Universal immunization of infants with low doses of a low-cost, plasma-derived hepatitis B vaccine in South Africa.
OBJECTIVE
To evaluate the effectiveness of universal vaccination against viral hepatitis B in South Africa among 18-month-old rural children.


METHODS
Children were immunized with a course of low-dose (1.5 microg), plasma-derived hepatitis B vaccine at 6, 10 and 14 weeks of age, and blood samples from the children were tested for three hepatitis B markers: hepatitis B surface antigen (HBsAg), anti-HBs and anti-HBc.


RESULTS
One year after vaccination, a protective anti-HBs antibody titre of at least 10 IU/l was present in 669/769 (87.0%) of blood serum samples tested. Only 3/756 children (0.4%) were HBsAg positive and a fourth child was anti-HBc positive (HBsAg negative). This is a marked decrease compared to the hepatitis B prevalences reported in previous studies. Among rural migrant mine-workers, for example, HBsAg prevalence was 9.9%, and was 10.1% among children 0-6 years of age in the Eastern Cape Province.


CONCLUSIONS
The low-dose, plasma-derived hepatitis B vaccine, which is affordable to most developing countries, was very successful in controlling endemic hepatitis B infection, where the virus is predominantly spread by horizontal transmission among infants and young children.
Schoub
B D
BD
National Insitute for Virology, Department of Virology, University of the Witwatersrand, South Africa. schoub@niv.ac.za
Matai
U
U
Singh
B
B
Blackburn
N K
NK
Levin
J B
JB
D015415:Biomarkers; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003906:Developing Countries; D006679:HIV Seropositivity / Q000453:epidemiology; D006510:Hepatitis B Antibodies / Q000097:blood; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000191:economics; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007223:Infant; D007231:Infant, Newborn; D015995:Prevalence; D015397:Program Evaluation; D013019:South Africa / Q000453:epidemiology
D015415:Biomarkers; D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines