TY - JOUR
T1 - Long-term immunogenicity of hepatitis B vaccination and policy for booster
T2 - An Italian multicentre study
AU - Zanetti, Alessandro Remo
AU - Mariano, Andrea
AU - Romanò, Luisa
AU - D'Amelio, Raffaele
AU - Chironna, Maria
AU - Coppola, Rosa Cristina
AU - Cuccia, Mario
AU - Mangione, Rossana
AU - Marrone, Fosca
AU - Negrone, Francesco Saverio
AU - Parlato, Antonino
AU - Zamparo, Emanuela
AU - Zotti, Carla
AU - Stroffolini, Tommaso
AU - Mele, Alfonso
PY - 2005/10/15
Y1 - 2005/10/15
N2 - Background: Universal anti-hepatitis-B vaccination of infants and adolescents was implemented in Italy in 1991. We undertook a multicentre study in previously vaccinated individuals to assess the duration of immunity and need for booster, over 10 years after vaccination. Methods: In 1212 children and 446 Italian Air Force recruits vaccinated as infants and adolescents, respectively, we measured the concentrations of antibodies to hepatitis-B surface antigen (anti-HBs) and the presence of antibodies to hepatitis-B core antigen (anti-HBc) at enrolment; postimmunisation values were not available. Individuals positive for anti-HBc were tested for hepatitis B surface antigen (HBsAg) and hepatitis B viral DNA. Individuals with anti-HBs concentrations at 10 IU/L or more were regarded as protected; those with antibody less than 10 IU/L were given a booster dose and retested 2 weeks later. Individuals showing postbooster anti-HBs concentrations of less than 10 IU/L were offered two additional vaccine doses and retested 1 month after the third dose. Findings: Protective anti-HBs concentrations were retained in 779 (64%, 95% CI 61·6-67) children and 398 (89%, 86·4-92·1) recruits. We recorded antibody amounts of less than 10 IU/L in 433 children (36%, 33-38·4) and 48 (11%, 7·9-13·6) recruits. One child and four recruits were positive for anti-HBc, but negative for HBsAg and hepatitis B viral DNA. Antibody concentrations were higher in recruits than in children (geometric mean titre 234·8 IU/L vs 32·1 IU/L, p=0·0001). 332 (97%) of 342 children and 46 (96%) of 48 recruits who received a booster showed an anamnestic response, whereas ten (3%) children and two (4%) recruits remained negative for anti-HBs or had antibody concentrations of less than 10 IU/L. Prebooster and postbooster antibody titres were strongly correlated with each other in both groups. All individuals given two additional vaccine doses (eight children and two recruits) showed anti-HBs amounts of more than 10 IU/L at 1 month after vaccination. Interpretation: Strong immunological memory persists more than 10 years after immunisation of infants and adolescents with a primary course of vaccination. Booster doses of vaccine do not seem necessary to ensure long-term protection.
AB - Background: Universal anti-hepatitis-B vaccination of infants and adolescents was implemented in Italy in 1991. We undertook a multicentre study in previously vaccinated individuals to assess the duration of immunity and need for booster, over 10 years after vaccination. Methods: In 1212 children and 446 Italian Air Force recruits vaccinated as infants and adolescents, respectively, we measured the concentrations of antibodies to hepatitis-B surface antigen (anti-HBs) and the presence of antibodies to hepatitis-B core antigen (anti-HBc) at enrolment; postimmunisation values were not available. Individuals positive for anti-HBc were tested for hepatitis B surface antigen (HBsAg) and hepatitis B viral DNA. Individuals with anti-HBs concentrations at 10 IU/L or more were regarded as protected; those with antibody less than 10 IU/L were given a booster dose and retested 2 weeks later. Individuals showing postbooster anti-HBs concentrations of less than 10 IU/L were offered two additional vaccine doses and retested 1 month after the third dose. Findings: Protective anti-HBs concentrations were retained in 779 (64%, 95% CI 61·6-67) children and 398 (89%, 86·4-92·1) recruits. We recorded antibody amounts of less than 10 IU/L in 433 children (36%, 33-38·4) and 48 (11%, 7·9-13·6) recruits. One child and four recruits were positive for anti-HBc, but negative for HBsAg and hepatitis B viral DNA. Antibody concentrations were higher in recruits than in children (geometric mean titre 234·8 IU/L vs 32·1 IU/L, p=0·0001). 332 (97%) of 342 children and 46 (96%) of 48 recruits who received a booster showed an anamnestic response, whereas ten (3%) children and two (4%) recruits remained negative for anti-HBs or had antibody concentrations of less than 10 IU/L. Prebooster and postbooster antibody titres were strongly correlated with each other in both groups. All individuals given two additional vaccine doses (eight children and two recruits) showed anti-HBs amounts of more than 10 IU/L at 1 month after vaccination. Interpretation: Strong immunological memory persists more than 10 years after immunisation of infants and adolescents with a primary course of vaccination. Booster doses of vaccine do not seem necessary to ensure long-term protection.
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U2 - 10.1016/S0140-6736(05)67568-X
DO - 10.1016/S0140-6736(05)67568-X
M3 - Article
C2 - 16226616
AN - SCOPUS:26644435772
VL - 366
SP - 1379
EP - 1384
JO - The Lancet
JF - The Lancet
SN - 0140-6736
IS - 9494
ER -