Impact of hepatitis B vaccination in a highly endemic area of south Italy and long-term duration of anti-HBs antibody in two cohorts of vaccinated individuals

Villa, G. Da; Romanò, Luisa; Sepe, A.; Iorio, Raffaele; Paribello, Nunzio; Zappa, Alessandra; Zanetti, Alessandro

doi:10.1016/j.vaccine.2007.01.044

Cited by 62 publications

(52 citation statements)

References 12 publications

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“…Unlike many other publications from former highly endemic countries describing a dramatic drop in the prevalence of HBV carriage after the introduction of the HBV vaccine in their national immunization programs 17,[26][27][28] , we report an overall prevalence of HBV carriage identified only in highly endemic areas, possibly with no counterpart in the literature thus far in the post-vaccination era.…”

Section: Discussioncontrasting

confidence: 92%

“…This is in contrast to the situation in Italy, where the prevalence of HBsAg dropped from 13% to less than 1% after twenty years of universal vaccination 26 , and in Taiwan, which expected an overall prevalence rate of HBsAg carriage of less than 0.01% in the year 2010 27 . In the Colombian Amazon, the prevalence of HBsAg carriage among those 5-9 years old dropped from 9% to 2%, indicating a reduction of more than 70% after eight years of HBV vaccination 22 .…”

Section: Discussionmentioning

confidence: 60%

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Prevalence of hepatitis B virus infection and carriage after nineteen years of vaccination program in the Western Brazilian Amazon

Braga

Castilho

Borges

et al. 2012

Rev. Soc. Bras. Med. Trop.

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Introduction: Reductions in the prevalence of hepatitis B virus (HBV) infection and carriage, decreases in liver cancer incidence, and changes in patterns of liver dysfunctions are described after hepatitis B vaccination. Methods: We conducted a population-based seroprevalence study aimed at estimating the HBV prevalence and risk of infection in the rural area of Lábrea following nineteen years of HBV vaccination. Results: Half of the subjects showed total anti-HBc of 52.1% (95% CI 49.6-54.7). The HBsAg prevalence was 6.2% (95% CI 5.1-7.6). Multivariate analysis showed an inverse association between HBV infection and vaccination (OR 0.62; 95% CI 0.44-0.87). HBsAg remained independently associated with past hepatitis (OR 2.44; 95% CI 1.52-3.89) and inversely to vaccination (OR 0.43; 95% CI 0.27-0.69). The prevalence of HBeAg among HBsAg-positive individuals was 20.4% (95% CI 12.8-30.1), with the positive subjects having a median age of 11 years (1-46) p=0.0003. Conclusions: We demonstrate that HBV infection is still an important public health issue and that HBV vaccination could have had better impact on HBV epidemiology. If we extrapolate these findings to other rural areas in the Brazilian Amazon, we can predict that the sources of chronic infected patients remain a challenge. Future studies are needed regarding clinical aspects, molecular epidemiology, surveillance of acute cases, and risk groups.

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Section: Discussioncontrasting

confidence: 92%

Section: Discussionmentioning

confidence: 60%

Prevalence of hepatitis B virus infection and carriage after nineteen years of vaccination program in the Western Brazilian Amazon

Braga

Castilho

Borges

et al. 2012

Rev. Soc. Bras. Med. Trop.

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“…A study in China has shown that adequate training is effective in improving Chinese village doctors' hepatitis B-related knowledge. 24 Receiving a vaccination was related to reduced HBV-related discrimination scores, suggesting that HBV vaccination not only effectively protects vulnerable people from HBV infection, 25,26 it also reduces their levels of HBV-related discrimination. This circumstance probably occurs because individuals feel a stronger sense of security because they are not as vulnerable to HBV.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis B-related knowledge and vaccination in association with discrimination against Hepatitis B in rural China

Wang

Zhu

et al. 2015

Human Vaccines & Immunotherapeutics

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Hepatitis B virus (HBV) remains a challenging public-health issue in China. Hepatitis B carriers and patients suffer not only physically but also experience strong discrimination and stigma. China's rural population is 629 million. Thus, there is a great need to understand the situation surrounding HBV-related discrimination in everyday life in rural China. We studied 6,538 participants (18 y old) from 42 villages across 7 provinces (districts). Many studies have addressed discrimination against those with human immunodeficiency virus (HIV) and hepatitis C virus (HCV). However, few studies have addressed HBV-related discrimination. We found that the fear of HBV infection, not lack of knowledge about it, predominantly leads to HBV-related discrimination (although limited knowledge is also a cause). Notably, receiving the HBV vaccination contributes to reduced discrimination. In addition, the existence of fewer misunderstandings about false HBV transmission routes plays a more important role in discrimination than does understanding of true HBV transmission routes. Therefore, to reduce HBV-related discrimination, policy makers should consider eliminating HBV-related fear, strengthening adult HBV immunization programs, developing large-scale education dissemination about HBV transmission routes and non-transmission routes, and paying greater attention to target populations.

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“…Overall, the clinical significance of anti-HBs <10 mIU/ml in immunized individuals is not well understood. Studies suggest that long-term persistence of high anti-HBs levels, as well as immunological memory and the degree of protection from infection are associated with peak anti-HBs concentrations after vaccination [31,33,[42][43][44]. Several studies have shown that healthy individuals with an anti-HBs concentration <10 mIU/ml can be infected with hepatitis B, but mostly retain protection against chronic infection provided that they initially responded well to the vaccine [2,3,17,33,42,43].…”

Section: Discussionmentioning

confidence: 99%

Low hepatitis B immunogenicity of a hexavalent vaccine widely used in Germany: results of the German Health Survey for Children and Adolescents, 2003–2006

et al. 2010

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SUMMARYThe success of childhood vaccination against hepatitis B relies on persistence of immunity into adolescence and adulthood. In 2000, two hexavalent vaccines with a hepatitis B component (Hexavac 1 , Infanrix hexa 1 ) were introduced in Germany. Hexavac was withdrawn in 2005 amidst concerns about its long-term hepatitis B protection. We compared hepatitis B surface antibody (anti-HBs) levels in children fully vaccinated with Hexavac or Infanrix hexa (n=477) in a secondary data analysis of a large cross-sectional health survey in Germany. On average 2 . 4 years after vaccination, 25 . 3 % of Hexavac vaccinees had anti-HBs levels <10 mIU/ml (95 % CI 19 . 0-32 . 8) compared to 4 . 7 % of Infanrix hexa vaccinees (95 % CI 2 . 4-8 . 9). These findings suggest that short-term hepatitis B immunogenicity in Hexavac vaccinees may also be weaker. Further studies are warranted to assess whether Hexavac vaccinees should be re-vaccinated or receive a booster vaccination before these birth cohorts reach adolescence.

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Impact of hepatitis B vaccination in a highly endemic area of south Italy and long-term duration of anti-HBs antibody in two cohorts of vaccinated individuals

Cited by 62 publications

References 12 publications

Prevalence of hepatitis B virus infection and carriage after nineteen years of vaccination program in the Western Brazilian Amazon

Prevalence of hepatitis B virus infection and carriage after nineteen years of vaccination program in the Western Brazilian Amazon

Hepatitis B-related knowledge and vaccination in association with discrimination against Hepatitis B in rural China

Low hepatitis B immunogenicity of a hexavalent vaccine widely used in Germany: results of the German Health Survey for Children and Adolescents, 2003–2006

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