Abstract
Background: Hepatitis B still represents a health concern, although safe and effective vaccines have been available since 1982. Italy introduced a program of universal vaccination against hepatitis B in 1991. The aim of this study was to assess the immunity levels towards hepatitis B in a sample of sera from the pediatric and adolescent population in the province of Florence, Central Italy, twenty-seven years after the implementation of universal vaccination. Methods: A total of 165 sera samples were collected from the resident population of Florence aged 1–18 years. The anti-HBs and anti-HBc enzyme-linked immunosorbent Assay (ELISA) tests were performed on all samples. The anamnestic and vaccination status data were also collected. Results: Seroprevalence of anti-HBs was approximately 60%, with children aged 1–5 years having the highest positivity rate (81.6%), and decreasing trends in the older age groups. The zero prevalence of anti-HBc shows that the detected protective immunity is mainly due to vaccination, and natural infection was not reported in the studied population. Conclusions: The seroprevalence of anti-HBs and the lack of anti-HBc in this study highlights that immunity levels have been derived mainly from immunization. This confirms how vaccination dramatically reduced circulation of the hepatitis B virus in Italy in the pediatric and adolescent population twenty-seven years after implementation of the mandatory universal program.
Highlights
Hepatitis B is a serious infection due to the hepatitis B virus (HBV), which infects the hepatocytes causing an acute or a chronic disease
Considering the general population, the estimated burden of migrants chronically infected with the hepatitis B virus from endemic countries accounts for 1–1.9 million residing in the European
The serological analysis showed that most enrolled subjects have anti-HBs titers ≥ 10 mIU/mL, and about 40% of vaccinated subjects are seronegative for anti-HBs. This percentage does not imply a susceptibility status for these subjects: the World Health Organization (WHO) affirms that even if the anti-HBs titers are not detectable following the immunization series, no booster dose is needed [1,2,3]. This is a consequence of the immune memory widely described for hepatitis B vaccination in the scientific literature [35,38]
Summary
Hepatitis B is a serious infection due to the hepatitis B virus (HBV), which infects the hepatocytes causing an acute or a chronic disease. The aim of this study was to assess the immunity levels towards hepatitis B in a sample of sera from the pediatric and adolescent population in the province of Florence, Central Italy, twenty-seven years after the implementation of universal vaccination. Conclusions: The seroprevalence of anti-HBs and the lack of anti-HBc in this study highlights that immunity levels have been derived mainly from immunization. This confirms how vaccination dramatically reduced circulation of the hepatitis B virus in Italy in the pediatric and adolescent population twenty-seven years after implementation of the mandatory universal program
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