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Updated: Nov 10, 2025

Analysis of HBV-Specific CD4 T-cell Responses and Identification of HLA-DR-Restricted CD4 T-Cell Epitopes Based on a Peptide Matrix
Published on: October 20, 2021
How does the immunogenicity of hepatitis B vaccine change over the years in childhood?
Gulsum Iclal Bayhan1, Sidika Elif Balli2, Hatice Demir2
1Department of Pediatric Infectious Disease, Faculty of Medicine, Yenimahalle Educational and Training Hospital, Yildirim Beyazit University, Ankara, Turkey.
Insights
Hepatitis B vaccination protects children, but antibody levels decrease with age. Most children maintain protective antibodies for years, though positivity rates decline after age seven.
Area of Science:
- Pediatrics
- Immunology
- Public Health
Background:
- Hepatitis B remains a global health concern, causing chronic liver disease and cancer.
- Hepatitis B vaccination significantly reduces infection rates.
- The national schedule involves infant vaccination at 0, 1, and 6 months.
Purpose of the Study:
- To assess anti-HBs positivity rates and titers over time in vaccinated children.
- To understand the duration of protective immunity following childhood vaccination.
Main Methods:
- Retrospective analysis of 4326 children's HBsAg and anti-HBs titers.
- Evaluation of data from July 2011 to May 2018.
- Comparison of anti-HBs positivity by age group, with a protective cutoff of ≥10 mIU/mL.
Main Results:
- 69.2% of children (2292/4326) had protective anti-HBs levels (≥10 mIU/mL).
- Highest antibody positivity was observed in children under 3 years old.
- Positivity rates significantly decreased after age 7, but remained positive in over half of older children.
Conclusions:
- Anti-HBs positivity and levels decline with increasing age in children.
- Childhood hepatitis B vaccination provides sustained protection for many, but monitoring is important.
- Further research may explore optimal booster strategies based on age-related antibody decline.
Abstract:
Hepatitis B is the leading cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma worldwide. The incidence of HBV infection has significantly decreased with hepatitis B vaccination. Hepatitis B vaccine is administered to children at 0, 1 and 6 months of age according to the national schedule. There is a high rate of protective antibody (anti-HBs) development after hepatitis B vaccination. We conducted the study to investigate how the hepatitis B surface antibody (anti-HBs) positivity rates and the titers change over time in childhood following vaccination. Patients who presented at the general pediatric outpatient clinic of Yenimahalle Education and Training Hospital and the HBsAg and anti-HBs titers were tested for any reason between July 2011 and May 2018 were retrospectively evaluated. The cutoff level for protection by the anti-HBs titer was accepted as ≥10 mIU/mL with lower levels indicating no protection. Anti-HBs positivity was compared by age group. Anti-HBs levels were studied in 4326 children. The mean age of the included in the study was 127 ± 62 months. A protective anti-HBs level (≥10 mIU/mL) was present in 2292 children (69.2%). The highest anti-HBs antibody positivity rate was in the under 3 years' age group. The positivity rate significantly decreased after age 7 years. The HBsAg level was determined in all children in the study and five had a positive result. In conclusion, our study found that the anti-HBs positivity rate and the anti-HBs level decreased with age. However, the anti-HBs antibody result remained positive in more than half of the children.
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