Evaluation of recent pre-booster studies on hepatitis B vaccine effectiveness across WHO regions with HBV prevalence above 1% in the general population up to 60 years of age: a systematic review
Tahereh Zadeh Mehrizi, Babak Eshrati, Hasan Ebrahimi Shahmabadi
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Abstract
Hepatitis B vaccination has substantially reduced the global burden of HBV infection. However, the long-term vaccine effectiveness (VE) and the need for booster doses are still uncertain, especially in some age groups living in meso- and hyperendemic regions. WHO has therefore emphasized the need for further studies to identify subgroups requiring booster doses to ensure sufficient levels of protection against HBV infection. Accordingly, in the present review, we evaluate VE and the need for booster doses among healthy urban populations aged up to 60 years in the WHO regions where the HBV prevalence exceeds 1%. This systematic review included studies reporting VE stratified by age that expressed estimates as odds ratios, risk ratios, or absolute risk. Of the 2,421 studies identified in PubMed, Web of Science, and Scopus, 11 met the inclusion criteria. There were significant age-related trends in VE. Among the 20- to 59-year-olds, especially the 20–39 age group, the effectiveness was the lowest in the Eastern Mediterranean Region, namely Tunisia and Iran. In China, the highest breakthrough infection rates were reported in the 18–29 age group, highlighting the significance of considering booster doses for enhanced protection in this population. The highest-risk ages in Vietnam were found to be 33.7, 53.8, and 24.9 years. In Africa, although the effectiveness was high among those who had received complete vaccine dosages, it declined among those aged 30–59 years with increasing age. Increased abnormal ALT rates with advancing age, a predictor of chronic HBV infection, also highlighted the need for additional booster immunizations in Taiwan and Gambia. The results indicate waning vaccine effectiveness, particularly in individuals 20–59 years old in meso- to hyper-endemic regions. These findings strongly support revisiting the vaccination schedules with consideration for targeted booster doses to maintain immunity for a longer period. This review also highlights the fact that the assessment of vaccine effectiveness and its side effects in various age and geographical groups is incomplete.
乙型肝炎疫苗接种大大减少了乙型肝炎病毒感染的全球负担。然而，疫苗的长期有效性（VE）和需要加强剂量仍然不确定，特别是在生活在中流行和高流行地区的一些年龄组。因此，世卫组织强调需要进一步研究，以确定需要加强剂量的亚群体，以确保对HBV感染的足够保护水平。因此，在本综述中，我们评估了世卫组织区域中HBV患病率超过1%的60岁以下健康城市人群的VE和加强剂量的需求。本系统综述纳入了报告VE按年龄分层的研究，这些研究以比值比、风险比或绝对风险来表示估计。在PubMed， Web Of Science和Scopus中确定的2421项研究中，有11项符合纳入标准。VE有明显的年龄相关趋势。在20- 59岁人群中，特别是20- 39岁人群中，东地中海地区，即突尼斯和伊朗的有效性最低。在中国，18-29岁年龄组的突破感染率最高，这突出了考虑在这一人群中加强保护的加强剂量的重要性。越南的最高风险年龄分别为33.7岁、53.8岁和24.9岁。在非洲，虽然接种完整剂量疫苗的人的有效性很高，但随着年龄的增长，30-59岁人群的有效性有所下降。随着年龄的增长，ALT异常率增加，这是慢性HBV感染的预测因子，也强调了在台湾和冈比亚需要额外的加强免疫接种。结果表明疫苗的有效性正在下降，特别是在中、高流行地区20-59岁的个体中。这些发现有力地支持重新考虑疫苗接种计划，考虑有针对性的加强剂量，以维持更长时间的免疫力。这一审查还强调了这样一个事实，即对不同年龄和地理群体的疫苗有效性及其副作用的评估是不完整的。摘要部分图形摘要
期刊介绍：
Archives of Virology publishes original contributions from all branches of research on viruses, virus-like agents, and virus infections of humans, animals, plants, insects, and bacteria. Coverage spans a broad spectrum of topics, from descriptions of newly discovered viruses, to studies of virus structure, composition, and genetics, to studies of virus interactions with host cells, organisms and populations. Studies employ molecular biologic, molecular genetics, and current immunologic and epidemiologic approaches. Contents include studies on the molecular pathogenesis, pathophysiology, and genetics of virus infections in individual hosts, and studies on the molecular epidemiology of virus infections in populations. Also included are studies involving applied research such as diagnostic technology development, monoclonal antibody panel development, vaccine development, and antiviral drug development.Archives of Virology wishes to publish obituaries of recently deceased well-known virologists and leading figures in virology.
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