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Hepatitis B immunisation with a reduced number of doses in newborn babies and children
Insights
A three-dose hepatitis B vaccine regimen provides superior protection compared to a two-dose regimen in infants and children. This enhanced antibody response is crucial for long-term immunity against hepatitis B virus (HBV) infection.
Area of Science:
- Immunology
- Vaccinology
- Hepatology
Background:
- Hepatitis B virus (HBV) infection poses a significant global health risk.
- Effective vaccination strategies are critical for preventing HBV transmission, especially in infants born to infected mothers.
- Optimizing vaccine schedules is essential for achieving robust and sustained immune responses.
Purpose of the Study:
- To compare the immunogenicity of a two-dose versus a three-dose hepatitis B vaccine regimen in different at-risk populations.
- To evaluate seroconversion rates and anti-hepatitis B surface antigen (anti-HBs) antibody titers.
- To determine the optimal vaccination schedule for infants and children exposed or at risk of HBV infection.
Main Methods:
- Randomized controlled trials were conducted in three groups: infants born to HBsAg-positive mothers, infants born to HBsAg-negative mothers, and children at risk aged 1-12 years.
- Participants received either a two-dose or a three-dose hepatitis B vaccine regimen, with varying intervals.
- Hepatitis B immunoglobulin (HBIG) was administered to infants born to HBsAg-positive mothers.
- Serological markers including HBsAg, anti-HBs, and anti-HBc were assessed.
Main Results:
- Infants receiving a three-dose vaccine regimen demonstrated higher seroconversion rates and geometric mean titers (GMTs) of anti-HBs compared to those receiving a two-dose regimen.
- This finding was consistent across both groups of infants, regardless of maternal HBsAg status.
- In children at risk, both two-dose and three-dose regimens yielded satisfactory seroconversion rates and anti-HBs GMTs.
Conclusions:
- A three-dose hepatitis B vaccination schedule is more immunogenic than a two-dose schedule in infants, leading to higher antibody levels.
- The three-dose regimen is recommended for infants, particularly those born to HBsAg-positive mothers, to ensure adequate protection against HBV.
- While satisfactory, the two-dose regimen may be considered for older children at risk, though the three-dose approach offers a more robust immune response.
Abstract:
74 healthy babies born to mothers positive for hepatitis B surface antigen (HBsAg) were randomly divided at birth to receive either HB immunoglobulin and 2 doses of HB vaccine 2 months apart, or HB immunoglobulin and 3 doses of HB vaccine 1 month apart. 80 healthy babies born to HBsAg, anti-HBs, and anti-HB core (c) negative mothers were randomly divided at birth to receive either 2 doses of vaccine 2 months apart or 3 doses 1 month apart. The seroconversion rates and the geometric means of anti-HBs titres were lower in both groups of babies given 2 doses of vaccine than in the groups given 3 doses. 60 pairs of children at risk, aged 1 to 12 years and HBsAg, anti-HBs, and anti-HBc negative, were randomly divided to receive either the 2-dose regimen or the 3-dose regimen. The seroconversion rates and the geometric means of anti-HBs titres were satisfactory in both groups.