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Journal Article

The necessity of booster vaccination after neonatal hepatitis B vaccination.

01 Jun 2011-Hepatitis Monthly (Kowsar Medical Institute)-Vol. 11, Iss: 6, pp 419-421
TL;DR: The effectiveness of universal neonatal vaccination has been shown by investigators in reducing the incidence of HBV car-rier rate and probably cirrhosis and hepatocellular car-cinoma.
Abstract: Soon after introducing recombinant hepatitis B virus (HBV) vaccine, universal neonatal vaccination became the corner stone of the preventive measures for this po-tentially life threatening infection (1-3). By 2006 more than 177 out of 193 member states of world health orga-nization (WHO) introduced HBV vaccination in their national infant immunization programs (1). Following a complete series of vaccination during neonatal period, protective antibody level raises in more than 95% of in-fant’s blood test up to 18 months after vaccination (3-5). The effectiveness of this strategy has been shown by sev-eral investigators in reducing the incidence of HBV car-rier rate and probably cirrhosis and hepatocellular car-cinoma (1, 2, 5-7).A level of 10 IU/L of anti hepatitis B surface antibody (Anti HBsAb) is usually considered as a protective level against future infections. Although this level was ini-tially determined in studies about passive prophylaxis of HBV infection, the same level was arbitrary applied to active immunization though this was debated by some researchers (8-10). Universally there is a consistent de-
Citations
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Journal ArticleDOI
TL;DR: This review article aimed at highlighting potential pitfalls in genetic and phylogenetic analyses of HBV and suggest novel terms for HBV classification, including the term "immigro-subgenotype" to distinguish exotic (sub)genotypes from native ones and "recombino- subgenotype", which is proposed for many strains misclassified due to genetic differences resulting from recombination.
Abstract: The clinical course of infections with the hepatitis B virus (HBV) substantially varies between individuals, as a consequence of a complex interplay between viral, host, environmental and other factors. Due to the high genetic variability of HBV, the virus can be categorized into different HBV genotypes and subgenotypes, which considerably differ with respect to geographical distribution, transmission routes, disease progression, responses to antiviral therapy or vaccination, and clinical outcome measures such as cirrhosis or hepatocellular carcinoma. However, HBV (sub)genotyping has caused some controversies in the past due to misclassifications and incorrect interpretations of different genotyping methods. Thus, an accurate, holistic and dynamic classification system is essential. In this review article, we aimed at highlighting potential pitfalls in genetic and phylogenetic analyses of HBV and suggest novel terms for HBV classification. Analyzing full-length genome sequences when classifying genotypes and subgenotypes is the foremost prerequisite of this classification system. Careful attention must be paid to all aspects of phylogenetic analysis, such as bootstrapping values and meeting the necessary thresholds for (sub)genotyping. Quasi-subgenotype refers to subgenotypes that were incorrectly suggested to be novel. As many of these strains were misclassified due to genetic differences resulting from recombination, we propose the term "recombino-subgenotype". Moreover, immigration is an important confounding facet of global HBV distribution and substantially changes the geographic pattern of HBV (sub)genotypes. We therefore suggest the term "immigro-subgenotype" to distinguish exotic (sub)genotypes from native ones. We are strongly convinced that applying these two proposed terms in HBV classification will help harmonize this rapidly progressing field and allow for improved prophylaxis, diagnosis and treatment.

156 citations

Book
10 May 2011
TL;DR: To answer the question of long-term protection after vaccination and the possible need for booster dose of vaccine, two different approaches were used to determine the duration of protection provided by HB vaccine.
Abstract: Hepatitis B virus (HBV) infection is a major public health problem worldwide and HB vaccine is the most effective measure to prevent HB virus infection. An initial anti-HBs threshold value of 10 mIU/ml or greater is considered generally protective. However, the protective antibodies induced by HB vaccine wane gradually over time and may reach very low or even undetectable level. Immunologic studies indicated that HB vaccine induces immunologic memory and memory B cells can generate a rapid and vigorous anamnestic anti-HBs response upon re-exposure to HBsAg. Accordingly, long-term protection after vaccination and the possible need for booster dose of vaccine has remained controversial. To answer this question, we used two different approaches to determine the duration of protection provided by HB vaccine. Four different studies will be presented: a) Seroprotection of HB vaccine and need for booster dose: A meta-analysis b) Long-term protection provided by HB vaccine and need for booster dose: A meta-analysis c) Capture-recapture method for assessing publication bias. d) MetaPlot: A novel Stata graph for assessing heterogeneity at a glance

