title: [Combined immunoprophylaxis induces changes in anti-hepatitis B surface protein titer in infants born to mothers with positivity for hepatitis B surface antigen].
abstract: OBJECTIVE
  To conduct a prospective randomized controlled trial of infants born to hepatitis B virus (HBV) surface antigen (HBsAg)-positive mothers in order to investigate the dynamic changes in the titer of anti-HBV surface protein (HBS) induced by treatment with combined immunoprophylaxis (200 IU hepatitis B immunoglobulin (HBIG) and 5 or 10 mug yeast recombinant hepatitis B vaccine), to compare the protective effect of 5 and 10 mug hepatitis B vaccine, and to provide an immunization strategy, monitoring mode and booster immunization schedule for the high-risk group.
  
  
  METHODS
  Two-hundred-and-sixty-nine infants born to HBsAg positive mothers were given combined immunoprophylaxis at birth, and the venous blood samples (at birth, and 1, 7 and 12 months) were tested for HBV DNA load, and HBsAg and anti-HBS titers.
  
  
  RESULTS
  The overall 1-year protective rate of combined immunoprophylaxis was 95.9%. There was no significant difference between the infectious rates of infants given the 5 mug or the 10 mug hepatitis B vaccine (x2 = 0.876, P = 0.377). The geometric mean titers (GMTs) of anti-HBS were 144.1 mIU/ml at 1-month old and 564.9 mIU/ml at the age of 7 months old (the highest point), but declined to 397.6 mIU/ml at the age of 12 months old. The rate of infants with anti-HBS titer less than 100 mIU/ml was 20.9%, and that of less than 10 mIU/ml was 7.4% at 7-month-old; the rate of infants with anti-HBS titer less than 100 mIU/ml increased to 30.2% and that of less than 10 mIU/ml increased to 15.9% at 12-month-old. At 7-month-old, the GMT of the 10 mug vaccine group was higher than that of the 5 mug vaccine group (675.3 mIU/ml vs. 25.0 mIU/ml, P = 0.001) and the rate of infants with anti-HBS titer less than 10 mIU/ml was significantly lower in the 10 mug vaccine group (2.3% vs. 12.6%, P = 0.002); at 12-month-old, the rate of infants with anti-HBS titer less than 100 mIU/ml was also significantly lower in the 10 mug group (20.6% vs. 40.2%, P = 0.001).
  
  
  CONCLUSIONS
  Combined immunoprophylaxis is therapeutically efficacious for treating infants born to HBsAg positive mothers. Monitoring these infants' anti-HBs titer will help to identify non- or low-responders in a timely manner. The high-dose hepatitis B vaccine is preferable to the low-dose, and should be considered for use in immunization strategies for these infants.
authors.affiliation: First Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an 710061, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.forename: Yu-ling
authors.initials: YL
authors.lastname: Feng
authors.forename: Ming-hui
authors.initials: MH
authors.lastname: Liu
authors.forename: Yun
authors.initials: Y
authors.lastname: Bai
authors.forename: Da-hong
authors.initials: DH
authors.lastname: Feng
authors.forename: Ning-xia
authors.initials: NX
authors.lastname: Yuan
authors.forename: Dong-qing
authors.initials: DQ
authors.lastname: Du
authors.forename: Wei-hong
authors.initials: WH
authors.lastname: Feng
authors.forename: Hong-Li
authors.initials: HL
authors.lastname: Liu
authors.forename: Yuan
authors.initials: Y
authors.lastname: Yang
authors.forename: Jin-feng
authors.initials: JF
authors.lastname: Liu
authors.forename: Ying-li
authors.initials: YL
authors.lastname: He
authors.forename: Hong-xia
authors.initials: HX
authors.lastname: Song
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.forename: Ying-ren
authors.initials: YR
authors.lastname: Zhao
authors.forename: Tian-yan
authors.initials: TY
authors.lastname: Chen
mesh_terms: D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000276:immunology* / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood / Q000276:immunology*; D006514:Hepatitis B Surface Antigens / Q000097:blood* / Q000276:immunology; D017325:Hepatitis B Vaccines / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D009035:Mothers; D011446:Prospective Studies; D019562:Viral Load
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines