Transient Surface Antigenemia in Newborn Infants Vaccinated With Engerix B

Weintraub, Zalman; Khamaysi, Naif; Elena, Hertz; Gershtein, Vladimir; Orenstein, Lea; Lahat, Nitza

doi:10.1097/00006454-199410000-00016

Cited by 20 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There have been several reported instances of detectable hepatitis B surface antigenemia after hepatitis B vaccination with Engerix B. 8 described detectable levels of HBsAg in 17% of 47 newborns tested after administration of Engerix B. All the newborns were seropositive between 24 and 72 hours after vaccination, and all were seronegative 2 weeks after initial detection.…”

Section: Case Reportmentioning

confidence: 97%

Prolonged Hepatitis B Surface Antigenemia After Vaccination

Lunn¹,

Hoggarth²,

Cook³

2000

Pediatrics

View full text Add to dashboard Cite

A pproximately 200 000 to 300 000 acute infections with hepatitis B virus (HBV) occur each year in the United States. More than 1 million persons have chronic HBV infection and ϳ5000 persons die each year from HBV-induced hepatocellular carcinoma and chronic liver disease in the United States.1,2 HBV is usually transmitted through sexual contact, exposure to blood or blood products, from mothers to neonates at birth, and inapparent percutaneous and permucosal exposures.Previous attempts at controlling HBV infection in the United States consisted of vaccinating high-risk populations and serologic screening of all pregnant women for hepatitis B surface antigen (HBsAg). However, these measures had little impact on the control of HBV infections; therefore, in 1992, the American Academy of Pediatrics recommended universal hepatitis B vaccination for newborns and routine vaccination of adolescents when feasible. Since then, immunization rates for newborns and adolescents with hepatitis B vaccine have steadily risen. The 2 currently available recombinant hepatitis B vaccines are Recombivax HB and Engerix B. Both contain purified recombinant HBsAg obtained by culturing genetically engineered Saccharomyces cerevisiae cells, which carry the surface antigen gene of HBV. CASE REPORTAs part of a class function, a 17-year and 8-month-old male donated blood at a local blood collection center. One week later he received a letter indicating he tested positive for HBsAg and recommending review with his personal physician. He was also notified that his name was added to the confidential Deferred Donor Directory stating, "You are now permanently deferred from donating blood, plasma, tissues or organs for others." He was brought to the pediatric clinic for additional evaluation of HBV infection. On further review of the laboratory studies from the blood collection center, he was noted to have a reactive HBsAg by enzyme immunoassay (EIA), a positive HBsAg confirmatory test by neutralization, alanine aminotransferase (Ͻ100 IU/L), nonreactive antibody to hepatitis B core antigen, and nonreactive antibody to hepatitis C virus. Evaluation in the pediatric clinic revealed no risk factors for HBV infection. In further discussion with him, it was determined that he received his third Engerix B vaccination (20-g dose) 18 days before his blood donation. Physical examination did not reveal any abnormalities. Laboratory studies were obtained 48 days after his third hepatitis B vaccination and revealed a nonreactive HBsAg by EIA, asparate aminotransferase (25 IU/L; normal: 8 -42), alanine aminotransferase (14 IU/L; normal: 0 -55), total bilirubin (.4 mg/dL; normal: .2-1.2), and direct bilirubin (.2 mg/dL; normal: .0 -.4). Repeat laboratory studies were performed 117 days after his third hepatitis B vaccination and revealed a negative HBsAg by EIA, negative immunoglobulin G and immunoglobulin M antibodies to hepatitis B core antigen by EIA, and a positive antibody to HBsAg. This is consistent with successful hepatitis B immunization.HBsAg is the ...

show abstract

Section: Case Reportmentioning

confidence: 97%

Prolonged Hepatitis B Surface Antigenemia After Vaccination

Lunn¹,

Hoggarth²,

Cook³

2000

Pediatrics

View full text Add to dashboard Cite

show abstract

“…Unrecognized false positives can lead to additional downstream effects such as reporting to public health authorities and use of dedicated dialysis equipment for renal failure patients. Positive HBsAg results following HBV vaccination have been reported in a variety of patient populations: neonates [6-10], hemodialysis patients [4,11-13], blood donors [5,14,15], and general adult patients [16-18]. The present study aims to clarify the nature and duration of transient post-vaccination positivity and how common vaccine-induced positive results occur in an academic center population.…”