25 citations

Journal ArticleDOI
TL;DR: A universal vaccination program in infancy provides adequate protection against hepatitis B virus infection for school age children and a booster vaccination is not recommended.
Abstract: OBJECTIVES To evaluate the long term immunity provided by a universal hepatitis B vaccination program in infancy and the booster effect on school age children who had no protective antibody titers to hepatitis B surface antigen. METHODS We conducted a community-based seroepidemiologic study of 1337 healthy 7-year-old children in Taiwan one decade after the implementation of a mass hepatitis B vaccination program. A booster vaccination was suggested for noncarrier children who did not have protective titers of surface antibody. Serologic responses and infection rates were compared with those of the nonboostered children. In a nonselected group of 39 volunteer noncarrier vaccinees, quantitative serologic response was determined before, 1 month after a booster vaccination and 1 year later. RESULTS A total of 572 children (42.8%) had low concentrations of surface antibody, and 9 were hepatitis B surface antigen carriers (0.7%). Eighty-two percent of \"nonprotected\" vaccinees showed immunologic memory to a booster dose and developed protective antibody titers 1 month later; 60.6% maintained protective titers 1 year later. The frequency of new hepatitis B virus infection was similar for those who received a booster and those who did not as investigated by the core antibody seroconversion during 1-year follow-up. However, the risk was low, with annual incidences of <1% in both groups, and none became chronic carriers. CONCLUSION According to these data a universal vaccination program in infancy provides adequate protection against hepatitis B virus infection for school age children and a booster vaccination is not recommended.

24 citations

Journal ArticleDOI
TL;DR: LT is now an affordable treatment for patients with ESLD in Iran with acceptable survival, which has further been improved in recent years.
Abstract: Background: Liver transplantation (LT) is the only approved treatment for patients with end stage liver disease (ESLD). Shiraz organ transplantation center (SOTC) was the first center in Iran to provide LT. This report is on the evolution of LT program in this center. Methods: We report the clinical features and outcomes of all those who received LT between May 15, 1993 to December 31, 2015 as well as donor features. All LT were performed at Namazi hospital in Shiraz, Iran. The Kaplan-Meier and multivariate Cox proportional hazards regression analyses were performed to determine prognostic factors and the overall long-term survival after liver transplantations. Results: During this period, 3191 recipient patients received LT from 3110 donors. Overall patient survival rates were 84% at 1 year, 80% at 5 years, and 73% at 10 years. The survival rates for recipients from living donors were 74.0% at 1 year and 70.0% at 5 years compared to 86.0% at 1 and 81.0% at 5 years for recipients from deceased donors (P < 0.0001). The survival rates of LT for 2 different Era I (1993 - 2005) and II (2006 - 2015) were estimated to be 76.0% vs. 85.0% at one year, 69.0% vs. 81% at 5 years, and 60.0% vs. 78.0% at 10 years, respectively (P < 0.0001).The most common indications for LT were cryptogenic cirrhosis, hepatitis B, primary sclerosing cholangitis, autoimmune hepatitis, and metabolic liver diseases during this period. Conclusions: LT is now an affordable treatment for patients with ESLD in Iran with acceptable survival, which has further been improved in recent years.

17 citations


Cites background from "The necessity of booster vaccinatio..."

  • ...This has increased utilization of this life saving procedure, especially in children, patients from lower socioeconomic classes, and those residing in more distant parts of the country (14)....

    [...]

Journal ArticleDOI
TL;DR: Evaluated hepatitis B surface antibody (anti-HBs) levels one year after hepatitis B booster vaccination in anti- HBs-negative children 11–15 y after primary vaccination found Protective levels declined more rapidly for those with lower titers.
Abstract: The aim of this study was to evaluate hepatitis B surface antibody (anti-HBs) levels one year after hepatitis B booster vaccination in anti-HBs-negative (<10 mIU/mL) children 11–15 y after primary ...

10 citations

References
More filters
Journal ArticleDOI
TL;DR: Current available monotherapies-interferon, lamivudine, and adefovir dipivoxil-very rarely eradicate the virus, but greatly reduce its replication, necroinflammatory histological activity, and progression of fibrosis.

1,813 citations

Journal ArticleDOI
TL;DR: The incidence of hepatocellular carcinoma in children in Taiwan from 1981 to 1994 has declined since the institution of Taiwan's program of universal hepatitis B vaccination, and the corresponding rates of mortality have decreased.
Abstract: Background A nationwide hepatitis B vaccination program was implemented in Taiwan in July 1984. To assess the effect of the program on the development of hepatocellular carcinoma, we studied the incidence of this cancer in children in Taiwan from 1981 to 1994. Methods We collected data on liver cancer in children from Taiwan's National Cancer Registry, which receives reports from each of the country's 142 hospitals with more than 50 beds. Data on childhood liver cancer were also obtained from Taiwan's 17 major medical centers. To prevent the inclusion of cases of hepatoblastoma, the primary analysis was confined to liver cancers in children six years of age or older. Data were also obtained on mortality from liver cancer among children. Results The average annual incidence of hepatocellular carcinoma in children 6 to 14 years of age declined from 0.70 per 100,000 children between 1981 and 1986 to 0.57 between 1986 and 1990, and to 0.36 between 1990 and 1994 (P<0.01). The corresponding rates of mortality f...

1,711 citations


"The necessity of booster vaccinatio..." refers background in this paper

  • ...The effectiveness of this strategy has been shown by several investigators in reducing the incidence of HBV carrier rate and probably cirrhosis and hepatocellular carcinoma (1, 2, 5-7)....

