Hepatitis B Clinical Trial
Official title:
Seroprevalence of Hepatitis B Infection, Effect of Booster Response, and Significance of Anti-HBc Positivity Amongst Taiwanese Young Adults
The aim of this study is to observe and evaluate initiate serum anti-HBs titers during entrance health examination among undergraduate freshmen in a university who showed a complete 4-dose HBV vaccination in infancy and whose serum status was (1) HBsAg negative and anti-HBc negative and (2) anti-HBc positive alone. For those students whose anti-HBs <10 mIU/ml, additional HBV vaccination boosters were given according to routine governmental suggested schedules. The anamnestic effect then is observed in both groups. The results of this study may contribute to the analysis of the effectiveness of anti-HBV vaccination twenty years after the commencement of the program and the necessity of initiating HBV booster program among Taiwanese young adults.
Hepatitis-B virus infection is endemic in Taiwan with 90% of the adult population having
been previously infected with HBV at some stage in their lives, and with approximately 15 -
20% of the general population being carriers of HBV surface antigen at time of writing. In
1984, Taiwan implemented a hepatitis-B vaccination program for high risk newborns. In 1986,
the program was extended to all newborns. At the commencement of the program, the HBV
carrier rate amongst children was 9.8 percent. Subsequently, from later reports (namely from
the 5-, 10-, 15-, 16-,18-, and 20-year post mass HBV vaccination program commencement
follow-up studies), the HBV infection and carrier rates would appear to have been declining
continuously. However, the long-term efficacy of such vaccination still has remained as one
of the main points of interests amongst Taiwan's public-health officials.
Previous researches indicated that hepatitis B surface antibody (HBsAb) acquired from
vaccination would decline over time. However, whether the decline of HBsAb implicated loss
of protection to hepatitis B infection remained controversial. Reports pertaining to
previously immunized healthcare worker (HCW) found that protective HBsAb still persisted in
76% and 52% of HCW after 3 and 13 years respectively. Anamnestic response was also observed,
though the study population were limited. Hepatitis B vaccination has been documented to
provide protection to HBV infection for at least 15 years for various age groups. Those who
were younger than 4 years had the most pronounced decline or protective HBsAb.
Our previous observations have demonstrated that the implementation of the HBV vaccination
program since 1984 had reduced the transmission of HBV in Taiwan. However, an increase of
prevalence rate of HBV natural infection (anti-HBc positivity) in 1987 cohort, which may
suggest the possibility of protection of HBV mass vaccination has gradually decreasing
through years. The waning-off of serum anti-HBs level to no protective level among half of
our student population has occurred eighteen years after mass vaccination. As a result, the
aim of this study is to observe and evaluate initiate serum anti-HBs titers during entrance
health examination among undergraduate freshmen in a university who showed a complete 4-dose
HBV vaccination in infancy and whose serum status was (1) HBsAg negative and anti-HBc
negative and (2) anti-HBc positive alone. For those students whose anti-HBs <10 mIU/ml,
additional HBV vaccination boosters were given according to routine governmental suggested
schedules. The anamnestic effect then is observed in both groups. The results of this study
may contribute to the analysis of the effectiveness of anti-HBV vaccination twenty years
after the commencement of the program and the necessity of initiating HBV booster program
among Taiwanese young adults.
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