The Impact of Hepatitis B Vaccine Failure on Long-term Natural Course of Chronic Hepatitis B Virus Infection in Hepatitis B e Antigen–Seropositive Children

• Published in: The Journal of infectious diseases Vol. 216; no. 6; pp. 662 - 669
• Main Authors: Tai, Chi-San, Wu, Jia-Feng, Chen, Huey-Ling, Ni, Yen-Hsuan, Hsu, Hong-Yuan, Chang, Mei-Hwei
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 15.09.2017
• Subjects: Child; Child, Preschool; Cross-Sectional Studies; Dose-Response Relationship, Drug; Female; Follow-Up Studies; Hepatitis B e Antigens - blood; Hepatitis B Surface Antigens - blood; Hepatitis B Vaccines - administration & dosage; Hepatitis B Vaccines - therapeutic use; Hepatitis B, Chronic - blood; Hepatitis B, Chronic - immunology; Humans; Infant; Infant, Newborn; Male; Treatment Failure; VIRUSES; mother-to-infant transmission; HBeAg seroconversion; immunoprophylaxis; hepatitis B virus; vaccine failure
• ISSN: 0022-1899; 1537-6613; 1537-6613
• DOI: 10.1093/infdis/jix339

Summary Vaccine failure with chronic hepatitis B virus (HBV) infection still develops in children after universal hepatitis B immunization. Vaccine failure HBV-carrier children were associated with delayed hepatitis B e antigen seroconversion, and more HBV genotype C infection. Abstract Background Vaccine failure with chronic hepatitis B virus (HBV) infection still develops in children after universal hepatitis B immunization. This study aimed to investigate the natural course of chronic HBV infection in children with vaccine failure and compare it with that of nonvaccinated children. Methods Three hundred fifty-six hepatitis B e antigen (HBeAg)–seropositive, hepatitis B surface antigen (HBsAg) carrier children, who were followed for at least 1 year without antiviral therapy, were enrolled. These comprised 105 vaccine failure subjects who received 3 doses of HBV vaccine in infancy and 251 nonvaccinated subjects. The clinical, serologic, and virologic features were compared between the 2 groups. Results The cumulative HBeAg seroconversion rate was significantly lower in the vaccine failure group than in the nonvaccinated group (30.5% vs 77.7%, P < .0001). Genotype C HBV infection was more frequent in the vaccine failure group (33.7% vs 13.4%, P < .0001), and the maternal HBsAg-positive rate was higher (97.1% vs 66.4%, P < .0001). In a multivariate analysis, vaccine failure, genotype C infection, and maternal HBsAg positivity were significantly associated with delayed HBeAg seroconversion. Conclusions HBeAg-seropositive vaccine failure HBV-carrier children were associated with delayed HBeAg seroconversion during long-term follow-up, and more HBV genotype C infection and maternal HBsAg seropositivity.