Long-term persistence of anti-HBs after hepatitis B vaccination among adults: 8-year results

Abstract

The long-term persistence of hepatitis B surface antibody (anti-HBs) after hepatitis B vaccination among adults was not known clearly. This study aimed to assess the immunogenicity and persistence of antibodies 8 years after hepatitis B immunization with different vaccination schedules among adults who tested negative for hepatitis B surface antigen (HBsAg), anti-HBs, and hepatitis B core antibody (anti-HBc). A total of 771 participants who received the full vaccination course (three doses) and also had a blood sample taken 1 month after the first vaccination were recruited. Of these, 529 were excluded due to the missing data of anti-HBs 8 years after the first vaccination. Vaccinations were carried out at 0-1-3, 0-1-6 and 0-1-12 month vaccination schedules, and 104, 45, and 93 participants were included, respectively. The positive seroprotection rate was 85.9% 1 month after the third vaccination, and 58.3% 8 years later (χ 2 = 54.52, P < .001), while the geometric mean titer (GMT) of anti-HBs was 158.49 mIU/mL [95% confidence interval (CI): 131.83-190.55)] and 15.14 mIU/mL (95% CI: 10.96-20.42) after 1 month and 8 years, respectively. Compared with the standard 0-1-6 month vaccination schedule, the positive seroprotection rate and the GMT of the 0-1-3 month vaccination schedule had no difference. The longterm immune effect of the 0-1-3 month vaccination schedule was better than that of the 0-1-12 month vaccination schedule. No correlation was found between the GMT of anti-HBs 1 month and 8 years later.

The Two-years Immune Effect Between 0-1-2-months and 0-1-6-months of HBV Vaccination Schedule in Adults

“…In a recent systematic review, the different vaccination schedule obtain the similar short-term immune effect, demonstrating that anti-HBs concentrations ≥ 10 m IU/ml were approximately 65.0-85.0% using the 0-1-2-months schedule, approximately 77.0-90.8% using the 0-7-21-day schedule, 87.0% using the 0-2-6-week schedule, and around 79.0% after the 0-14-28-day schedule, respectively. 22 Ren et al 18 also reported that the accelerated schedule (0-1-3-months) and the standard schedule (0-1-6 months) enhanced the long-term immune memory (8 years after) in comparison to (0-1-12-months) schedule, which we found a similar long-term immune effect in the present study (2 years after). Regarding the short-term immune effect, we speculate that the different short-term immune effect may be explained by that the measurement was taken at a different time (4th months for "0-1-3-months", 7th months for "0-1-6-months" and 13th months for "0-1-12-months), since the 6-months and 12-months injection serve as a booster dose, which was known to increase the seroconversion rate.…”

“…12,13 Such accelerated immunization schedules ( 0-1-2-months, 0-1-3-months and 0-7-21-days, etc.) were veri ed to have the same short-term immune effect and to increase the completion rate in the general population 14 , vein-injected drug users 15,16 and adults who were refused to receive the second or third dose owing to occupational reasons 17,18 . However, antibody maintenance by immune memory was even more crucial than antibody production in protecting patients from HBV infection.…”

“…12,19 Ren et al recently reported that the same positive seroprotection rate and the quantitative anti-HBs level between 0-1-3-months vaccination and 0-1-6-months schedule in 8 years after the vaccination. 18 However, the author also declared in limitation part that high loss to follow-up (from initial 771 participants to 242 in nal follow-up, 529 participants were lost to follow-up) caused by the oating population and relatively small sample size may in uence the reliability. We proposed a prospectively interventional study in two comparable towns study to investigate the short-term and long-term immune effects, as well as the completion rate between the accelerated vaccination schedule (0-1-2-months) and the standard vaccination schedule (0-1-6-months).…”

Persistence of Immunity in Adults after 1, 5 and 10 Years with Recombinant Hepatitis B Vaccine in Beijing in 2010–2020

“…The hepatitis B vaccine has been proved very effective at preventing infection with HBV [6,7]. Currently, the recombinant hepatitis B vaccine is widely used in China for immunization; it can be classified as Hansenula (HepB-HP), Saccharomyces cerevisiae (HepB-SC) and Chinese hamster ovary cells (HepB-CHO), and the dosage forms can be classified as 5 µg/dose, 10 µg/dose, 20 µg/dose and 60 µg/dose.…”

“…Several long-term studies of immune persistence have shown that the anti-HBs ≥ 10 mIU/mL proportion of adults immunized with hepatitis B vaccine after 20-30 years was 50-60%, but booster immunization was not recommended [14][15][16]. However, in China, according to a cohort study, the seroprotection rate of adult vaccination against hepatitis B was reduced to 58.3% after eight years [7].…”