Abstract
Hepatitis B virus infection is a vaccine preventable infection of liver which remains a key public health burden globally. The development of Anti-HBs titre greater than or equal to 10 IU/L is considered as protective immunity and any titre less than 10 IU/L as non-protective following HBV vaccination. There is no comprehensive and authentic data regarding the immune response even 10 years after the integration of the HBV vaccine in to the EPI programme in Bangladesh and specifically, in Brahmonbaria district. The study was also aimed to assess the long term immune response among HBV vaccinated children. Blood sample from 500 vaccinated children were tested for Anti-HBs, and anti-HBc. Sero negative children were given 1 dose of HBV vaccine as a booster. Samples from booster vaccine were taken one month later and tested for anti Hbs titre. Anti HBs titre was found below protective level in about 46.0% (230/500) participants. Sero-protection rate decreased to 72.2% in 5 to 6 years age group which further decreased to 58.3% in 7 to 9 years age group and increased again to 69.5% in 10 to 12 years age group children. On the other hand, the mean anti Hbs titre was 97.72 IU/L initially and then increased with the increasing of age from 165.40 IU/L to 196.67 IU/L. Breakthrough infection of HBV was seen in 1.2% (6/500) participants measuring by anti HBc which indicated protective efficacy of HBV vaccine was about 98.8% (494/500). Sero negative participants were given a booster dose; 93.6% (131/140) participants showed boosting of mean anti HBs titre upto 804.92 IU/L which was below protective level (<10 IU/L) before booster dose. Anti-HBs titre goes below with the increase of age after vaccination. Most of the participants had immunological memory which will boost antibody titre after any exposure, so routine booster dose is not needed. But non-responder to vaccination should screen after primary vaccination because of chance of breakthrough infection.
Highlights
Hepatitis B virus infection is a vaccine preventable carriers, which is less than 10.0% in case of adults infection of liver which remains a key public or grown-up children.[3,4] health burden globally
According to World Health Organization, 177 countries have incorporated the Hepatitis B virus vaccine into their Expanded Programme on Immunization (EPI) by 2008.6 In Bangladesh, the penta-valent, diphtheria-pertussistetanus (DPT), hepatitis B (HBV), and Haemophilus influenza type b (Hib) vaccine was incorporated into EPI program while maintaining the immunization schedule at 6, 10 and 14 weeks after birth in 2009 as recommended by the WHO
Anti-HBs titre among the participants were divided as ‘No protection’ if antibody titre was below 10 IU/L, ‘moderate protection’ if the titre is between 10 to 100 IU/L and as ‘strong protection’ if titre is more than 100 IU/L.Figure 1 shows, among the participants 46.0% (230/500) had titre below protection level, 36.4% (182/500) had moderate protection and only 17.6 (88/500) had strong protection
Summary
Hepatitis B virus infection is a vaccine preventable carriers, which is less than 10.0% in case of adults infection of liver which remains a key public or grown-up children.[3,4] health burden globally. This study seeks to determine long term immune response to HBV vaccination prevalence of HBV among the vaccinated children, to evaluate the effectiveness of the vaccine, the seroprotection rate and duration of immunity among recipients of the EPI vaccine 5-12 years after completion of their primary vaccination schedule. This was a cross sectional study conducted from January 2016 to June 2017 involving 500 healthy or asymptomatically healthy children of the Brahmonbaria district, Bangladesh. Children who met this criterion were included in the vaccinated group
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