Evaluation of immune response to hepatitis B vaccine and its determinants among immunized anti-HBc-negative children in Ethiopia: A community-based cross-sectional study

IF 2.2 Q3 IMMUNOLOGY

Vaccine: X Pub Date : 2025-07-23 DOI:10.1016/j.jvacx.2025.100694

Adane Adugna , Desalegn Abebaw , Mohammed Jemal

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Abstract

Background

The hepatitis B vaccine is a crucial tool for preventing hepatitis B virus (HBV) infection, particularly in children. However, various factors can influence the vaccine's protective effectiveness and the duration of protection it provides.

Objective

The objective of this study was to evaluate the immune response to the hepatitis B vaccine, specifically the levels of anti-HBs, and to identify the factors influencing its production among immunized anti-HBc-negative children in the northwestern region of Ethiopia.

Methods and materials

A community-based cross-sectional study was done with 157 participants ranging in age from 5 to 12 years, from July to December 2021. A simple random sampling method was employed to recruit the subjects. After drawing blood samples, serum was analyzed to detect the presence of antibodies to hepatitis B core antigen (anti-HBc) and antibodies to hepatitis B surface antigen (anti-HBs) via enzyme-linked immunosorbent assay (ELISA). Generalized linear models with a Poisson distribution, log link function, and robust standard errors were used for multivariable analysis, with 95 % confidence intervals. A p-value <0.05 was considered statistically significant.

Results

The total percentage of protective anti-HBs levels (anti-HBs ≥10 mIU/ml) among immunized anti-HBc-negative children in this study was 102/157 (65.0 %) (95 % CI: 57.0–73.0). Of these, 42.0 % were hypo-responders (their anti-HBs levels >10–100 mIU/ml), while 23.0 % were hyper-responders (their anti-HBs levels >100 mIU/ml). Moreover, concomitant vaccinations showed a significant negative association with anti-HBs antibody levels. Participants who had concomitant vaccinations, antibody levels decrease by ∼1.26 units compared to no concomitant vaccinations (APR: 1.26, 95 % CI: −1.892, −0.624) (P < 0.001). Conclusion: Childhood vaccination against hepatitis B is effective in only 65 % of children. In the study area, protective antibody levels (anti-HBs ≥10 mIU/ml) were reduced among immunized anti-HBc-negative children.

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埃塞俄比亚免疫抗乙肝病毒阴性儿童对乙肝疫苗的免疫反应及其决定因素的评估：一项基于社区的横断面研究

背景：乙型肝炎疫苗是预防乙型肝炎病毒（HBV）感染的重要工具，特别是在儿童中。然而，各种因素会影响疫苗的保护效力和保护的持续时间。目的本研究旨在评价埃塞俄比亚西北地区接种乙肝疫苗的儿童对乙肝疫苗的免疫反应，特别是抗hbs水平，并确定影响其产生的因素。方法和材料本研究于2021年7月至12月对157名年龄在5至12岁之间的参与者进行了基于社区的横断面研究。采用简单随机抽样方法招募受试者。抽取血样后，采用酶联免疫吸附试验（ELISA）检测血清中是否存在乙型肝炎核心抗原（anti-HBc）抗体和乙型肝炎表面抗原（anti-HBs）抗体。采用泊松分布、对数链接函数和稳健标准误差的广义线性模型进行多变量分析，置信区间为95%。p值<；0.05被认为具有统计学意义。结果本研究中免疫的抗hbs阴性儿童的保护性抗hbs水平（抗hbs≥10 mIU/ml）的总百分比为102/157 (65.0%)（95% CI: 57.0 ~ 73.0）。其中，42.0%为低反应（其抗hbs水平为10-100 mIU/ml），而23.0%为超反应（其抗hbs水平为100 mIU/ml）。此外，同时接种疫苗与抗hbs抗体水平呈显著负相关。与未接种疫苗的参与者相比，接种了联合疫苗的参与者抗体水平降低了约1.26个单位（APR: 1.26, 95% CI: - 1.892, - 0.624） (P <；0.001)。结论：儿童接种乙型肝炎疫苗的有效率仅为65%。在研究区域，免疫抗hbc阴性儿童的保护性抗体水平（抗hbs≥10 mIU/ml）降低。

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