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      Prevalence of Hepatitis B Virus Seromarkers in Young Adults Vaccinated at Birth; Impact on the Epidemiology of Hepatitis B Infection in Iran

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          Abstract

          Background:

          The epidemiological impact and the duration of protection provided by infant hepatitis B (HB) vaccination are unknown.

          Objectives:

          This study was designed to determine the hepatitis B virus (HBV) infection seromarkers in young adults who have been vaccinated against HBV as the first group of Iranian neonates during 1993 and 1994.

          Patients and Methods:

          We recruited 510 young adults with a history of complete HB vaccination at birth. HBV seromarkers (HB surface antigen (HBs Ag), antibody against HBs Ag (Anti-HBs), and antibody against HB core antigen (Anti-HBc) were measured using ELISA method. Anti-HBs titers ≥ 10 IU/L were considered protective and titers more than 300 IU/L were indicative of a natural boosting. Positive results for Anti-HBc and HBs Ag were considered as breakthrough infection and possible vaccine failure, respectively. The history of acute symptomatic clinical hepatitis was also investigated.

          Results:

          Anti-HBs seropositivity rate was detected in 224 of 510 [95% CI: 39-47] young adults. Breakthrough infection (positive sera for Anti-HBc without chronic infection) was observed in 18 [95% CI: 2.5-3.5] subjects. There were neither HBs Ag positive results nor symptomatic hepatitis cases.

          Conclusions:

          The study results indicated that the neonatal HBV immunization induced a long-term protection against HBV and was very efficacious in reducing chronic HBV infection rate in vaccinated young adults in Iran.

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          Most cited references38

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          The changing epidemiology of viral hepatitis B in Iran.

          Hepatitis B virus (HBV) prevalence has decreased dramatically in Iranian population during the last decade, and now our country is classified as having low endemicity for hepatitis B infection. Improvement of the people's knowledge about HBV risk factors, national vaccination program since 1993 for all neonates, and vaccination of high risk groups might justify this decrease. The HBV vaccination started in infants in two provinces (Zanjan and Semnan) in 1989, and in 1993 the vaccination was included in the Expanded Program on Immunization (EPI) countrywide. After 13 years of implementation, the coverage has reached an appropriate level from 62% in 1993 to 94% in 2005. Evaluation of risk factors in HBV infected people is important for designing the strategies to control the disease. Intensifying HB vaccination of high risk groups, surveillance of hepatitis B infected subjects, and control on health state of refugees will further decrease the frequency of the disease in our country. Considering all possible routes of transmission in subjects without risk factors for infection is necessary. Changes in the pattern of transmission of new cases of hepatitis B, inform us of changes in the epidemiology of viral hepatitis B infection.
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            Hepatitis B vaccines.

            (2009)
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              Hepatitis B vaccination: The key towards elimination and eradication of hepatitis B.

              Ding Chen (2009)
              Hepatitis B virus infection is a global health problem. Worldwide, about 360 million people are chronically infected with the virus. They continue to spread the virus to others and are themselves at risk of chronic liver diseases and hepatocellular carcinoma. The infection can now be treated by antivirals or interferons and the transmission route can be interrupted. Nevertheless, the most effective means is to immunize all susceptible individuals, especially young children, with safe and efficacious vaccines. The combined efforts of vaccination, effective treatment and interruption of transmission make elimination of the infection plausible and may eventually lead to eradication of the virus. Because hepatitis B vaccination has a key role in the control of hepatitis B, properties of this vaccine, its effectiveness in pre-exposure and post-exposure settings, duration of protection after vaccination and the need of booster doses are discussed. Mass hepatitis B vaccination in children decreases the carriage of the virus, and the diseases associated with acute and chronic infection, including hepatocellular carcinoma. Challenges that need to be solved to expand mass vaccination, and the strategies towards elimination and eventual eradication of hepatitis B in the world are also discussed.
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                Author and article information

                Journal
                Hepat Mon
                Hepat Mon
                10.5812/hepatmon
                Kowsar
                Hepatitis Monthly
                Kowsar
                1735-143X
                1735-3408
                01 May 2014
                May 2014
                : 14
                : 5
                : e17263
                Affiliations
                [1 ]Department of Pathology, Shariaty Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
                [2 ]Department of Immunology, Mazandaran University of Medical Sciences, Sari, IR Iran
                [3 ]Pediatric Infectious Diseases Ward, Boali-Cina Hospital, Mazandaran University of Medical Sciences, Sari, IR Iran
                [4 ]Provincial Center for Diseases Control and Prevention, Mazandaran University of Medical Sciences, Sari, IR Iran
                [5 ]Department of Statistics, Mazandaran University of Medical Sciences, Sari, IR Iran
                Author notes
                [* ]Corresponding Author: Mohammed Jafar Saffar, Pediatric Infectious Diseases Ward, Boali-Cina Hospital, Mazandaran University of Medical Sciences, Sari, IR Iran. Tel: +98-1512233018, Fax: +98-1512234506, E-mail: saffar@ 123456softhome.net
                Article
                10.5812/hepatmon.17263
                4013494
                afb3d3b2-c912-4cb8-a5e4-0856c366e96d
                Copyright © 2014, Kowsar Corp.; Published by Kowsar Corp.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 08 January 2014
                : 02 March 2014
                : 08 March 2014
                Categories
                Research Article

                Infectious disease & Microbiology
                hepatitis b,iran,hepatitis b vaccine,hb immunogenicity
                Infectious disease & Microbiology
                hepatitis b, iran, hepatitis b vaccine, hb immunogenicity

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