Abstract
World Health Organization recommends hepatitis B virus (HBV) immunization at 0, 1, and 6 months. However, studies have suggested that shortening the interval between the first and last HBV immunization can improve completion rates. Less clear is whether accelerated immunization is as immunogenic as standard immunization. Thus, the present study aimed to compare the short-term immunogenicity of yeast-derived hepatitis B vaccine in healthy adults immunized on an accelerated or standard schedule. Between June 2013 and March 2014, individuals from Jinfeng and Longmen, China were randomly assigned to receive the vaccine on an accelerated schedule (at 0, 1, and 2 months; n=201) or a standard schedule (at 0, 1, and 6 months; n=206). Subjects filled out a questionnaire asking about demographic and other health data, and they underwent physical examination. Blood was assayed for HBV surface antigen and HBV surface antibody (HBsAb) at 1–2 months after the three-dose schedule. Multivariate binary logistic regression was used to determine whether the rate of anti-HBs seroconversion differed with immunization schedule. Covariance analysis was used to compare geometric mean HBsAb concentration between the two schedules. The anti-HBs seroconversion rate was 84.6% in the accelerated group and 90.3% in the standard group. After controlling for several potential confounders, the accelerated schedule was associated with significantly lower anti-HBs seroconversion rate (OR: 0.560, 95% CI: 0.318–0.988). Similarly, the accelerated schedule was associated with significantly lower geometric mean HBsAb concentration. These results suggest that the standard schedule is more likely to lead to anti-HBs seroconversion and higher HBsAb levels in adults.
Highlights
Incidence of hepatitis B virus (HBV) in China among children younger than 15 years fell significantly after 1992, when the Ministry of Health included HBV vaccination in the national immunization program [1]
A national survey in China showed that 8.57% of adults aged 15–59 years are positive for HBV surface antigen (HBsAg), and 47.38% of adults are positive for anti-HBV surface antibodies (HBsAb) [2]
The two groups were similar in age, gender, body mass index (BMI), smoking, drinking, anti-HBc, and family history of hepatitis B (P>0.05, Table 1)
Summary
Incidence of hepatitis B virus (HBV) in China among children younger than 15 years fell significantly after 1992, when the Ministry of Health included HBV vaccination in the national immunization program [1]. The World Health Organization and US Centers for Disease Control and Prevention, as well as Chinese National Guidelines on chronic hepatitis B prevention and treatment (2015) recommend HBV immunization at 0, 1, and 6 months. This long duration translates to low completion rates [6] and has contributed to the fact that in the US only 24.5% of adults aged 19 and older were vaccinated against c 2018 The Author(s).
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