The Impact of Hepatitis B Vaccine Failure on Long-term Natural Course of Chronic Hepatitis B Virus Infection in Hepatitis B e Antigen-Seropositive Children
Journal
Journal of Infectious Diseases
Journal Volume
216
Journal Issue
6
Pages
662-669
Date Issued
2017
Abstract
Background: Vaccine failure with chronic hepatitis B virus (HBV) infection still develops in children after universal hepatitis B immunization. This study aimed to investigate the natural course of chronic HBV infection in children with vaccine failure and compare it with that of nonvaccinated children. Methods: Three hundred fifty-six hepatitis B e antigen (HBeAg)-seropositive, hepatitis B surface antigen (HBsAg) carrier children, who were followed for at least 1 year without antiviral therapy, were enrolled. These comprised 105 vaccine failure subjects who received 3 doses of HBV vaccine in infancy and 251 nonvaccinated subjects. The clinical, serologic, and virologic features were compared between the 2 groups. Results: The cumulative HBeAg seroconversion rate was significantly lower in the vaccine failure group than in the nonvaccinated group (30.5% vs 77.7%, P < .0001). Genotype C HBV infection was more frequent in the vaccine failure group (33.7% vs 13.4%, P < .0001), and the maternal HBsAg-positive rate was higher (97.1% vs 66.4%, P < .0001). In a multivariate analysis, vaccine failure, genotype C infection, and maternal HBsAg positivity were significantly associated with delayed HBeAg seroconversion. Conclusions: HBeAg-seropositive vaccine failure HBV-carrier children were associated with delayed HBeAg seroconversion during long-term follow-up, and more HBV genotype C infection and maternal HBsAg seropositivity.
SDGs
Other Subjects
alanine aminotransferase; hepatitis B surface antigen; hepatitis B vaccine; hepatitis B(e) antigen; hepatitis B surface antigen; hepatitis B vaccine; hepatitis B(e) antigen; child; chronic hepatitis B; Conference Paper; controlled study; female; follow up; human; immunization; immunological tolerance; major clinical study; male; priority journal; seroconversion; sex ratio; survival analysis; vaccine failure; blood; chronic hepatitis B; cross-sectional study; dose response; immunology; infant; newborn; preschool child; treatment failure; Child; Child, Preschool; Cross-Sectional Studies; Dose-Response Relationship, Drug; Female; Follow-Up Studies; Hepatitis B e Antigens; Hepatitis B Surface Antigens; Hepatitis B Vaccines; Hepatitis B, Chronic; Humans; Infant; Infant, Newborn; Male; Treatment Failure
Publisher
Oxford University Press
Type
conference paper