A Single Center Analysis of the Positivity of Hepatitis B Antibody after Neonatal Vaccination Program in Korea

Abstract

The antibody to hepatitis B surface antigen (anti-HBs) seropositivity rate after 3 doses of hepatitis B virus (HBV) vaccination during infancy period is known to be higher than 90%. However, a considerable number of vaccines do not form protective anti-HBs or chronologic decrease of anti-HBs. We retrospectively collected data of HBV serologic test results in 20,738 individuals from 2000 to 2015. After exclusion criteria were applied, 19,072 individuals were included. We analyzed the anti-HBs seropositivity rate, anti-HBs disappearance rate, anti-HBs positive seroconversion rate after receiving a booster vaccine, and the difference in anti-HBs positivity between the 2 groups; group A (born before 2005, while both recombinant vaccines and plasma-derived vaccines were used) and group B (born after 2005, when only recombinant vaccines were used by national regulation). The anti-HBs seropositivity rate was 55.8%, but there was a significant difference in the rate of seropositivity for anti-HBs between the group A and B (53.0% vs. 78.1%, P < 0.001). There was no significant age-adjusted difference in the mean seropositivity rate between the 2 groups (P = 0.058). In addition, the anti-HBs positivity rate was significantly lower in the group A as compared with the group B during infancy (83.1% vs. 92.1%, P < 0.001). A total of 1,106 anti-HBs-positive subjects underwent serologic tests more than twice. Of these, 217 subjects (19.6%) showed anti-HBs disappearance. After booster vaccinations, 87.4% (83/95) achieved seroconversion from seronegative to seropositive. Our results highlight the importance of lifelong protection against HBV and the possible necessity of booster vaccination after adolescent period.

Keywords: Booster; Children; Hepatitis B antibody; Plasma-derived Vaccine; Recombinant DNA Vaccine; South Korea.

Fig. 1

The anti-HBs seropositivity rate depending on the age. The anti-HBs seropositivity rate reached the highest level (90.0%) at the age of < 12 months old. Until the age of 15 years old thereafter, however, it was decreased and then reached the lowest level of 43.5%. Since the age of 16 years old, however, it was gradually increased. Anti-HBs = antibody to hepatitis B surface antigen.

Fig. 2

The rate of seroconversion from seropositive to seronegative status depending on the age. A total of 1,106 subjects aged between 1 and 25 years old underwent serologic tests more than twice. Of these, 217 subjects (19.6%) achieved seroconversion from seropositive to seronegative status. There was an age-dependent increase in the rate of seroconversion from seropositive to seronegative status; it reached the highest level (45.5%) at the age of 9 years old. Thereafter, however, it was decreased. Anti-HBs = antibody to hepatitis B surface antigen.