Abstract
Botswana introduced the HBV vaccine at birth for all newborns in 2000. To the best of our knowledge, since the introduction of HBV vaccination, there have been limited data for vaccine response to HBV and its impact on early childhood HBV infections among children HIV exposed but uninfected in Botswana. To determine the prevalence of hepatitis B surface antigen (HBsAg) and HBV vaccine response in 18 months old children HIV exposed but uninfected in Botswana. Stored plasma samples from 304 children at 18 months of age and 287 mothers from delivery were tested for HBsAg. Mothers with positive HBsAg had HBV DNA level tested, and their HBV genotypes were determined by amplifying a 415-base pair (bp) region of the surface gene. Plasma samples from children exposed to HIV were tested for hepatitis B surface antibody (anti-HBs) titers. No children (0 of 304) were positive for HBsAg at 18 months while 5 (1.74%) of 287 HIV-positive mothers were HBsAg positive. Four of the HBsAg positive mothers were infected with genotype A1, while 1 was infected with genotype E. The median anti-HBs titer in children was 174 mIU/mL [QR: 70, 457]. Three (1.1%) of 269 children had an inadequate vaccine response (<10 mIU/mL), while 266 (98.9%) of 269 had protective immunity. However, when using the ≥100mIU/mL threshold, only 170 (63.2%) of 269 children had complete protection. No HBsAg positivity was identified in a cohort of children HIV exposed but uninfected. The absence of HBsAg positives was associated with good HBV vaccine responses and low maternal HBsAg prevalence in Botswana.
Highlights
Hepatitis B virus (HBV) infection is a global health problem, with 257 million people estimated to be chronically infected [1]
No hepatitis B surface antigen (HBsAg) positivity was identified in a cohort of children human immunodeficiency virus (HIV) exposed but uninfected
We report the absence of HBsAg positivity (0%) and relatively strong HBV vaccine responses in this cohort by 18 months of age
Summary
Hepatitis B virus (HBV) infection is a global health problem, with 257 million people estimated to be chronically infected [1]. In HBV endemic regions including sub-Saharan Africa, HBV infections may be transmitted vertically from mother to child, most infections occur through horizontal transmission in early childhood [5]. A meta-analysis study showed that 42.1% of the children born to HBsAg-positive mothers who did not receive HBV passive-active immunoprophylaxis acquired infection perinatally [6]. This figure was reduced to 2.9% among children who received the immunoprophylaxis, thereby highlighting the significant benefit of immunization [6]. To the best of our knowledge, since the introduction of HBV vaccination, there have been limited data for vaccine response to HBV and its impact on early childhood HBV infections among children HIV exposed but uninfected in Botswana
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