Effects of hepatitis B vaccination on hepatitis B surface antigen in neonates and its change in vivo
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Shuqi Wang1, Yuting Bai2, Fangyuan Yuan2
1Department of Laboratory Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, China.
Insights
Hepatitis B vaccination can cause newborns to test positive for hepatitis B surface antigen (HBsAg). Maternal antibodies (anti-HBs) can mitigate this effect, and delaying HBsAg testing may reduce false positives.
Area of Science:
- Immunology
- Pediatrics
- Virology
Background:
- Hepatitis B vaccination is crucial for preventing hepatitis B virus (HBV) infection.
- Despite vaccination, a risk of infection persists, with some newborns testing positive for hepatitis B surface antigen (HBsAg) post-vaccination.
Purpose of the Study:
- To investigate the impact of hepatitis B vaccination on the detection trends of HBsAg in newborns.
- To analyze factors influencing HBsAg detection in vaccinated neonates.
Main Methods:
- Retrospective analysis of data from 1417 newborns regarding vaccination history, HBsAg levels, and maternal anti-HBs.
- In vitro experiments supplementing neonatal serum with recombinant hepatitis B vaccine at varying concentrations to measure HBsAg.
Main Results:
- 21.6% of neonates were HBsAg positive within 8 days post-vaccination (0.104-0.339 IU/mL).
- Neonatal HBsAg positivity correlated significantly with maternal anti-HBs levels (P < 0.01).
- In vitro, vaccine dose influenced HBsAg levels, with maternal anti-HBs showing a negative correlation at higher vaccine concentrations.
Conclusions:
- Hepatitis B vaccination can temporarily elevate detectable HBsAg levels in neonatal serum.
- Maternal anti-HBs can counteract the vaccine's effect on neonatal HBsAg levels.
- Delaying HBsAg measurement post-vaccination may reduce false positives.
Background:
Vaccination is effective to prevent hepatitis B virus (HBV) infection. However, there is still a risk of infection after vaccination. In clinical work, we found that newborns were positive for HBV surface antigen (HBsAg) after vaccination.
Objectives:
To determine the effect of hepatitis B vaccination on the detection of HBsAg trend in newborns.
Methods:
We collected data at birth, history of vaccination for hepatitis B, quantitative HBsAg results, and other information about newborns born in our hospital from July 2017 to July 2020. Serum samples from healthy neonates were randomly selected to be supplemented with recombinant hepatitis B vaccine on a concentration gradient, and HBsAg was measured quantitatively.
Results:
Data from 1417 neonates were included in the study; 306 (21.6%) were HBsAg positive within 8 d after vaccination, with levels ranging from 0.104 IU/mL to 0.339 IU/mL. The proportion of neonates with HBsAg-positive serum was significantly correlated with the level of hepatitis B surface antibodies (anti-HBs) in the serum of their mothers (P < 0.01). Experiments in vitro showed that the proportion of neonates with HBsAg-positive serum was correlated with the dose of the hepatitis B vaccine, and when the concentration of the hepatitis B vaccine reached 5 ng/mL and 10 ng/mL, the serum HBsAg levels showed a significant negative correlation with the original concentration of serum anti-HBs.
Conclusions:
Hepatitis B vaccination can affect the level of HBsAg detected in neonatal serum, and the effect could be mitigated by delaying the measurement. Moreover, maternal anti-HBs offset the effects of neonatal vaccination on HBsAg serum levels.
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