Protective effect of an improved immunization practice of mother-to-infant transmission of hepatitis B virus and risk factors associated with immunoprophylaxis failure

Wang, Chong; Wang, Chuan; Jia, Zhifang; Wu, Xing; Wen, Simin; Kong, Fei; Hu, Ke–Qin; Li, Jie; Jiang, Jing; Niu, Junqi

doi:10.1097/md.0000000000004390

Cited by 35 publications

(37 citation statements)

References 32 publications

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“…The risk of chronic hepatitis B (CHB) is inversely related to the age of exposure, with the highest rates of chronicity occurring in neonates (>95%) and the lowest occurring in healthy adults (<5%) (6)(7)(8). In many HBV-endemic regions (ie, Mainland China and Taiwan), infant vaccination has been shown to reduce HBV MTCT rates by more than 90% and even to reduce the risk of endstage liver disease, including childhood HCC (9)(10)(11)(12)(13). The World Health Organization (WHO) recommends HBV vaccination of children within 24 hours of birth, specifically highlighting this approach in its Global Health Sector Strategy on Viral Hepatitis, 2016-2021 (1).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and molecular characterization of occult hepatitis B virus in pregnant women from Gondar, Ethiopia

Meier-Stephenson

Deressa

Genetu

et al. 2020

CanLivJ

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BACKGROUND: The greatest risk of chronic hepatitis B (CHB) is from mother-to-child transmission. Approximately 20% of individuals in Sub-Saharan Africa are hepatitis B virus (HBV) surface antigen-positive (HBsAg+), but the prevalence of occult hepatitis B (OHB) is unknown. Aim: This study investigated CHB and OHB prevalence and viral variants in a cohort of pregnant women in Gondor, Ethiopia. METHODS: Patients were prospectively recruited from the University of Gondar Hospital (N = 200; median age 27 y, inter-quartile range 8.3) from March through June 2016. Data were collected using an investigator-administered questionnaire. Plasma was tested for HBsAg and HBV core antibody (anti-HBc), and HBV genotype and presence of HBV variants (i.e., vaccine escape mutants [VEMs]) were determined by polymerase chain reaction, Sanger sequencing, and phylogenetic analysis. RESULTS: Of women tested, 1% (2/200) were HBsAg+; 26.8% (47/182) of HBsAgnegative patients were anti-HBc+, of whom 37/47 (78.7%) had detectable HBV DNA. The overall rate of OHB was 20.3%. Both HBsAg+ cases were HBV genotype D, and 36/37 (97.3%) of OHB individuals were genotype D. None carried VEM, but both HBsAg+ cases and 32/37 (86.5%) of the OHB cases showed lamivudine-resistant mutations. CONCLUSIONS: Twenty-seven percent of pregnant women in this cohort showed evidence of CHB or prior HBV exposure (i.e., HBsAg+ or anti-HBc+) and clinically relevant HBV variants. Data from this single-centre study suggests high HBV prevalence, reinforcing the World Health Organization's recommendation for universal prenatal HBV screening and infant vaccination.

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Section: Introductionmentioning

confidence: 99%

Prevalence and molecular characterization of occult hepatitis B virus in pregnant women from Gondar, Ethiopia

Meier-Stephenson

Deressa

Genetu

et al. 2020

CanLivJ

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“…Anti-HBs 10 mIU/mL was considered as non-response; anti-HBs from 10 to 100mIU/mL was considered as low-response; anti-HBs>100 mIU/mL was considered as protective response; anti-HBs>1000 mIU/mL was considered as high-response [8,11].…”

Section: Definition Of Immunization Outcomementioning

confidence: 99%

“…Infants are still vulnerable to be infected with HBV if they do not obtain adequate anti-HBs which is negative or considers as low-response after a complete course of immunization [8]. Although significant progress has made in hepatitis B control in China, but challenges remain.…”

Section: Introductionmentioning

confidence: 99%

Exploring the influence of maternally derived antibody against hepatitis B surface antigen on infants’ immune response to hepatitis B vaccine in mice

