title: Immune response in infants after universal high-dose hepatitis B vaccination: A community-based study in Beijing, China.
abstract: BACKGROUND
  Vaccination of infants beginning at birth is recommended to prevent Hepatitis B virus (HBV) infection in China. Compared to 5 μg/dose vaccine administered in other regions in China, a three-dose HB recombinant yeast vaccine at 10 μg/dose has been administered for infants within 24h after birth, 1 month and 6 months of age in Beijing since 2006. In a community-based retrospective cohort study, factors influencing immunologic vaccine response were evaluated.
  
  
  METHODS
  A total of 3670 infants who completed a 3-dose 10 μg recombinant HB vaccine regimen and born to hepatitis B antigen negative mothers were included. The effect on anti-HBs titers of maternal nutrient status, infants' birth condition, growth factors, timeliness of vaccination, dosing interval and the interval until post-vaccination serologic testing (PVST) were evaluated.
  
  
  RESULTS
  A total of 3666 infants with no markers of HBV infection were included in analysis. The mean anti-HB titers were 1767.17 mIU/ml. Only 16.9% of the infants completed their PVST within 30-59 days after the final dose of vaccination. Multivariate linear regression analysis showed that delay in PVST (β=-0.097, p<0.0001) and maternal folic acid supplementation (β=0.067, p=0.002) were associated with log-transformed anti-HB titers. Also a trend toward significant association was observed between the calcium supplementation of infants and log-transformed anti-HBs titers (β=0.062, p=0.057). Longer interval between dose 2 and dose 3 was not observed to increase the anti-HB titers after cofactors adjustment.
  
  
  CONCLUSIONS
  Our findings illustrate the importance of timing of PVST to avoid unnecessary revaccination. Multi-center large cohort studies should verify the effect and magnitude of folate and calcium supplementation on HB vaccine response.
authors.affiliation: Dept of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China.
authors.forename: Min
authors.initials: M
authors.lastname: Xiao
authors.affiliation: Dept of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Qiu
authors.affiliation: Beijing Center for Disease Control and Prevention, Beijing 100013, China.
authors.forename: Xinghuo
authors.initials: X
authors.lastname: Pang
authors.affiliation: Chinese Center for Disease Control and Prevention, Beijing 100050, China.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Liang
authors.affiliation: Chinese Center for Disease Control and Prevention, Beijing 100050, China.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: Chinese Center for Disease Control and Prevention, Beijing 100050, China.
authors.forename: Fuqiang
authors.initials: F
authors.lastname: Cui
authors.affiliation: Chinese Center for Disease Control and Prevention, Beijing 100050, China.
authors.forename: Fuzhen
authors.initials: F
authors.lastname: Wang
authors.affiliation: Chinese Center for Disease Control and Prevention, Beijing 100050, China.
authors.forename: Guomin
authors.initials: G
authors.lastname: Zhang
authors.affiliation: Dept of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.affiliation: Dept of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China. Electronic address: liwang@ibms.pumc.edu.cn.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.affiliation: Beijing Center for Disease Control and Prevention, Beijing 100013, China. Electronic address: zhangweipumc@163.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
mesh_terms: D000068476:Beijing; D005260:Female; D006509:Hepatitis B / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D014614:Vaccines, Synthetic / Q000008:administration & dosage / Q000276:immunology
chemical_list: D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines; D014614:Vaccines, Synthetic
keywords: Antibody titers; Folate; Hepatitis B; Vaccine