    [...]

  • ...2011;11(6):419-421 420 Booster and neonatal hepatitis B vaccination Lankarani KB...

    [...]

Journal Article
TL;DR: This report, the second of a two-part statement from the Advisory Committee on Immunization Practices (ACIP), provides updated recommendations to increase hepatitis B vaccination of adults at risk for HBV infection.
Abstract: Hepatitis B vaccination is the most effective measure to prevent hepatitis B virus (HBV) infection and its consequences, including cirrhosis of the liver, liver cancer, liver failure, and death. In adults, ongoing HBV transmission occurs primarily among unvaccinated persons with behavioral risks for HBV transmission (e.g., heterosexuals with multiple sex partners, injection-drug users [IDUs], and men who have sex with men [MSM]) and among household contacts and sex partners of persons with chronic HBV infection. This report, the second of a two-part statement from the Advisory Committee on Immunization Practices (ACIP), provides updated recommendations to increase hepatitis B vaccination of adults at risk for HBV infection. The first part of the ACIP statement, which provided recommendations for immunization of infants, children, and adolescents, was published previously (CDC. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices [ACIP]. Part 1: immunization of infants, children, and adolescents. MMWR 2005;54[No. RR-16]:1-33). In settings in which a high proportion of adults have risks for HBV infection (e.g., sexually transmitted disease/human immunodeficiency virus testing and treatment facilities, drug-abuse treatment and prevention settings, health-care settings targeting services to IDUs, health-care settings targeting services to MSM, and correctional facilities), ACIP recommends universal hepatitis B vaccination for all unvaccinated adults. In other primary care and specialty medical settings in which adults at risk for HBV infection receive care, health-care providers should inform all patients about the health benefits of vaccination, including risks for HBV infection and persons for whom vaccination is recommended, and vaccinate adults who report risks for HBV infection and any adults requesting protection from HBV infection. To promote vaccination in all settings, health-care providers should implement standing orders to identify adults recommended for hepatitis B vaccination and administer vaccination as part of routine clinical services, not require acknowledgment of an HBV infection risk factor for adults to receive vaccine, and use available reimbursement mechanisms to remove financial barriers to hepatitis B vaccination.

1,146 citations


"The necessity of booster vaccinatio..." refers background in this paper

  • ...Some problems such as maintaining cold chain in transportation and handling of vaccine, improper injection and other technical problems in this context are still real challenges in many countries making effectiveness of vaccination, like HBV which need a stable cold chain, lower than expected in real practice (2, 5, 8, 9)....

    [...]

  • ...None of the international guidelines for HBV vaccination currently recommend booster dose (1-3, 5, 8, 9)....

    [...]

  • ...bers) and vertically (2, 8, 9) that leads to WHO recommendation regarding implementation of neonatal vaccination against HBV within the first 24 hours of life (5, 9)....

    [...]

  • ...There could be many confounding factors including malnutrition, concomitant diseases or even receiving vaccine in bad techniques such as inappropriate handling of vaccine including stable and sustained the cold chain (8, 9, 16, 24, 25)....

    [...]

  • ...Although this level was initially determined in studies about passive prophylaxis of HBV infection, the same level was arbitrary applied to active immunization though this was debated by some researchers (8-10)....

    [...]

Journal Article
TL;DR: This report provides updated recommendations to improve prevention of perinatal and early childhood HBV transmission, including implementation of universal infant vaccination beginning at birth, and to increase vaccine coverage among previously unvaccinated children and adolescents.
Abstract: This report is the first of a two-part statement from the Advisory Committee on Immunization Practices (ACIP) that updates the strategy to eliminate hepatitis B virus (HBV) transmission in the United States. The report provides updated recommendations to improve prevention of perinatal and early childhood HBV transmission, including implementation of universal infant vaccination beginning at birth, and to increase vaccine coverage among previously unvaccinated children and adolescents. Strategies to enhance implementation of the recommendations include 1) establishing standing orders for administration of hepatitis B vaccination beginning at birth; 2) instituting delivery hospital policies and procedures and case management programs to improve identification of and administration of immunoprophylaxis to infants born to mothers who are hepatitis B surface antigen (HBsAg) positive and to mothers with unknown HBsAg status at the time of delivery; and 3) implementing vaccination record reviews for all children aged 11-12 years and children and adolescents aged <19 years who were born in countries with intermediate and high levels of HBV endemicity, adopting hepatitis B vaccine requirements for school entry, and integrating hepatitis B vaccination services into settings that serve adolescents. The second part of the ACIP statement, which will include updated recommendations and strategies to increase hepatitis B vaccination of adults, will be published separately.

811 citations

Journal ArticleDOI
30 Jan 2006-Vaccine
TL;DR: The data suggest that individuals who had lost their anti-HBs seropositivity still show immunologic T cell memory and that these T cells are able to trigger anti- HBs production of B cells activated by revaccination.

210 citations