PERSISTENCE OF ANTI-HBs ANTIBODY AND IMMUNOLOGICAL MEMORY IN CHILDREN VACCINATED WITH HEPATITIS B VACCINE AT BIRTH

Authors

  • Abdollah Jafarzadeh
  • Sayed Jalal Montazerifar

Abstract

Aims: Vaccination with the hepatitis B surface antigen (HBsAg) induces protective levels ofantibody (anti-HBs = 10 IU/L) in majority of vaccinees. It has been shown that the levels ofanti-HBs antibody do wane after vaccination. The aim of this study was to evaluate thepersistence of anti-HBs antibodies in healthy Iranian children at 10 years after primaryvaccination and the response to a booster dose using recombinant hepatitis B vaccine. Materialsand Methods: Blood samples were collected from 146 healthy 10-11 years old children whoreceived primary course of Hepatitis B vaccine at 0, 1.5 and 9 months of age. The sera weretested for anti-HBs, antibody to Hepatitis B core antigen (anti-HBc) and HBsAg by ELISAtechnique. A single booster dose of recombinant hepatitis B vaccine was administeredintramuscularly to a total of 94 children, whose anti-HBs antibody was less than 50 IU/L (70children with anti-HBs <10 IU/L and 24 subjects with anti-HBs 10-50 IU/L). The sera ofchildren were re-tested for anti-HBs antibody levels at 4 weeks after booster vaccination.Results: At 10 years after primary vaccination 70/146 (47.9%) of children had protective levelsof antibody with geometric mean titer (GMT) of 68.12 IU/ml. All children were negative forHBsAg, although anti-HBc antibody was positive in 11 (7.5%) of children. In the 94 subjectswho received the booster dose the seroprotection and the GMT of anti-HBs antibody were25.5% and 9.58 IU/L at pre-booster time and rose to 95.75% and 575.6 IU/L after the boostervaccination, respectively. Seroprotection rates and mean titer of antibody similarly expressed inmales and females. Conclusion: The results of present study showed that at 10 years afterprimary vaccination with recombinant HB vaccine, 47.9% of the children had protective levelsof anti-HBs antibody. Moreover we have demonstrated an anamnestic response to boostervaccination that confirms the persistence of an effective immunological memory in vaccinees.Key words : Children, Hepatitis B vaccine, Anti-HBs antibody, Immunologic memory, Boostervaccination.

References

Wright TL. Introduction to chronic hepatitis B infection. Am

J Gastroenterol. 2006;101 Suppl 1:S1 -6.

Hipgrave DB, Maynard JE, Biggs BA. Improving birth dose

coverage of hepatitis B vaccine. Bull World Health Organ.

; 84:65-71.

Shokri F, Amani A. High rate of seroconversion following

administration of a single supplementary dose of recombinant

hepatitis B vaccine in Iranian healthy non-responder

neonates. Med Microbiol Immunol. 1997; 185:231-235.

Jafarzadeh A, Shokri F. The antibody response to HBs

antigen is regulated by coordinated Th1 and Th2 cytokine

production in healthy neonates. Clin Exp Immunol. 2003;

:451-456.

Shokri F, Jafarzadeh A. High seroprotection rate induced by

low doses of a recombinant hepatitis B vaccine in healthy

Iranian neonates. Vaccine. 2001; 19:4544-4548.

Jafarzadeh A, Khoshnoodi J, Ghorbani S, Hazrati SM, Faraj

Mazaheri B, Shokri F. Differential immunogenicity of a

recombinant hepatitis B vaccine in Iranian neonates:

influence of ethnicity and environmental factors. Iranian

Journal of Immunology. 2004; 1(2): 98-104.

Keating GM, Noble S . Recombinant hepatitis B vaccine

(Engerix -B): a review of its immunogenicity and protective

efficacy against hepatitis B. Drugs. 2003; 63(10):1021-1051.

J Ayub Med Coll Abbottabad; 18(4)

Fitzsimons D, Francois G, Hall A, McMahon B, Meheus A.

Long-term efficacy of hepatitis B vaccine, booster policy,

and impact of hepatitis B virus mutants. Vaccine. 2005; 23:

-4166.

West DJ, Calandra GB. Vaccine induced immunological

memory for hepatitis B surface antigen: implication for

policy on booster vaccination. Vaccine. 1996; 14:1019-1026.

Jafarzadeh A, Sajjadi SMA. Persistence of anti-HBs

antibodies in healthy Iranian children vaccinated with

recombinant hepatitis B vaccine and response to a booster

dose. Acta Med Iranica. 2005; 43(2): 79-84.

Gesemann M, Scheiermann N. Quantification of hepat itis B

vaccine -induced antibodies as a predictor of anti-HBs

persistence. Vaccine. 1995; 13:443-447.

Boxall EH, A Sira J, El-Shukhri N, Kelly DA. Long-term

persistence of immunity to hepatitis B after vaccination

during infancy in a country where endemicity is low. J Infec

Dis. 2004; 190: 1264-1269.

McMahon BJ, Bruden D, Petersen KM, Bulkow LR,

Parkinson AJ. Antibody levels and protection after hepatitis

B vaccination: results of a 15-year follow-up. Ann Intern

Med. 2005; 142:333-341.

Li H, Li RC, Liao SS, Yang XJ, Wang SS. Persistence of

hepatitis B vaccine immune protection and response to

hepatitis B booster immunization. World J Gastroenterol.

; 4:493-496.

Williams IT, Goldstein ST, Tufa J, Tauillii S, Margolis HS,

Mahoney FJ. Long term antibody response to hepatitis B

vaccination beginning at birth and to subsequent booster

vaccination. Pediatr Infect Dis J. 2003; 22:157-163.

Wang RX, Boland GJ, van Hattum J, de Gast GC. Long-term

persistence of T cell memory to HBsAg after hepatitis B

vaccination. World J Gastroentrol. 2004; 10:260-263.

Resti M, Difrancesco G, Azzari G, Rossi ME, Vierucci A.

Anti-HBs and immunological memory to HBV vaccine:

implication for booster timing. Vaccine. 1993; 11:1079-1082.

Gonzalez ML, Gonzalez JB, Salva F, Lardinois RA. 7-year

follow-up of newborns vaccinated against hepatitis B.

Vaccine. 1993; 11:1033-1036.

Banatvala JE, Van Damme P. Hepatitis B vaccine – do we

need boosters? J Viral Hepat. 2003; 10:1 -6.

Banatvala J, Van Damme P, Oehen S. Lifelong protection

against hepatitis B: the role of vaccine immunogenicity in

immune memory. Vaccine. 2001; 19:877-885.

Downloads

Most read articles by the same author(s)