Abstract

The neonatal hepatitis B vaccination (HBVac) was implemented 35 years ago in Taiwan, but many vaccinees exhibit inadequate long-term vaccine-induced seroprotective hepatitis B surface antibody (anti-HBs) levels. We investigated the association of the human leukocyte antigen (HLA) alleles (DPA1, DPB1, DQA1, and DQB1) with the long-term immunological response to the neonatal HBVac and adolescent booster HBVac in a Taiwanese cohort. We divided 281 Han students (median age 22, age range 17–29 years) into the following groups: (1) Group A (n = 61): anti-HBs titer ≥ 10 mIU/mL at the beginning of the study; (2) Group B (n = 75): anti-HBs level > 1000 mIU/mL after the first booster; (3) Group C (n = 37): anti-HBs level < 10 mIU/mL after the first booster; and (4) Group D (n = 5): anti-HBs level < 10 mIU/mL after three boosters. DQA1, DQB1, DPA1, and DPB1 typing of the participants was performed using sequence-specific oligonucleotides. Associations of HLA alleles and haplotypes with effects on neonatal HBVac and booster HBVac were examined through logistic regression analysis and Fisher’s exact test. A false discovery rate-based measure of significance, the q-value, was used for multiple comparisons, and an association was considered significant if the corresponding q-value was < 0.1. DPA1 alleles were associated with the long-term immunological response to the neonatal HBVac. The estimated odds ratio (OR) of the lack of HBV protective immunity when carrying an additional DPA1*01 and DPA1*02 was 0.36 [95% confidence interval (CI) = 0.17–0.76, p = 0.0076] and 2.39 (95% CI = 1.17–4.87, p = 0.016), respectively. DPB1 and DQB1 alleles were associated with a response to the adolescent booster vaccination. The estimated ORs of being nonresponsive to the first booster when carrying an additional DPB1*05 and DQB1*02 were 2.11 (95% CI = 1.13–3.93, p = 0.019) and 3.73 (95% CI = 1.43–9.71, p = 0.0070), respectively. All DPB1*03 carriers responded to the first booster (p of Fisher’s exact test = 0.0045). In our study, we discovered that HLA-DPA1 was primarily associated with the long-term response of primary infantile HBVac, and HLA-DPB1 and HLA-DQB1 exhibited associations with the HBV booster vaccination.

Highlights

  • Hepatitis B virus (HBV) infection is a major cause of chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma globally [1] and continues to be a serious public health threat worldwide

  • We investigated the association of human leukocyte antigen (HLA)-DPA1, HLA-DPB1, HLA-DQA1, and HLA-DQB1 alleles among a young Taiwanese population with anti-HBs persistence and who have observably lost immune memory to the neonatal HBV vaccine

  • This study investigated the associations of HLA alleles and haplotypes with the long-term immunological response to the primary neonatal hepatitis B vaccination (HBVac) and adolescent HBV booster vaccination

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Summary

Introduction

Hepatitis B virus (HBV) infection is a major cause of chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma globally [1] and continues to be a serious public health threat worldwide. To combat global HBV infection, the World Health Organization (WHO) recommended in 1997 that the HBV vaccination (HBVac) be incorporated into routine infant and childhood immunization programs [4]. By the end of 2019, 189 member states of the WHO have implemented these infant HBVac programs. The dramatic effect of neonatal HBV immunization on the decrease in the prevalence of the HBV surface antigen (HBsAg) among children has been reported by many countries including China (1%), South Korea (0.12%), Iran (0.6%), Colombia (0.5%), Italy (0.6%), Saudi Arabia (0.3%), and Canada (0.3%) [3]. Since the introduction of universal neonatal HBVac, the number of chronic HBV infections in Taiwanese adolescents has decreased substantially [8]

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