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. 2015 Oct 8;7(22):2418-26.
doi: 10.4254/wjh.v7.i22.2418.

Effectiveness of hepatitis B virus vaccination program in Egypt: Multicenter national project

Iman I Salama  1 , Samia M Sami  1 , Zeinab Nabil Ahmed Said  1 , Manal H El-Sayed  1 , Lobna A El Etreby  1 , Thanaa M Rabah  1 , Dalia M Elmosalami  1 , Amany T Abdel Hamid  1 , Somaia I Salama  1 , Aida M Abdel Mohsen  1 , Hanaa M Emam  1 , Safaa M Elserougy  1 , Amal I Hassanain  1 , Naglaa F Abd Alhalim  1 , Fatma A Shaaban  1 , Samia A Hemeda  1 , Nihad A Ibrahim  1 , Ammal M Metwally  1
Affiliations

Effectiveness of hepatitis B virus vaccination program in Egypt: Multicenter national project

Iman I Salama et al. World J Hepatol. .

Abstract

Aim: To assess the effectiveness of hepatitis B virus (HBV) vaccination program among fully vaccinated children.

Methods: A national community based cross-sectional study was carried out in 6 governorates representing Egypt. A total of 3600 children aged from 9 mo to 16 years who were fully vaccinated with HBV vaccine during infancy were recruited. Face to face interviews were carried out and sera were evaluated for hepatitis B surface antigen (HBsAg), anti-HBV core antibodies (total) and quantitative detection of hepatitis B surface antibody using enzyme linked immunoassays techniques. Samples positive to HBsAg/anti-HBV core antibodies were subjected to quantitative HBV-DNA detection by real time polymerase chain reaction with 3.8 IU/L detection limit.

Results: Sero-protection was detected among 2059 children (57.2%) with geometric mean titers 75.4 ± 3.6 IU/L compared to 3.1 ± 2.1 IU/L among non-seroprotected children. Multivariate logistic analysis revealed that older age and female gender were the significant predicting variables for having non sero-protective level, with adjusted odds ratio 3.3, 9.1 and 14.2 among children aged 5 to < 10, 10 to < 15 and ≥ 15 years respectively compared to those < 5 years and 1.1 among girls compared to boys with P < 0.01. HBsAg was positive in 0.11% and breakthrough infection was 0.36% and 0.39% depending on positivity of anti-HBc and DNA detection respectively. The prevalence of HBV infection was significantly higher among children aged ≥ 7 years (0.59%) compared to 0.07% among younger children with odds ratio equal to 8.4 (95%CI: 1.1-64.2) and P < 0.01.The prevalence was higher among girls (0.48%) than boys (0.29%) with P > 0.05.

Conclusion: The Egyptian compulsory HBV vaccination program provides adequate protection. Occult HBV infection exists among apparently healthy vaccinated children. Adherence to infection control measures is mandatory.

Keywords: Breakthrough infection; Children; Hepatitis B virus; Immunization; Sero-protection.

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Figures

Figure 1
Figure 1
Prevalence of hepatitis B surface antibody levels among all the studied children (A) and among children aged ≤ 1 year (B). Anti-HBs: Hepatitis B surface antibody.
Figure 2
Figure 2
Hepatitis B surface antibody geometric mean titer among the studied children according to age and gender. Anti-HBs: Hepatitis B surface antibody; GMT: Geometric mean titer.
See this image and copyright information in PMC

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