Hepatitis B antibody titers in Indonesian adolescents who received the primary hepatitis B vaccine during infancy
Keywords:
adolescent, anti-HBs, booster, hepatitis B vaccine, immunity
Abstract
Backgi-ound Hepatitis B (HB) has been classified as moderate-tohighlyendemic in Indonesia. HB vaccination, the most effective
method to prevent HB viral transmission, induces protective
antibodies against HB surface antigen (anti-HBs). However, these
antibodies decline in titer over time. Studies on the duration of
protection and the prevalence of n on-responders in Indonesian
adolescents have been limited.
Objectives To determine anti-HBs titers in 15-17-year old
Indonesian adolescents given primary HB vaccine during infancy
and the prevalence of non-responders after a HB vaccine booster
dosage.
Methods This cross-sectional study was performed from February
to September 2008 on adolescents aged 15-17 years in three
senior high schools in Jakarta who received complete primary HB
vaccines during infancy, based on parents' recall. Investigations
included HB vaccination history, anthropometric measurements,
and blood tests for anti-HBs before and 4-6 weeks after a booster
dose ofHB vaccine.
Results Of 94 subjects, 35 had protective anti-HBs and 59 had
undetectable anti-HBs. A booster dose was administered to 5 8 of the
n on-protected subjects, of which 33 showed anamnestic responses.
However, 25 subjects failed to generate protective anti-HBs. Taking
into consideration the adolescents with protective anti-HBs before
and after the booster dose, serologic protection was demonstrated
in 73%. Non-responder prevalence was 27%. The high prevalence
of non-responders may indicate bias of parents' recall.
Conclusion Protective anti-HBs is detected in less than half of
Indonesian adolescents given primary HB vaccine during infancy.
Following booster dosage, anamnestic responses are n oted in onethird
of subjects. The prevalence of non-responders is 27%, but
confirmation with further study is needed.
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27. Kruger A, Adams P, Hammer J, Bocher WO, Schneider PM,
Rittner C, et al. Hepatitis B surface antigen presentation and
HLA-DRB 1 * -lessons from twins and peptide binding studies.
Clin Exp Immunol. 2005;140 (2):325-32.
28. Valadez JJ, Weld LH. Maternal recall error of child
vaccination status in a developing nation. Am J Public
Health. 1991;82:120-3.
29. Dore! CG, Jain N, Yankey D. Validity of parent reported
vaccination status for adolescent aged 13-17 years: National
Immunization Survey-Teen 2008. Public Health Rep.
166 • Paediatrlndones, Vol. 53, No. 3, May 2013
2011;126:60-9.
30. Suarez L, Simpson DM, Smith DR. Errors and correlates in
parental recall of child immunization: effects of vaccination
coverage estimates. Pediatrics. 1997;99:3.
J Med Virol. 2000;61:362-6.
2. Goldstein ST, Zhou F, Hadler SC, Bell BP, Mast EE, Margolis
HS. A mathematical model to estimate global hepatitis B
disease burden and vaccination impact. Int J Epidemiol.
2005;34:1329-39.
3. World Health Organization. Hepatitis B. [cited 2008 Aug
3] Available from: http://www.who int/csr/disease!hepatitis/
HepatitisB ~ whocdscsrlyo2002 ~2 pdf 2002.
4. World Health Organization. Hepatitis B vaccines. Wkly
Epidemiol Rec. 2009;84:405-19.
5. Julitasari, Fahrni U. Permasalahan penyakit hepatitis virus
di Indonesia. In: Zulkamain BJ, Pujianto PS, Oswari H,
penyunting. Tinjauan komprehensif hepatitis virus pada
anak. Jakarta: Bagian Ilmu Kesehatan Anak, Universitas
Indonesia; 2000. p. 1-7.
6. Bisanto J. Hepatitis virus. In: Hadinegoro SR, Prawitasari
T, Endyami B, Kadim M, Sjakti HA, editors. Diagnosis dan
tatalaksana penyakit anak dengan gejala kuning. Jakarta:
Departemen Ilmu Kesehatan Anak FKUI; 2007. p. 55-77.
7. Aggarwal R, Ranjan P. Preventing and treating hepatitis B
infection. BMJ. 2004;329:1080-6.
8. Mast EE, Margolis HS, Fiore AE, Brink EW, Goldstein ST,
Wang SA, et al. A comprehensive immunization strategy to
eliminate transmission of hepatitis B virus infection in the
United States: recommendations of the Advisory Committee
on Immunization Practices (ACIP) part 1: immunization of
infants, children, and adolescents. MMWR Recomm Rep.
2005 ;5 4: 1-31.
9. Kementrian Kesehatan Republik Indoensia. Lembar fakta
hepa titis. [cited 2011 Feb 2] Available from: http://www
depkes go id/hepatitis/index php/component/content/artic 1e/34pess-
re lease/799-lembar-f akta- hepatitis html 2010.
10. Hessel L, West DJ. Antibody respon ses to recombinant
hepatitis B vaccines. Vaccine. 2002;20:2164-5.
