Antibody levels in children after 10 years of vaccination against hepatitis B: a brazilian community-based study

Abstract

Revista da Sociedade Brasileira de Medicina Tropical 45(2):260-262, mar-abr, 2012Antibody levels in children after 10 years of vaccination against hepatitis B: a Brazilian community-based study Níveis de anticorpos em crianças 10 anos após a vacinação contra hepatite B: um estudo brasileiro de base comunitária Glauco Danielle Fagundes¹, Fábio de Oliveira Tabalipa² and Jane da Silva² , ³ ABSTRACT Introduction: It is known that the hepatitis B (HB) vaccine is effective, but it is alarming that sudden drops of antibody levels may coincide with the onset of adolescence. Methods: Antibody levels against HB vaccine surface antigen (anti-HBs) and HB vaccine core antigen (anti-HBc) were measured on the blood samples of children with a mean age of 11.4 years. Results: About 54.8% had protective levels of anti-HBs. Of those who were anti-HBc-positive (4.4%), an average of 218.4 anti-HBs mIU/mL was found. Conclusions: Immunological protection was found in the majority of children. However, more studies are needed to elucidate the heritability of nonresponders and establish strategies against such events. Keywords: Hepatitis B virus. Vaccination. Anti-HBs. Anti-HBc. HBsAg. The vaccine against hepatitis B (HB) is included in the routine immunization schedule for children in most countries and has been proven effective in long-term reduction of chronic HB virus (HBV) infections¹. It is known that the duration of immune protection of the vaccine in various populations ranges from 5 to 10 years [2][3][4] . More recent studies of longer follow-ups show that there is still sufficient anamnestic response up to 20 years after vaccination 1 . However, it is alarming that the levels of antibody against HBV surface antigen (anti-HBs) is decreasing over time [2][3][4] , and sudden drops coincide with the beginning of adolescence, the age group that historically has an increased risk for the development of HB 5 .Brazil has a variable distribution of endemicity for HBV. Most regions have a low degree of endemicity 6 . However, the southern region of Brazil includes areas of intermediate to high endemicity and has the highest incidence of Brazilian HB. The State of Santa Catarina is a component of this region, and the City of Criciúma is located in the southern part of Santa Catarina, which showed the highest number of cases for HBV infection in the state 7 . These findings may reflect a higher relative number of diagnoses, but the endemicity is still significant and worrisome.There are few long-term, large-scale population studies and community case studies to monitor the immunogenicity of the vaccination that stemmed from universal programs against HB in childhood. From a demographic standpoint, the analysis of a universal vaccination program is important to guide collective or individual conduct to rise above its failures. This study aimed at verifying different types of antibodies in children who received vaccination against HB in accordance with the standard method in the City of Criciúma in 1994 and 1995.The classic method of vaccin...

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“…Seroprotection at year 10 was 54.8% in Brazilian children and 86.4% in Canadian children [31,32]. Seroprotection rates decreased gradually over time, reaching 79.7% at year 15 in one study [32] and between 33.7% and 75.5% 18-22-years post-primary immunization in two studies [39,42].…”

High prevalence of hepatitis B virus and low vaccine response in children and adolescents in Northeastern Brazil

“…Another common situation, which could justify the result of low effectiveness found here, is the drop in anti-HBs titers that normally occurs with advancing age after vaccination 10 , 12 , 38 . A study of vaccinated children followed for 10 years found protective titers in 54.8% of the children 38 .…”

Níveis De Anticorpos Anti-HBS Em Estudantes E Profissionais De Saúde Vacinados Para Hepatite B De Uma Universidade Do Interior Paulista

“…Não houve diferenças significativas nos níveis de anti-HBs em relação ao gênero (p=0,9367) e ao esquema de vacinação (p=0,7498). Quanto ao gênero, nossos resultados corroboram com os estudos de Fagundes & Tabalipa 18 , Rezaei et al 19 e Shooshtari et al 16 . As irregularidades na administração das doses parece não interferir na resposta de anticorpos, se a série de vacinação é interrompida após a primeira dose, a segunda deve ser administrada logo que possível.…”

“…Encontramos uma melhor resposta de anti-HBs em indivíduos na faixa etária de 20-29 anos (p= 0,0137), concordante com o resultado de Shooshtari et al 16 . Acima de 40 anos, há um declínio na imunogenicidade e com 60 anos, apenas 75% das pessoas vacinadas desenvolvem níveis protetores de anti-HBs 10,18,21 . Houve diminuição de anti-HBs com tempo após a vacinação, sendo significativa a queda nos títulos de anticorpos no grupo dos vacinados há mais de 15 anos (p= 0,0008).…”

“…Foi realizado um estudo transversal, evolvendo estudantes e profissionais de saúde de uma universidade do interior paulista, com idade de 18 Os participantes foram agrupados segundo a faixa etária em 5 grupos: < 20 anos, 20-29 anos, 30-39 anos, 40-49 anos e ≥ 50 anos. Quanto a titulação de anti-HBs, os participantes foram classificados em 3 grupos: 0-9 mUI/mL, 10-99 mUI/mL, e ≥ 100 mUI/mL.…”