Impact of Hepatitis B Vaccination in Children Born to HBsAg-Positive Mothers: a 20-year Retrospective Study
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Preventive measures remain the best approach to control the spread of hepatitis B virus (HBV) infection.
Patients and Methods:
To evaluate the effectiveness of vaccination against HBV, we conducted a 20-year retrospective study on 100 subjects, born to hepatitis B surface antigen (HBsAg)-positive mothers, who had received postexposure prophylaxis at the Clinic of Infectious Diseases (Siena University, Italy) during 1984–2004. All patients were tested for the presence of HBsAg, anti-HBs and anti-HB core antigen (anti-HBc).
Two subjects (2%) acquired the infection as shown by the presence of anti-HBc. Of the 98 patients who did not acquire the infection, 62 of these (63.3%) had an anti-HBs concentration considered protective (‡ 10 mIU/ml). The percentage of protected subjects decreased in relation to time from vaccination with a significant reduction (p = 0.009) of anti-HBs geometric mean titre (GMT) after 5 years, which reached the level of 10 mIU/ml after about 15 years. No patients without protective concentration have acquired the infection as of today. Only 12% of the HBsAgpositive mothers were followed in specialized structures after pregnancy, reflecting the scarce knowledge of the problem in the general population.
Our data, while confirming the effectiveness of anti hepatitis B vaccination, highlight the need for postvaccination follow-up, particularly in high-risk categories, to prolong protection, through booster doses if necessary. We show, moreover, the importance of maintaining active surveillance in the territory to improve follow-up to chronic carriers and to sensitize families.
KeywordsAcute Hepatitis Booster Dose Postexposure Prophylaxis Vaccination Cycle
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- 3.Stroffolini T, Bianco E, Szklo A, Bernacchia R, Bove C, Colucci M, Coppola RC, D’Argenio P, Lopalco P, Parlato A, Ragni P, Simonetti A, Zotti C, Mele A: Factors affecting the compliance of the antenatal hepatitis B screening programme in Italy. Vaccine 2003; 21: 1246–1249.PubMedCrossRefGoogle Scholar
- 5.Mele A, Tosti ME, Mariano A, Pizzuti R, Ferro A, Borrini B, Zotti C, Lopalco P, Curtale F, Balocchini E, Spada E: National surveillance system for acute viral hepatitis (SEIEVA) Collaborating group: acute hepatitis B 14 years after the implementation of universal vaccination in Italy: areas of improvement and emerging challenges. Clin Infect Dis 2008; 46: 868–875.PubMedCrossRefGoogle Scholar
- 8.Stroffolini T, Mele A, Tosti ME, Gallo G, Balocchini E, Sangalli M, Ragni P, Santonastasi F, Marzolini A, Ciccozzi M, Mioraghi A: The impact of the Hepatitis B mass immunisation campaign on the incidence and risk factors of acute hepatitis B in Italy. J Hepatol 2000; 33: 980–985.PubMedCrossRefGoogle Scholar
- 12.Zanetti AR, Mariano A, Romanò L, D’Amelio R, Chironna M, Coppola RC, Cuccia M, Mangione R, Marrone F, Negrone FS, Parlato A, Zamparo E, Zotti C, Stroffolini T, Mele A: Study group Long-term immunogenicity of hepatitis B vaccination and policy for booster: an Italian multicentre study. Lancet 2005; 366: 1379–1384.PubMedCrossRefGoogle Scholar
- 17.Marzano A, Angelucci E, Andreone P, Brunetto M, Bruno R, Burra P, Caraceni P, Daniele B, Di Marco V, Fabrizi F, Fagiuoli S, Grossi P, Lampertico P, Meliconi R, Mangia A, Puoti M, Raimondo G, Smedile A: Italian association for the study of the liver: prophylaxis and treatment of hepatitis B in immunocompromised patients. Dig Liver Dis 2007; 39: 397–408.PubMedCrossRefGoogle Scholar