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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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              Two decades of universal hepatitis B vaccination in taiwan: impact and implication for future strategies.

              Following the world's first successful implementation of a universal hepatitis B virus (HBV) vaccination program for infants in Taiwan 20 years ago, we performed this study to evaluate the long-term protection afforded by HBV vaccination and to rationalize further prevention strategies. HBV seromarkers, including hepatitis B surface antigen (HBsAg) and antibodies to HBsAg (anti-HBs) and core antigen (anti-HBc), were studied in 18,779 subjects from neonates to adults below 30 years of age in 2004. The birth cohort effect was evaluated by comparing the results of the same birth cohorts at different ages among this survey and the previous 1984, 1989, 1994, and 1999 surveys. The seropositive rates for HBsAg, anti-HBs, and anti-HBc were 1.2%, 50.5%, and 3.7%, respectively, in those born after the vaccination program (<20 years of age) in 2004. A positive maternal HBsAg status was found in 89% of the HBsAg seropositive subjects born after the vaccination program. The absence of an increase in HBsAg seropositive subjects at different ages in the same birth cohorts born after the vaccination program implied no increased risk of persistent HBV infection with aging. Universal HBV vaccination provides long-term protection up to 20 years, and a universal booster is not indicated for the primary HBV vaccinees before adulthood. Maternal transmission is the primary reason for vaccine failure and is the challenge that needs to be addressed in future vaccination programs. This may include an appropriate hepatitis B immunoglobulin administration strategy for high-risk infants and involve efforts to minimize noncompliance.
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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
                24829589
                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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