title: Minimization of hepatitis B infection among children in Jiangsu, China, 12years after integration of hepatitis B vaccine into the expanded program on immunization.
abstract: China has integrated hepatitis B vaccine into the Expanded Program on Immunization since 2002. We aimed to survey the seroprevalence of and immunity to hepatitis B virus (HBV) in children born from 2002 to 2014 in Jiangsu, China.
  
  
  
  Totally 3442 children (M:F=2072:1370) at the age of 7months to 12years (5.5±3.6), from five cities and rural areas across Jiangsu province, were enrolled. Blood samples were measured for HBV markers by ELISA and quantitative microparticle enzyme immunoassay. HBV DNA was tested by real-time PCR and S region was amplified by nested PCR.
  
  
  
  Twelve (0.35%) children were positive for hepatitis B surface antigen (HBsAg) and 34 (0.99%) were HBsAg negative and positive for antibody against hepatitis B core antigen (anti-HBc). Totally 2542 (73.85%) children had anti-HBs levels ⩾10mIU/ml and 535 (15.54%) with 2-9.9mIU/ml. All 12 HBsAg-positive children had detectable HBV DNA with a mean level of 6.1±1.7logIU/ml (3.3-8.1logIU/ml); 8 were genotype C and 4 were genotype B. No mutation was detected in the a determinant of HBsAg. HBV DNA was not detected in all the 34 children with positive anti-HBc and negative HBsAg.
  
  
  
  HBsAg prevalence among children in Jiangsu born after the introduction of universal vaccination against hepatitis B has significantly decreased. No mutation of S gene is associated with vaccine failure in the cohort of children.
authors.affiliation: Department of Obstetrics and Gynecology, Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China.
authors.forename: Xiaoqian
authors.initials: X
authors.lastname: Lin
authors.affiliation: Department of Obstetrics and Gynecology, Taixing People's Hospital, Taixing 225400, China.
authors.forename: Jishi
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Laboratory Medicine, Zhongda Hospital, Southeast University, School of Medicine, Nanjing 210009, China.
authors.forename: Huixia
authors.initials: H
authors.lastname: Lu
authors.affiliation: Department of Infectious Diseases, Yixing People's Hospital, Yixing 214200, China.
authors.forename: Yulin
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Laboratory Medicine, Yixing Second People's Hospital, Yixing 214221, China.
authors.forename: Guiping
authors.initials: G
authors.lastname: Zhou
authors.affiliation: Department of Laboratory, Lianyungang First People's Hospital, Lianyungang 222002, China.
authors.forename: Huiyi
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Obstetrics and Gynecology, Zhenjiang Fourth People's Hospital, Zhenjiang 212001, China.
authors.forename: Chenyu
authors.initials: C
authors.lastname: Xu
authors.affiliation: Department of Obstetrics and Gynecology, Mingji Hospital, Nanjing 210021, China.
authors.forename: Qiaozhen
authors.initials: Q
authors.lastname: Wu
authors.affiliation: Department of Experimental Medicine, Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China.
authors.forename: Jingli
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Experimental Medicine, Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Obstetrics and Gynecology, Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China.
authors.forename: Muyi
authors.initials: M
authors.lastname: Yang
authors.affiliation: Department of Experimental Medicine, Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China.
authors.forename: Guangyu
authors.initials: G
authors.lastname: Gu
authors.affiliation: Department of Obstetrics and Gynecology, Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China; Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing 210008, China. Electronic address: dtylhu@126.com.
authors.forename: Yali
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Department of Experimental Medicine, Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China; Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing 210008, China; Department of Infectious Diseases, Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China. Electronic address: zgr03summer@126.com.
authors.forename: Yi-Hua
authors.initials: YH
authors.lastname: Zhou
mesh_terms: D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D002947:Cities / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D008297:Male; D012424:Rural Population; D016036:Seroepidemiologic Studies; D014505:Urban Population
chemical_list: D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines
keywords: Children; Hepatitis B virus; Immunity; Seroepidemiology