title: Maternal anti-HBVs suppress the immune response of infants to hepatitis B vaccine.
abstract: It is still controversial whether maternal anti-HBV antibodies (anti-HBVs) affect the infants' immune response to hepatitis B virus (HBV) vaccination. This multicentre study aims to address this question. First, we determined whether the transplacental transfer of maternal anti-HBVs occurs by measuring the titres of 90 anti-HBVs-positive pregnant women and their newborns. The anti-HBVs-positive rates of newborns ranged from 89.7% to 100.0%, depending on the maternal anti-HBVs titres. Secondly, we investigated the effects of maternal anti-HBVs on the immune response of infants to HBV vaccination. A total of 1063 mother-and-infant pairs were enrolled and divided into three groups with maternal anti-HBVs titres of <10 IU/L (negative - 37.9%), 10-499 and ≥500 IU/L. The infants' anti-HBVs-positive rate and titres were negatively correlated with maternal anti-HBVs titres: the anti-HBVs-positive rate of infants were 88.9% (360/405), 84.5% (381/451) and 77.3% (160/207) in mothers with low, intermediate and high antibody titres, respectively, P<.0001. Median titres of anti-HBVs (IU/L) among infants were 169.1, 141.0 and 79.4, respectively, P=.020. One hundred and sixty-two infants were negative for anti-HBVs after the standard vaccination, and 120 of 131 of these infants (91.6%) reached anti-HBVs positivity after the first "booster" dose. The maternal anti-HBVs titres did not significantly affect infant response to this booster. In summary, transplacental transfer of anti-HBVs occurs and high titres of maternal anti-HBVs may suppress the immune response of infants to the standard HBV vaccination. The current schedule of the 0, 1 and 6 month may not be the optimal choice of infants with anti-HBVs-positive mothers.
authors.affiliation: Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan, Hubei Province, China.
authors.forename: X
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan, Hubei Province, China.
authors.forename: X
authors.initials: X
authors.lastname: Gui
authors.affiliation: Department of Infection Control, Qingdao Municipal Hospital, Qingdao, China.
authors.forename: L
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Wuhan, China.
authors.forename: F
authors.initials: F
authors.lastname: Huang
authors.affiliation: Mother and Child Hospital, Wuxue, Huanggang, China.
authors.forename: H
authors.initials: H
authors.lastname: Zhong
authors.affiliation: Centers for Disease Control and Prevention, Chongyang County, Xianning, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Pang
authors.affiliation: Centers for Disease Control and Prevention, Xiaonan District, Xiaogan, China.
authors.forename: S
authors.initials: S
authors.lastname: Wang
authors.affiliation: Centers for Disease Control and Prevention, Chibi, Xianning, China.
authors.forename: L
authors.initials: L
authors.lastname: Tang
authors.affiliation: Centers for Disease Control and Prevention, Chibi, Xianning, China.
authors.forename: L
authors.initials: L
authors.lastname: Fu
authors.affiliation: Centers for Disease Control and Prevention, Guangshui, Shuizhou, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Department of Dermatology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Shellman
mesh_terms: D000328:Adult; D000917:Antibody Formation; D005260:Female; D006510:Hepatitis B Antibodies / Q000097:blood*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D006515:Hepatitis B virus / Q000276:immunology*; D006801:Humans; D007112:Immunity, Maternally-Acquired; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines
keywords: HBV vaccine; immune response; maternal anti-HBVs; standard vaccination; suppress