title: Evidence of protection against clinical and chronic hepatitis B infection 20 years after infant vaccination in a high endemicity region.
abstract: Vaccination against hepatitis B virus (HBV) immediately after birth prevents neonatal infection by vertical transmission from HBV carrier mothers. There is an ongoing debate whether infant vaccination is sufficient to protect against infection when exposed to HBV later in life. We studied 222 Thai infants born to HBsAg -/+ and HBeAg -/+ mothers who were vaccinated with recombinant hepatitis B vaccine at 0-1-2-12 months of age. A subset of 100 subjects received a booster dose at age 5 years. Blood samples collected yearly for 20 years were examined for anti-HBs antibodies and serological markers of hepatitis B infection (anti-HBc, HBsAg, and in selected cases HBeAg, anti-HBe, HBV DNA). During the 20-year follow-up, no subject acquired new chronic HBV infection or clinical hepatitis B disease. During the first decade, possible subclinical breakthrough HBV infection (anti-HBc seroconversion) was only observed in subjects born to HBsAg +/HBeAg + mothers (6/49 [12.2%]). During the second decade, breakthrough HBV infections were detected in all groups (18/140 [12.8%]). Increases in anti-HBs concentrations that were unrelated to additional HBV vaccination or infection were detected in approximately 10% of subjects in each decade. Primary infant vaccination with a recombinant hepatitis B vaccine confers long-term protection against clinical disease and new chronic hepatitis B infection despite confirmed hepatitis B exposure.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Center of Excellence in Clinical Virology, Chulalongkorn University, Bangkok, Thailand. Yong.P@chula.ac.th
authors.forename: Y
authors.initials: Y
authors.lastname: Poovorawan
authors.forename: V
authors.initials: V
authors.lastname: Chongsrisawat
authors.forename: A
authors.initials: A
authors.lastname: Theamboonlers
authors.forename: G
authors.initials: G
authors.lastname: Leroux-Roels
authors.forename: S
authors.initials: S
authors.lastname: Kuriyakose
authors.forename: M
authors.initials: M
authors.lastname: Leyssen
authors.forename: J-M
authors.initials: JM
authors.lastname: Jacquet
mesh_terms: D000293:Adolescent; D002353:Carrier State / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000097:blood; D019353:Endemic Diseases / Q000517:prevention & control*; D005260:Female; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood / Q000276:immunology; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000276:immunology; D006513:Hepatitis B e Antigens / Q000097:blood / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology / Q000472:pathogenicity; D019694:Hepatitis B, Chronic / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D006801:Humans; D007117:Immunization, Secondary; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D008137:Longitudinal Studies; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology / Q000821:virology; D013785:Thailand / Q000453:epidemiology; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D006513:Hepatitis B e Antigens
references.citation: PLoS One. 2007 Aug 15;2(8):e753
references.pmid: 17710152
references.citation: Asian Pac J Cancer Prev. 2008 Jul-Sep;9(3):507-9
references.pmid: 18990029
references.citation: J Clin Microbiol. 2002 Jun;40(6):1972-6
references.pmid: 12037050
references.citation: JAMA. 1989 Jun 9;261(22):3278-81
references.pmid: 2523981
references.citation: Vaccine. 2002 Nov 1;20(31-32):3739-43
references.pmid: 12399203
references.citation: Epidemiol Rev. 2006;28:126-35
references.pmid: 16782778
references.citation: Vaccine. 2008 Nov 18;26(49):6266-73
references.pmid: 18848855
references.citation: Arch Dis Child Fetal Neonatal Ed. 1997 Jul;77(1):F47-51
references.pmid: 9279183
references.citation: Med Microbiol Immunol. 2005 May;194(3):163-8
references.pmid: 15834754
references.citation: J Infect. 2008 Nov;57(5):404-9
references.pmid: 18829116
references.citation: Vaccine. 2007 Nov 19;25(47):8085-90
references.pmid: 17920732
references.citation: Bull World Health Organ. 1988;66(4):443-55
references.pmid: 2971466
references.citation: Travel Med Infect Dis. 2007 Mar;5(2):79-84
references.pmid: 17298912
references.citation: Pediatr Infect Dis J. 1992 Oct;11(10):816-21
references.pmid: 1408478
references.citation: J Med Assoc Thai. 2001 Jun;84 Suppl 1:S18-25
references.pmid: 11529332
references.citation: Vaccine. 1990 Mar;8 Suppl:S56-9; discussion S60-2
references.pmid: 2139286
references.citation: Trop Med Int Health. 2006 Oct;11(10):1496-502
references.pmid: 17002723
references.citation: J Gastroenterol Hepatol. 2000 Dec;15(12):1356-61
references.pmid: 11197043
references.citation: Vaccine. 2010 Jan 8;28(3):730-6
references.pmid: 19892043
references.citation: Viral Immunol. 2009 Apr;22(2):125-30
references.pmid: 19326999
references.citation: Vaccine. 2008 Dec 2;26(51):6587-91
references.pmid: 18835318
references.citation: Vaccine. 2009 Mar 13;27(12):1858-62
references.pmid: 19186203