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Comparison of the seroconversion rate after primary hepatitis B vaccination and after revaccination of non-responders in full-term infants according to mother's HBsAg seropositivity

Korean Journal of Pediatrics 2008;51(11):1165-1171.
Published online November 15, 2008.
Comparison of the seroconversion rate after primary hepatitis B vaccination and after revaccination of non-responders in full-term infants according to mother's HBsAg seropositivity
Jang Hee Kang1, Jae Won Moon2, Seung Hyun Kong1, Kwang Su Hwang1, Ji Sun Mok1, Hyeon Jung Lee1
1Department of Pediatrics, Good Moonhwa Hospital, Busan, Korea
2Department of Pediatrics, Wallace Memorial Baptist Hospital, Busan, Korea
산모의 HBsAg 보유 여부에 따른 만삭아의 B형간염 기본접종 및 무반응자에서 재접종 후 항체 양전율에 대한 연구
강장희1, 문재원2, 공승현1, 황광수1, 목지선1, 이현정1
1좋은문화병원 소아청소년과
2왈레스기념 침례병원 소아청소년과
Correspondence: 
Hyeon Jung Lee, Email: Leesoa07@yahoo.co.kr
Abstract
Purpose
: This study aimed to identify the true extent of non-responsiveness in full-term infants born from HBsAg-negative or HBsAg-positive mothers and vaccinated against hepatitis B virus (HBV) at 0, 1, and 6 months of age and to evaluate the effect of revaccination among non-responders.
Methods
: The study included 716 full-term infants born in 2004-2007. Of 716, 662 infants (A group) were born to HBsAg- negative mothers and 54 infants (B group: 50, except HBsAg-positive infants) were born to HBsAg-positive mothers. All infants were administered DNA recombinant vaccines at 0, 1, and 6 months of age. B group infants received hepatitis B immunoglobulin at birth. Anti-HBs titers were tested at 7-12 and 9-15 months in A and B groups, respectively. Three revaccination doses were administered to non-responders whose anti-HBs titers were under 10 mIU/ml; revaccinated infants were retested at 1-3 months after last vaccination. The association between HBeAg seropositivity of mother and the failure of HBV immunoprophylaxis was evaluated.
Results
: The seroconversion rates after primary hepatitis B vaccination were higher in A group (94.1%) than in B group (78%, P<0.001). The seroconversion rates were high in revaccinated infants (A group non-responders: 96.9%, B group non- responders: 87.5%). The failure of HBV immunoprophylaxis was significantly associated with maternal HBeAg seropositivity (P<0.001).
Conclusion
: The seroconversion rates after primary hepatitis B vaccination were low in B group infants. Revaccination of non-responders in B group was very effective. Therefore, anti-HBs testing and revaccination of B group is very important. Revaccination of non-responders in A group was also very effective. Thus, testing the immune status of infants born to HBsAg-negative mothers even after primary hepatitis B vaccination should be considered. However, to realize this, further studies on the cost-effectiveness of anti-HBs testing in healthy full-term infants are necessary.
Key Words: Hepatitis B revaccination, Anti-HBs, Non-responders


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