title: Hepatitis B Virus Infection in Indonesia 15 Years After Adoption of a Universal Infant Vaccination Program: Possible Impacts of Low Birth Dose Coverage and a Vaccine-Escape Mutant.
abstract: A universal hepatitis B vaccination program for infants was adopted in Indonesia in 1997. Before its implementation, the prevalence of hepatitis B surface antigen (HBsAg)-positive individuals in the general population was approximately 5-10%. The study aimed to investigate the hepatitis B virus (HBV) serological status and molecular profile among children, 15 years after adoption of a universal infant vaccination program in Indonesia. According to the Local Health Office data in five areas, the percentages of children receiving three doses of hepatitis B vaccine are high (73.9-94.1%), whereas the birth dose coverage is less than 50%. Among 967 children in those areas, the seropositive rate of HBsAg in preschool- and school-aged children ranged from 2.1% to 4.2% and 0% to 5.9%, respectively. Of the 61 HBV DNA-positive samples, the predominant genotype/subtype was B/adw2 Subtype adw3 was identified in genotype C for the first time in this population. Six samples (11.5%) had an amino acid substitution within the a determinant of the S gene region, and one sample had T140I that was suggested as a vaccine-escape mutant type. The low birth dose coverage and the presence of a vaccine-escape mutant might contribute to the endemicity of HBV infection among children in Indonesia.
authors.affiliation: Department of Microbiology, Faculty of Medicine, Airlangga University, Surabaya, Indonesia. Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Surabaya, Indonesia.
authors.forename: Priyo Budi
authors.initials: PB
authors.lastname: Purwono
authors.affiliation: Department of Microbiology, Faculty of Medicine, Airlangga University, Surabaya, Indonesia. Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Surabaya, Indonesia.
authors.lastname: Juniastuti
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Surabaya, Indonesia.
authors.forename: Mochamad
authors.initials: M
authors.lastname: Amin
authors.affiliation: Local Health Office, Kota Sorong, Indonesia.
authors.forename: Rendra
authors.initials: R
authors.lastname: Bramanthi
authors.affiliation: Bahteramas Hospital, Kendari, Indonesia.
authors.lastname: Nursidah
authors.affiliation: Health Polytechnics of Ministry of Health, Kupang, Indonesia.
authors.forename: Erika Maria
authors.initials: EM
authors.lastname: Resi
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Surabaya, Indonesia.
authors.forename: Rury Mega
authors.initials: RM
authors.lastname: Wahyuni
authors.affiliation: Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Yano
authors.affiliation: Department of Biochemistry, Faculty of Medicine, Airlangga University, Surabaya, Indonesia. Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Surabaya, Indonesia.
authors.lastname: Soetjipto
authors.affiliation: Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Hak
authors.initials: H
authors.lastname: Hotta
authors.affiliation: Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Yoshitake
authors.initials: Y
authors.lastname: Hayashi
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Surabaya, Indonesia. Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Utsumi
authors.affiliation: Department of Microbiology, Faculty of Medicine, Airlangga University, Surabaya, Indonesia. Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Surabaya, Indonesia. ingelusida@yahoo.com.
authors.forename: Maria Inge
authors.initials: MI
authors.lastname: Lusida
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005838:Genotype; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000627:therapeutic use*; D006515:Hepatitis B virus / Q000235:genetics; D006801:Humans; D017589:Immunization Programs / Q000379:methods*; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D008297:Male
chemical_list: D017325:Hepatitis B Vaccines