Anti-HBs levels in children under the age of two years born to HBV carrier mothers after immunoprophylaxis: a multicenter cross-sectional study

Abstract

Background Serological testing for the presence of Hepatitis B Virus (HBV) markers and anti-HBs titers in infants born to HBsAg positive women is critically important for estimation in immunisation programme. Methods This was a multi-center and cross-sectional study conducted in Zhejiang province, China. Children aged 7 to 24 months born to HBsAg positive women during December 2018 to February 2019, completed additional HBV serological markers screening. We indicated distribution of HBV serological markers and anti-HBs titers in children. Multiple logistic regression model with adjusted odds ratio and 95% confidence interval (ORadj and 95% CI) was used to explore the factors associated with inadequate immune response (anti-HBs titers< 100 mIU/ml) among children. Results A total of 1849 children were included. Overall 25 children tested HBsAg positive, giving HBsAg positive rate of 1.35%(95%CI: 0.83-1.88%). 92.00% (23/25) HBsAg positive children were delivered by HBeAg positive mothers. The proportion of protective seroconversion (anti-HBs titers≥10mIU/ml) was 99.29% in all children, and 86.48% children were reported with adequate anti-HBs titers (≥100mIU/ml).We found a significant higher proportions of early antenatal health care (< 13 gestational weeks), and term birth in children with adequate response compared with inadequate response (all P < 0.05). Logistic regression showed preterm birth was a negative factor for inadequate anti-HBs titers (ORadj = 1.868,95%CI 1.132-3.085,P = 0.015). Conclusions Children delivered by HBeAg positive mothers had higher risk of vertical transmission of HBV, despite completion of 3 doses of hepatitis B vaccine and HBIG injection. Inadequate anti-HBs level was significantly associated with preterm birth in HBsAg positive women.

Vaginal Delivery and Breastfeeding Benefit Infant Immune Response to Hepatitis B Vaccine: A Prospective Cohort Study

“…Consistent with previous studies, 7 – 11 the rates of nonresponse and low response were 1.59% (20/1,254) and 10.05% (124/1,234), respectively. Infant sex, delivery mode, feeding pattern, maternal anti-HBs negativity, parental history of nonresponse to HepB, parental immune diseases and birth weight were included in this study of nonresponse and low response to HepB in infants.…”

“…[3][4][5][6] Nevertheless, despite receiving the standard primary HepB vaccination, approximately 3-10% of healthy infants have no response or a low response to the vaccine respectively, which places them at high risk of HBV infection. [7][8][9][10][11] More important, it has been well established that people infected with HBV in infancy or early childhood have an almost 80-90% risk of developing chronic HBV infection. Therefore, it is necessary to investigate the occurrence rate and related risk factors of nonresponse and low response to HepB in infants, so as to find a solution to improve the level of immune response to HepB.…”

Factors Affecting the Long-Term Protection Against Hepatitis B Immunization in Infancy: A Meta-Analysis

“…37,38 Gestational age in this study showed a p value <0.0001 for anti-HBs titers, which means that a significant relationship was found. This result is in line with the study by Jiang et al (2021) conducted on 1,849 children, 81 children with an adequate response (titers ≥100mIU/ mL) and 21 inadequately responding children who were born prematurely showed that preterm birth was associated with an anti-HBs titer below 100 (mIU/mL). 39 The neonate's immune system is depending on gestational status and early exposure to a variety of stimuli, while preterm infants have a different immune system than full-term infants.…”

Profile of Liver Function Tests, Serology and Demographic Status of Children with Hepatitis B and Comorbidities at RSUD Dr. Soetomo in 2019 - May 2023

“…Given the high prevalence of chronic HBV in mothers, HBV vaccination of newborns within the first 24 hours after birth should be included in current immunisation schedules, and the use of TDF-based ART regimens in combination with lamivudine or emtricitabine is recommended during pregnancy (Yendewa et al, 2021). In 1849 children tested, 25 were HBsAg positive with a HBsAg positive rate of 1.35%, 92% or 23 children were born to HBeAg positive mothers (Jiang et al, 2021).…”