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The optimal interval for post-vaccination serological test in infants born to mothers with positive hepatitis B
Hongyu Huang1,2, Xuhui Zhang3, Yuqian Luo2
1Department of Infection Management, Wuxi 9th People's Hospital Affiliated to Soochow University, Wuxi, Jiangsu, China.
Insights
Postvaccination serologic testing (PVST) for hepatitis B virus (HBV) in infants of HBsAg-positive mothers is crucial. Optimal timing for PVST is around 7 months or one month post-final vaccine dose to ensure vaccine efficacy.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Hepatology
Background:
- Infants born to hepatitis B surface antigen (HBsAg)-positive mothers are at high risk of vertical transmission of hepatitis B virus (HBV).
- Hepatitis B vaccination is critical for preventing HBV infection, and postvaccination serologic testing (PVST) monitors vaccine response.
- Determining the optimal timing for PVST is essential for timely identification of non-responders and ensuring adequate protection.
Purpose of the Study:
- To determine the optimal interval for postvaccination serologic testing (PVST) after completing three doses of hepatitis B vaccine in infants born to HBsAg-positive mothers.
- To analyze the relationship between the timing of PVST and anti-hepatitis B surface antibody (anti-HBs) levels and non-response rates.
- To provide evidence-based recommendations for the timing of PVST in this high-risk infant population.
Main Methods:
- Secondary analysis of 1255 infants of HBsAg-positive mothers from two prospective studies.
- Infants received three doses of hepatitis B vaccine according to a standard schedule (0, 1, and 6 months).
- Quantitative testing of HBsAg and anti-HBs using microparticle enzyme immunoassay at 7-14 months of age.
Main Results:
- Overall, 1.7% of infants had inadequate anti-HBs levels (<10 mIU/mL).
- Non-response rates increased significantly when PVST was performed 7-8 months after the third vaccine dose compared to 1 month (P=.032).
- Anti-HBs titers significantly declined with longer intervals between the final vaccine dose and PVST, particularly at 6 and 7-8 months post-vaccination (P<.001).
Conclusions:
- Postvaccination serologic testing (PVST) for hepatitis B vaccine can be performed at 7-12 months of age for infants vaccinated on a 0, 1, and 6-month schedule.
- To ensure early identification of non-responders and maintain protective antibody levels, PVST is recommended at 7 months of age or 1 month after the final vaccine dose.
- Timely PVST is crucial for managing infants at high risk of hepatitis B virus infection.
Abstract:
Postvaccination serologic testing (PVST) is utilized to monitor the success or failure of vaccination against hepatitis B virus (HBV) infection in infants of hepatitis B surface antigen (HBsAg) positive mothers. This secondary analysis of 1255 infants of HBsAg-positive mothers at 7-14 months age included in two prospective studies aimed to determine the optimal interval for PVST after three hepatitis B vaccine doses. HBsAg and anti-HBs were quantitatively tested with microparticle enzyme immunoassay. The average PVST interval was 3.8 ± 2.2 months. Overall, 1.7% (21/1255) infants had anti-HBs <10 mIU/mL. The non-response rates were 1.6%, 1.1%, 0.9%, 0.7%, 1.1%, 0.7%, and 5.7% when PVST was performed at an interval of 1, 2, 3, 4, 5, 6, and 7-8 months after the third vaccine dose, respectively. Compared with 1 month of PVST interval, the non-response rate in infants who underwent PVST 7-8 months was significantly higher (χ2 = 4.616, P = .032). Anti-HBs titers were significantly declined in infants with medium responses when PVST was performed with longer intervals (χ2 = 27.592, P < .001), actually declined from interval of 6, and 7-8 months (Z = -3.177, P = .001 and Z = -3.715, P < .001), respectively. These results indicate that PVST may be performed at the age of 7-12 months for infants vaccinated on 0, 1, and 6-month schedule. To identify non-responders as early as possible, we suggest that PVST is performed at 7 months age or 1 month after the final vaccine dose.
