistence in neonates born to hepatitis B surface antigen (HBsAg) positive mothers with different schedules for HB immunization.
Methods:
Two hundred and three neonates born to HBsAg positive mothers were immunized at birth with HB vaccine in different schedules and doses, and followed-up for six years continuously for antibodies against HBs (anti-HBs) and carriage status of HBsAg.
Results:
Prevalence of anti-HBs in the neonates kept in more than 90% during the six years since immunization, with a peak at the ages of seven to twelve months and decreasing by 48.82% at the ages of one to two years. Their anti-HBs kept relative stable during two to six years of age. Eight children converted to anti-HBs negative for three to five years still kept uninfected. Fourteen children converted to anti-HBs negative reconverted positive again one to two years later. No single chronic carrier with HBsAg was found in them.
Conclusion:
A booster dose of HB vaccine seems unnecessary for children in six to ten years after primary immunization.
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