Lv¹,

Wei²,

Tan³

et al. 2020

Preprint

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Background: Whether maternal anti-HBs acquired transplacentally plays a negative role in newborn infants’ immune response to hepatitis B vaccine (HepB Vac), it remains controversial and has not been paid enough attention.Methods: 267 BALB/c mice were bred. All mice were divided into two groups according to different doses of HepB Vac (2μg, 5μg) injected to mice. Each group was sub-divided into three subgroups according to different doses of hepatitis B immunoglobulin (HBIG) (50 IU, 25 IU, 0 IU) injected combined with the first dose of HepB Vac. Three doses of HepB Vac were administrated at 0 week, 4week and 8 week respectively. Antibodies against hepatitis B surface antigen (anti-HBs) were tested four weeks after the third dose of HepB Vac.Results: Among 267 mice, 40 were of low- and non-response to HepB Vac (anti-HBs<100 mIU/mL). Multivariate logistic regression analysis showed that rates of anti-HBs<100 mIU/mL were: 1.1%, 23.1% and 20.7% in groups of HBIG=0 IU(1), HBIG=25 IU(2) and HBIG=50 IU(3) respectively, p = 0.002, and among subgroups, (1) vs (3), RR= 0.032, 95% CI [0.004, 0.255], p = 0.001, (2) vs (3), RR= 1.359, 95% CI [0.588, 3.144], p = 0.473; 4.5% and 25.6% in groups of HepB Vac 5μg and 2μg, RR=0.093, 95% CI [0.035, 0.250], p <0.001; 6.1% and 23.7% in groups of intramuscular injection and hypodermic injection, RR=0.139, 95% CI [0.056, 0.346], p <0.001. The mean titers of anti-HBs (log10mIU/m) were on the decrease in turn in groups of HBIG= 0 IU, HBIG= 25 IU and HBIG= 50 IU, p <0.001.Conclusions: HBIG has a negative impact on both the rate of effective immune response and response level of anti-HBs, which preliminarily indicates maternal anti-HBs inhibits infants’ immune response to HepB Vac.

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“…Anti-HBs<10 mIU/ml was considered as non-response; anti-HBs from 10 to 100mIU/mL was considered as low-response; anti-HBs>100 mIU/ml was considered as protective response (Wang et al, 2016;Lu et al, 2016).…”

Section: Definition Of Immunization Outcomementioning

confidence: 99%

Factors influencing survival of BALB/c mice and their effects on immune efficacy in an experiment of hepatitis B immunization

Wei¹,

Li²,

Lv³

et al. 2020

J. Vet. Med. Anim. Health

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There was an accidental death of BALB/c mice in the course of the experiment about hepatitis B immunization. The reasons of the mice breeding failure were analyzed in order to provide some experience for future animal preparation about hepatitis B immunization. Items of all mice including sex, age, dose of hepatitis B vaccine (HepBVac), dose of hepatitis B immunoglobulin (HBIG), immunization route, vaccination schedule and the acclimatization period were recorded before the first immunization. Among 334 mice included, the survival rates in different groups of initial ages were 45.9% in 3-week-old, 49.3% in 4-week-old, 51.9% in 5-week-old, 84.8% in 7-week-old and 96.6% in 8week-old; the survival rate in seven days acclimatization group was 96.6% and 53.3% in one day acclimatization group. Multivariate logistic regression analysis indicated that smaller ages (3 weeks, 4 weeks) and acclimatization for only one day were the independent risk factors affecting the survival of mice. Multivariate logistic regression analysis showed that injection with HBIG, lower dose of HepBVac and hypodermic injection were independent risk factors for low-and non-response to HepB Vac. It is suggested that the mice should be more than five-week-old and must have acclimated to the environment for one week before the experiment begins. The initial ages of the mice have no impact on their immune efficacy.

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Protective effect of an improved immunization practice of mother-to-infant transmission of hepatitis B virus and risk factors associated with immunoprophylaxis failure

Abstract: Supplemental Digital Content is available in the text

Cited by 35 publications

References 32 publications

Prevalence and molecular characterization of occult hepatitis B virus in pregnant women from Gondar, Ethiopia

Prevalence and molecular characterization of occult hepatitis B virus in pregnant women from Gondar, Ethiopia

Exploring the influence of maternally derived antibody against hepatitis B surface antigen on infants’ immune response to hepatitis B vaccine in mice

Factors influencing survival of BALB/c mice and their effects on immune efficacy in an experiment of hepatitis B immunization

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