Levels of hepatitis B antibody titers are affected by age and doses gap time in children from a high endemic area of the western Amazon.

Laura Cordeiro Gomes,Philip Brainin,Rodrigo Medeiros De Souza,Marina Cordeiro Gomes Sanson,Júnia Silva Resende,Karine Oliveira Lima,Carsten Wrenger,Maria Da Conceição Vieira De Melo,Isabelle Victória Martins Vieira,Rita Do Socorro Uchôa Da Silva,Isabelle Caroline Silva Dutra,Giuseppe Palmisano,Janaína Mazaro,Claudio Romero Farias Marinho,Edinilson Da Silva Mesquita,Luan Oliveira Matos,Isabelle Chemin

doi:10.1371/journal.pone.0253752

Laura Cordeiro Gomes, Philip Brainin + Show 15 more

Open Access

https://doi.org/10.1371/journal.pone.0253752

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Abstract

BackgroundDespite completion of the vaccine schedule for hepatitis B virus (HBV), children may display levels of HBV surface antibodies (anti-HBs) that are considered inadequate for sufficient protection (<10 IU/L).AimsOur aim was to investigate if age and gap time between HBV vaccine doses may negatively affect the levels of anti-HBs in children, and if these relationships are modified by sex.MethodsIn a high-endemic HBV region of the western Brazilian Amazon we enrolled children who had completed the HBV vaccine schedule. All children underwent analysis of anti-HBs and a clinical examination.ResultsWe included 522 children (mean age 4.3 ± 0.8 years; 50% male). Median anti-HBs was 28.4 [interquartile range (IQR) 5.4 to 128.6] IU/L and 32% had anti-HBs <10 IU/L. The median gap time from last to preceding dose was 2.4 [IQR 2.1 to 3.3] months. Levels of anti-HBs decreased with higher age (-42% per year increase [95%CI -56% to -24%], p<0.001), but not with longer gap time (+23% per month increase [95%CI -16% to +62%], p = 0.249). After adjusting for relevant confounders, gap time became significant (p = 0.032) and age remained a significant predictor of anti-HBs (p<0.001).ConclusionOne third of assessed children displayed anti-HBs <10 IU/L. Levels of anti-HBs decreased with higher age and increased with longer gap time between the last two doses.

Highlights

Infection with hepatitis B virus (HBV) is associated with significant morbidity and mortality, and constitutes a major public health challenge [1]
Levels of anti-HBs decreased with higher age (-42% per year increase [95%confidence interval (CI) -56% to -24%], p
This region suffers from a high prevalence of hepatitis delta virus (HDV) [5,7,8], which is associated with super- and co-infections of patients already infected with HBV [8]

Summary

Introduction

Infection with hepatitis B virus (HBV) is associated with significant morbidity and mortality, and constitutes a major public health challenge [1]. In Brazil, the occurrence of HBV is heterogeneously distributed [5], such that the western Brazilian Amazon has the highest endemicity in the country [6]. This region suffers from a high prevalence of hepatitis delta virus (HDV) [5,7,8], which is associated with super- and co-infections of patients already infected with HBV [8]. Despite completion of the vaccine schedule for hepatitis B virus (HBV), children may display levels of HBV surface antibodies (anti-HBs) that are considered inadequate for sufficient protection (

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Conclusion