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Author Spotlight: Advancements and Challenges in Hepatitis B Virus Detection
Published on: December 15, 2023
Hepatitis B birth vaccination, cohort study, Tunisia 2000-2017
Wafa Dhouib1, Meriem Kacem1, Cyrine Bennasrallah1
1Department of Epidemiology and Preventive Medicine, University of Monastir , Monastir, Tunisia.
Insights
Administering the Hepatitis B (HB) vaccine at birth (HepB-BD) is highly effective, demonstrating 99.4% efficacy in preventing HB infections. This strategy is crucial for achieving global HB elimination goals.
Area of Science:
- Immunology
- Public Health
- Epidemiology
Background:
- Hepatitis B (HB) remains a significant global health concern.
- Vaccination strategies are key to controlling HB transmission.
- Evaluating vaccine timing is crucial for optimizing public health outcomes.
Purpose of the Study:
- To compare the efficiency and efficacy of the first dose of the Hepatitis B (HB) vaccine administered at birth versus at 3 months of age.
- To assess the long-term impact of different HB vaccination schedules on disease incidence.
- To evaluate the contribution of the Hepatitis B Birth Dose (HepB-BD) to the World Health Organization's (WHO) HB elimination targets.
Main Methods:
- A cohort study was conducted in Monastir from January 2000 to December 2017.
- Two vaccination protocols were compared: Protocol 1 (first dose at 3 months) and Protocol 2 (first dose at birth - HepB-BD).
- Hepatitis B virus (HBV) infection was determined using serological markers (HBsAg and anti-HBc), and Absolute Risk (AR) and Relative Risk Reduction (RRR) were calculated.
Main Results:
- The HepB-BD protocol (Protocol 2) showed significantly higher efficacy, with an Absolute Risk (AR) of 0.11 per 100,000 PY compared to 5.67 in Protocol 1.
- The Relative Risk Reduction (RRR) was 99.4% for HepB-BD versus 77% for the 3-month schedule.
- Zero HB cases were observed in children aged 5-11 who received HepB-BD, compared to 4 cases in the same age group who received the first dose at 3 months.
Conclusions:
- The Hepatitis B vaccine administered at birth (HepB-BD) is highly effective (99.4%) in preventing Hepatitis B infections.
- Implementing HepB-BD globally is essential for achieving the WHO's goal of eliminating Hepatitis B as a public health threat by 2050.
- The study highlights the critical importance of early vaccination in reducing HB incidence and achieving elimination targets.
Abstract:
We aimed to compare the efficiency of the first dose of Hepatitis B (HB) vaccine: at Birth versus at 3 months and to evaluate the efficacy of HB vaccine. We conducted a cohort study in the governorate of Monastir. Vaccinated Cohort (VC) included populations receiving the first dose at 3 months (Protocol 1), and at birth (HepB-BD) (Protocol 2). First dose was followed by at least two doses. We collected, from January 2000 to December 2017, cases diagnosed by serological markers (hepatitis B surface antigen (HBsAg) and anti-HBc). We calculated Absolute Risk (AR) per 100,000 PY and the Relative risk reduction (RRR). Twenty-five cases were notified among VC and 1501 cases among not vaccinated cohort (NVC). Twenty-three cases were notified among the cohort receiving the first dose at 3 months and two cases in Protocol 2. The AR per 100,000 PY was 5.67 (CI95%: 3.36-7.99) in Protocol 1 and 0.11 (CI95%: 0.001-0.26) in Protocol 2. The RRR was 77% (95% CI: 66; 85) in Protocol 1 and 99.4% (95% CI: 97.8; 99.9) in Protocol 2. We identified 4 HB cases for children aged between 5 and 11 who benefited from protocol 1 (born between 2000 and 2006) and zero cases for children of the same age group benefiting from protocol 2 (born between 2011 and 2017). The annual number of HB has decreased from 112 in 2000 to 48 in 2017. We predicted 40 new cases of HB in 2030. HepB-BD was 99.4% effective at preventing HB. The continuity of HepB-BD worldwide would achieve WHO's goal of eliminating HB as a threat to health by 2050.
Abbreviations:
AR: Absolute Risk; ARR: Absolute Risk Reduction; G1: Group1; G2: Group2; HB: Hepatitis B; HepB-BD: Hepatitis B Birth Dose; MENA: Middle East and North Africa; NNV: Number Needed to Vaccine; HIV: Human Immunodeficiency Virus; NVC: Not Vaccinated Cohort; PY: Person Year; RRR: Relative Risk Reduction; RR: Relative Risk; VC: Vaccinated Cohort; WHO: World Health Organization.
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