Long-term protection against carriage of hepatitis B virus after infant vaccination

M A B van der Sande, P Waight, M Mendy, P Rayco-Solon, P Hutt, T Fulford, C Doherty, S J McConkey, D Jeffries, A J Hall, H C Whittle

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Carriage of hepatitis B virus (HBV) is a major risk factor for liver cirrhosis and hepatocellular carcinoma. Infant vaccination has been effective in preventing horizontal transmission during early childhood. It is unknown whether protection is maintained into early adulthood.

METHODS: In 1984, early childhood vaccination was introduced in 2 rural Gambian villages. In 2003, serological assessment of 81.5% of 1,350 eligible participants 1-24 years old was done, to determine vaccine efficacy against infection and carriage.

RESULTS: Overall vaccine efficacy against infection and carriage was 83.4% (95% confidence interval [CI], 79.8%-86.6%) and 96.5% (85% CI, 93.9%-98.9%), respectively. Vaccine efficacy against infection was similar when restricted to primary responders (85.3%), but a significant effect of peak antibody concentration was found. Both vaccine efficacy and levels of hepatitis B surface antibody (anti-HBs) decreased with age, resulting in a vaccine efficacy against infection and carriage among 20-24-year-old participants of 70.9% (95% CI, 60.4%-80.5%) and 91.1% (95% CI, 75.8%-100%), respectively. Fifteen years after vaccination, fewer than half of the vaccinees had detectable anti-HBs. The prevalence of carriage in the unvaccinated population was similar to the prevalence 20 years earlier.

CONCLUSIONS: HBV vaccination early during life can provide long-lasting protection against carriage, despite decreasing antibody levels. The role played by subclinical boosting and the necessity of a booster need to be evaluated.

Original languageEnglish
JournalJournal of Infectious Diseases
Volume193
Issue number11
Pages (from-to)1528-35
Number of pages8
ISSN0022-1899
DOIs
Publication statusPublished - 1-Jun-2006

Keywords

  • Adolescent
  • Adult
  • Age Factors
  • Carrier State/prevention & control
  • Child
  • Child, Preschool
  • Gambia
  • Hepatitis B/prevention & control
  • Hepatitis B Antibodies/blood
  • Hepatitis B Surface Antigens/blood
  • Hepatitis B Vaccines/administration & dosage
  • Humans
  • Infant

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