Section: Introductionmentioning

confidence: 99%

Positive hepatitis B surface antigen tests due to recent vaccination: a persistent problem

et al. 2012

View full text Add to dashboard Cite

BackgroundHepatitis B virus (HBV) is a common cause of viral hepatitis with significant health complications including cirrhosis and hepatocellular carcinoma. Assays for hepatitis B surface antigen (HBsAg) are the most frequently used tests to detect HBV infection. Vaccination for HBV can produce transiently detectable levels of HBsAg in patients. However, the time course and duration of this effect is unclear. The objective of this retrospective study was to clarify the frequency and duration of transient HBsAg positivity following vaccination against HBV.MethodsThe electronic medical record at an academic tertiary care medical center was searched to identify all orders for HBsAg within a 17 month time period. Detailed chart review was performed to identify all patients who were administered HBV vaccine within 180 days prior to HBsAg testing and also to ascertain likely cause of weakly positive (grayzone) results.ResultsDuring the 17 month study period, 11,719 HBsAg tests were ordered on 9,930 patients. There were 34 tests performed on 34 patients who received HBV vaccine 14 days or less prior to HBsAg testing. Of these 34 patients, 11 had grayzone results for HBsAg that could be attributed to recent vaccination. Ten of the 11 patients were renal dialysis patients who were receiving HBsAg testing as part of routine and ongoing monitoring. Beyond 14 days, there were no reactive or grayzone HBsAg tests that could be attributed to recent HBV vaccination. HBsAg results reached a peak COI two to three days following vaccination before decaying. Further analysis of all the grayzone results within the 17 month study period (43 results out of 11,719 tests) revealed that only 4 of 43 were the result of true HBV infection as verified by confirmatory testing.ConclusionsOur study confirms that transient HBsAg positivity can occur in patients following HBV vaccination. The results suggest this positivity is unlikely to persist beyond 14 days post-vaccination. Our study also demonstrates that weakly positive HBsAg results often do not reflect actual HBV infection, underscoring the importance of confirmatory testing. This study also emphasizes that vaccination-induced HBsAg positives occur most commonly in hemodialysis patients.

show abstract

“…Weintraub et al found eight of 47 neonates after vaccination with Engerix B® on the first day of life to be seropositive against HBsAg, 24 to 72 h after vaccination. In all seropositive infants, the HBsAg was undetectable beyond the 17th day post-vaccination [15]. Köksal et al studied 39 normal neonates and found 27 of them (69%) to be seropositive for HBsAg at least once post anti-hepatitis B vaccination administered soon after birth.…”

Section: Discussionmentioning

confidence: 99%

Transient hepatitis B surface antigen circulation after Infanrix-Hexa®: a case report and review of the literature

et al. 2010

View full text Add to dashboard Cite

The authors describe the case of a 70-day-old boy who was mistakenly diagnosed as suffering from acute hepatitis B, when he presented with persistent unconjugated hyperbilirubinemia and transaminasemia and was found to be seropositive for the hepatitis B surface antigen. The antigenemia was transient and related to his recent immunization with Infanrix-Hexa. Caution is required during interpretation of a positive HBsAg test that is obtained within 28 days after vaccination against hepatitis B.

show abstract

Transient Surface Antigenemia in Newborn Infants Vaccinated With Engerix B

Cited by 20 publications

References 0 publications

Prolonged Hepatitis B Surface Antigenemia After Vaccination

Prolonged Hepatitis B Surface Antigenemia After Vaccination

Positive hepatitis B surface antigen tests due to recent vaccination: a persistent problem

Transient hepatitis B surface antigen circulation after Infanrix-Hexa®: a case report and review of the literature

Contact Info

Product

Resources

About