Impact of Hepatitis B Vaccination in Children Born to HBsAg-Positive Mothers: a 20-year Retrospective Study

• Published in: Infection Vol. 37; no. 4; pp. 340 - 343
• Main Authors: Bracciale, L, Fabbiani, M, Sansoni, A, Luzzi, L, Bernini, L, Zanelli, G
• Format: Journal Article
• Language: English
• Published: Munchen Munchen : Urban and Vogel 01.08.2009; Urban and Vogel; Springer; Springer Nature B.V
• Subjects: Adolescent; Biological and medical sciences; Child; Children; Clinical and Epidemiological Study; Core protein; Data processing; Family Medicine; Female; General Practice; Hepatitis B - immunology; Hepatitis B - prevention & control; Hepatitis B Antibodies - blood; Hepatitis B surface antigen; Hepatitis B Surface Antigens - blood; Hepatitis B Vaccines - immunology; Hepatitis B virus; Humans; Infant, Newborn; Infectious Diseases; Internal Medicine; Italy; Male; Medical sciences; Medicine; Medicine & Public Health; Miscellaneous; Pregnancy; Pregnancy Complications, Infectious; Prophylaxis; Public health. Hygiene; Public health. Hygiene-occupational medicine; Retrospective Studies; Risk groups; Territory; Vaccination; Young Adult; Italy; Vaccination Cycle; Booster Dose; Postexposure Prophylaxis; Acute Hepatitis; Infection; Viral hepatitis B; Nosocomial infection; Pediatrics; Survey; Efficiency; Viral disease; Vaccine; Hospital; Hygiene; Retrospective
• ISSN: 0300-8126; 1439-0973
• DOI: 10.1007/s15010-008-8252-3

Background: 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). Results: 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 ([double dagger] 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. Conclusion: 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.