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Asymptomatic hepatitis B carriers who were vaccinated at birth

Xueyan Wang1, Qinyan Chen1, Hai Li1

  • 1Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis, Nanning, Guangxi, China.

Journal of Medical Virology
|March 19, 2019
PubMed

Insights

Universal infant immunization against hepatitis B virus (HBV) may not provide lifelong protection. A significant percentage of vaccinated children acquired HBV, suggesting a need for adolescent booster doses in endemic regions.

Area of Science:

  • Virology
  • Immunology
  • Public Health

Background:

  • The long-term effectiveness of infant hepatitis B virus (HBV) vaccination and the necessity of adolescent booster doses are debated.
  • Previous studies indicated rising HBV surface antigen (HBsAg) prevalence with age in vaccinated adults, suggesting waning immunity.
  • Infant immunization is standard practice in many countries, including China.

Purpose of the Study:

  • To investigate the source of hepatitis B virus (HBV) transmission in vaccinated individuals.
  • To determine if HBV infection in vaccinated children is acquired from non-maternal sources.
  • To assess the role of antibody escape mutations in HBV transmission.

Main Methods:

  • Phylogenetic analysis of complete HBV S gene sequences from infected individuals and their family members.
  • Screening of vaccinated children aged 3-17 for HBsAg carriers in Guangxi, China.
  • Analysis of asymptomatic HBsAg carriers and their family members, including genetic sequencing.

Main Results:

  • 25% of HBsAg-positive children acquired HBV from non-maternal sources, with this trend increasing with age.
  • Antibody escape mutations were identified in 22.9% of HBV isolates.
  • Hepatitis B virus (HBV) transmission occurred within families, indicating potential for horizontal spread.

Conclusions:

  • Infant hepatitis B virus (HBV) vaccination alone may not confer sufficient long-term immunity.
  • A booster dose in adolescence might be necessary for individuals vaccinated at birth in highly endemic countries.
  • Further research is needed to understand transmission dynamics and optimize vaccination strategies.

Keywords:
HBsAgescape mutationsgenotypeshepatitis B virusimmunizationvaccine

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