https://scholars.lib.ntu.edu.tw/handle/123456789/582065
標題: | Secular trend of the viral genotype distribution in children with chronic hepatitis B virus infection after universal infant immunization | 作者: | Wen W.-H. HUEY-LING CHEN YEN-HSUAN NI HONG-YUAN HSU JIA-HORNG KAO Hu F.-C. MEI-HWEI CHANG |
公開日期: | 2011 | 卷: | 53 | 期: | 2 | 起(迄)頁: | 429-436 | 來源出版物: | Hepatology | 摘要: | Genotypes B and C are the major hepatitis B virus (HBV) genotypes in Taiwan, and genotype C is associated with more severe liver disease than genotype B. Whether the implementation of the hepatitis B immunization program has affected the secular trend of the HBV genotype distribution remains unknown. We thus investigated the HBV genotypes in hepatitis B surface antigen (HBsAg)-carrier children born before the implementation of the universal infant immunization program and in those born afterward. One hundred seven children who were infected with HBV despite appropriate immunization were enrolled as immunized cases with HBV breakthrough infection. Each case was matched with two unimmunized HBsAg carriers according to the age at enrollment. HBV genotypes were determined with molecular methods. Compared with unimmunized HBsAg carriers, more immunized children had HBsAg-positive mothers (65.9% versus 100%, P < 0.001) and were infected with genotype C (16.4% versus 42.1%, P < 0.001). Among the children born to HBsAg-positive mothers, the mothers' and children's HBV genotypes were highly concordant in both unimmunized [κ = 0.97, 95% confidence interval (CI) = 0.90-1.00] and immunized children (κ = 0.97, 95% CI = 0.92-1.00). After adjustments for gender, maternal age, and delivery mode, immunized HBsAg-carrier children born to HBsAg-positive mothers had a higher likelihood of genotype C infection than unimmunized children (odds ratio = 3.03, 95% CI = 1.62-5.65, P = 0.001). However, the increased genotype C to genotype B ratio was not seen in the HBsAg-carrier mother pool in the postimmunization era. Conclusion: In the postimmunization era, most HBV breakthrough infections are due to maternal transmission, and immunized children born to genotype C mothers may have a higher rate of breakthrough infection than those born to genotype B mothers. ? 2010 American Association for the Study of Liver Diseases. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-79251480716&doi=10.1002%2fhep.24061&partnerID=40&md5=d9ff3b1babc1d3afd335bd2e2c7bdbd8 https://scholars.lib.ntu.edu.tw/handle/123456789/582065 |
ISSN: | 0270-9139 | DOI: | 10.1002/hep.24061 | SDG/關鍵字: | hepatitis B antibody; hepatitis B surface antigen; hepatitis B vaccine; recombinant hepatitis B vaccine; virus DNA; article; blood sampling; child; child health care; chronic hepatitis; female; genotype; health program; hepatitis B; Hepatitis B virus; human; immunization; infant; infection rate; major clinical study; male; newborn; nonhuman; nucleotide sequence; pregnant woman; priority journal; repeated drug dose; virus carrier; virus hepatitis; Adolescent; Adult; Child; Child, Preschool; Female; Genotype; Hepatitis B; Hepatitis B Surface Antigens; Hepatitis B Vaccines; Hepatitis B virus; Humans; Immunization Programs; Incidence; Infectious Disease Transmission, Vertical; Male; Regression Analysis; Retrospective Studies; Taiwan; Young Adult |
顯示於: | 臨床醫學研究所 |
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