Evidence of protection against clinical and chronic hepatitis B infection 20 years after infant vaccination in a high endemicity region

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http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2010.01312.x/abstract

Evidence of protection against clinical and chronic hepatitis B infection 20

years after infant vaccination in a high endemicity region

Y. Poovorawan1, V. Chongsrisawat1, A. Theamboonlers1, G. Leroux-Roels2, S.

Kuriyakose3, M. Leyssen3, J.-M. Jacquet3

Article first published online: 1 APR 2010

DOI: 10.1111/j.1365-2893.2010.01312.x

© 2010 Blackwell Publishing Ltd

Issue

Journal of Viral Hepatitis

Volume 18, Issue 5, pages 369–375, May 2011

Summary.  Vaccination against hepatitis B virus (HBV) immediately after birth

prevents neonatal infection by vertical transmission from HBV carrier mothers.

There is an ongoing debate whether infant vaccination is sufficient to protect

against infection when exposed to HBV later in life. We studied 222 Thai infants

born to HBsAg −/+ and HBeAg −/+ mothers who were vaccinated with recombinant

hepatitis B vaccine at 0-1-2-12 months of age. A subset of 100 subjects received

a booster dose at age 5 years. Blood samples collected yearly for 20 years were

examined for anti-HBs antibodies and serological markers of hepatitis B

infection (anti-HBc, HBsAg, and in selected cases HBeAg, anti-HBe, HBV DNA).

During the 20-year follow-up, no subject acquired new chronic HBV infection or

clinical hepatitis B disease. During the first decade, possible subclinical

breakthrough HBV infection (anti-HBc seroconversion) was only observed in

subjects born to HBsAg +/HBeAg + mothers (6/49 [12.2%]). During the second

decade, breakthrough HBV infections were detected in all groups (18/140

[12.8%]). Increases in anti-HBs concentrations that were unrelated to additional

HBV vaccination or infection were detected in approximately 10% of subjects in

each decade. Primary infant vaccination with a recombinant hepatitis B vaccine

confers long-term protection against clinical disease and new chronic hepatitis

B infection despite confirmed hepatitis B exposure.

(http://www.clinicaltrials.gov NCT00240500 and NCT00456625)