11. Samandari T, Fiore AE, Negus S, Williams JL, Kuhnert W,
McMahon BJ, et al. Differences in response to a hepatitis B
vaccine booster dose among Alaskan children and adolescents
vaccinated during infancy. Pediatrics. 2007;120:e373-81.
12. Amirzargar M , Mohseni N, Shokrgozar MA, Arj ang Z,
Ahmadi N, Yousaefi Behzadi M, et al. HLA-DRBl, DQAl
and DQB 1 alleles and haplotypes frequencies in Iranian
healthy adult responders and non-responders to recombinant
hepatitis B vaccine . Iran J Immunol. 2008;5:92-9.
13. HouJ, Liu Z, Gu F. Epidemiology and prevention ofhepatitis
B virus infection. Int J Med Sci. 2005;2:50-7.
14. Department of Health and Ageing. Hepatitis B. The
Australian immunization handbook. 9 ed. Canberra:
Australian Government; 2008.
15. Center for Disease Control and Prevention. Data Table of
BMI-for-age Charts 2000. Available from: http://www.cdc.gov/
growthcharts/charts.htm# set3.
16. Chang MH, Chen CJ, Lai MS, Hsu HM, Wu TC, Kong
MS, et al. Universal hepatitis B vaccination in Taiwan and
the incidence of hepatocellular carcinoma in children.
Taiwan Childhood Hepatoma Study Group. N Engl J Med.
1997 ;336:1855-9.
17. Poland GA, Jacobson RM. Clinical practice: prevention
of hepatitis B with the hepatitis B vaccine. N Engl J Med.
2004;3 51:2832-8.
18. Suraiyah. Proporsi seroproteksi hepatitis B pada usia 10-12
tahun dengan riwayat imunisasi dasar hepatitis B lengkap
pada dua sekolah dasar di Jakarta [ tesis]. Jakarta: Universitas
Indonesia; 2007.
19. Lu CY, Chiang BL, Chi WK, Chang MH, Ni YH, Hsu HM, et
al. Waning immunity to plasma-derived hepatitis B vaccine
and the need for boosters 15 years after neonatal vaccination.
Hepatology. 2004;40:1415-20.
20. Chinchai T, Chirathaworn C, Praianantathavom K,
Theamboonlers A, Hutagalung Y, Bock PH, et al. Long-term
humoral and cellular immune response to hepatitis B vaccine
in high-risk children 18-20years after neonatal immunization.
Viral Immunol. 2009;22:125-30.
21. Bauer T, Jilg W. Hepatitis B surface antigen-specific T and B
cell memory in individuals who had lost protective antibodies
after h epatitis B vaccination. Vaccine. 2006;24:572-7.
22. Desombere I, Cao T, Gijbels Y, Leroux-Roels G. Non-
responsiveness to hepatitis B surface antigen vaccines is
n ot caused by defective antigen presentation or a lack of B7
co-stimulation. Clin Exp Immunol. 2005;140:126-37.
23. Zhuang GH, Yan H, Wang XL, Hwang LY, Wu Q, Wang LR,
et al. Hepatitis B revaccination in h ealthy n on-responder
Chinese children: five-year follow-up of immune response
and immunologic memory. Vaccine. 2006;24:21 86-92.
24. Alper CA, Kruskall MS, Marcus-Bagley D, Craven DE, Katz
AJ, Brink SJ, et al. Genetic prediction of n onresponse to
hepatitis B vaccine. N Engl J Med. 1989;32 l (11) :708- 12.
25. Desombere I, Willems A, Leroux-Roels G. Response to
hepatitis B vaccine: multiple HLA genes are involved. Tissue
Antigens. 1998;5 l (6) :593-604.
26. Wang C, Tang J, Song W, Lobashevsky E, Wilson CM,
Kaslow RA. Human leukocyte antigen and cytokine gene
polymorphisms are independently associated with responses
to hepatitis B vaccination. Hepatology. 2004;39:978-88.
27. Kruger A, Adams P, Hammer J, Bocher WO, Schneider PM,
Rittner C, et al. Hepatitis B surface antigen presentation and
HLA-DRB 1 * -lessons from twins and peptide binding studies.
Clin Exp Immunol. 2005;140 (2):325-32.
28. Valadez JJ, Weld LH. Maternal recall error of child
vaccination status in a developing nation. Am J Public
Health. 1991;82:120-3.
29. Dore! CG, Jain N, Yankey D. Validity of parent reported
vaccination status for adolescent aged 13-17 years: National
Immunization Survey-Teen 2008. Public Health Rep.
166 • Paediatrlndones, Vol. 53, No. 3, May 2013
2011;126:60-9.
30. Suarez L, Simpson DM, Smith DR. Errors and correlates in
parental recall of child immunization: effects of vaccination
coverage estimates. Pediatrics. 1997;99:3.
Published
2013-06-30
How to Cite
1.
Gunardi H, Firmansyah A, Harun S, Sastroasmoro S. Hepatitis B antibody titers in Indonesian adolescents who received the primary hepatitis B vaccine during infancy. PI [Internet]. 30Jun.2013 [cited 25Apr.2024];53(3):160-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/274
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Received 2016-08-21
Accepted 2016-08-21
Published 2013-06-30
Accepted 2016-08-21
Published 2013-06-30
