Levels of hepatitis B antibody titers are affected by age and doses gap time in children from a high endemic area of the western Amazon

Laura Cordeiro Gomes; Marina Cordeiro Gomes Sanson; Philip Brainin; Maria da Conceição Vieira de Melo; Rodrigo Medeiros de Souza; Janaína Mazaro; Karine Oliveira Lima; Júnia Silva Resende; Isabelle Victória Martins Vieira; Edinilson da Silva Mesquita; Luan Oliveira Matos; Isabelle Caroline Silva Dutra; Giuseppe Palmisano; Carsten Wrenger; Claudio Romero Farias Marinho; Rita do Socorro Uchôa da Silva

doi:10.1371/journal.pone.0253752

Levels of hepatitis B antibody titers are affected by age and doses gap time in children from a high endemic area of the western Amazon

Laura Cordeiro Gomes, Marina Cordeiro Gomes Sanson^*, Philip Brainin, Maria da Conceição Vieira de Melo, Rodrigo Medeiros de Souza, Janaína Mazaro, Karine Oliveira Lima, Júnia Silva Resende, Isabelle Victória Martins Vieira, Edinilson da Silva Mesquita, Luan Oliveira Matos, Isabelle Caroline Silva Dutra, Giuseppe Palmisano, Carsten Wrenger, Claudio Romero Farias Marinho, Rita do Socorro Uchôa da Silva

^*Corresponding author for this work

Herlev and Gentofte Hospital

7 Citations (Scopus)

Abstract

BACKGROUND: Despite completion of the vaccine schedule for hepatitis B virus (HBV), children may display levels of HBV surface antibodies (anti-HBs) that are considered inadequate for sufficient protection (<10 IU/L).

AIMS: Our aim was to investigate if age and gap time between HBV vaccine doses may negatively affect the levels of anti-HBs in children, and if these relationships are modified by sex.

METHODS: In a high-endemic HBV region of the western Brazilian Amazon we enrolled children who had completed the HBV vaccine schedule. All children underwent analysis of anti-HBs and a clinical examination.

RESULTS: We included 522 children (mean age 4.3 ± 0.8 years; 50% male). Median anti-HBs was 28.4 [interquartile range (IQR) 5.4 to 128.6] IU/L and 32% had anti-HBs <10 IU/L. The median gap time from last to preceding dose was 2.4 [IQR 2.1 to 3.3] months. Levels of anti-HBs decreased with higher age (-42% per year increase [95%CI -56% to -24%], p<0.001), but not with longer gap time (+23% per month increase [95%CI -16% to +62%], p = 0.249). After adjusting for relevant confounders, gap time became significant (p = 0.032) and age remained a significant predictor of anti-HBs (p<0.001).

CONCLUSION: One third of assessed children displayed anti-HBs <10 IU/L. Levels of anti-HBs decreased with higher age and increased with longer gap time between the last two doses.

Original language	English
Article number	e0253752
Journal	PLoS One
Volume	16
Issue number	7
Pages (from-to)	e0253752
ISSN	1932-6203
DOIs	https://doi.org/10.1371/journal.pone.0253752
Publication status	Published - 1 Jul 2021

Keywords

Age Factors
Brazil
Child, Preschool
Cross-Sectional Studies
Endemic Diseases/prevention & control
Female
Hepatitis B/blood
Hepatitis B Antibodies/blood
Hepatitis B Surface Antigens/immunology
Hepatitis B Vaccines/administration & dosage
Hepatitis B virus/immunology
Humans
Immunization Schedule
Male
Mass Vaccination
Serologic Tests/statistics & numerical data
Time Factors

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Gomes, L. C., Sanson, M. C. G., Brainin, P., da Conceição Vieira de Melo, M., de Souza, R. M., Mazaro, J., Lima, K. O., Resende, J. S., Vieira, I. V. M., da Silva Mesquita, E., Matos, L. O., Dutra, I. C. S., Palmisano, G., Wrenger, C., Marinho, C. R. F., & do Socorro Uchôa da Silva, R. (2021). Levels of hepatitis B antibody titers are affected by age and doses gap time in children from a high endemic area of the western Amazon. PLoS One, 16(7), e0253752. Article e0253752. https://doi.org/10.1371/journal.pone.0253752

Gomes, LC, Sanson, MCG, Brainin, P, da Conceição Vieira de Melo, M, de Souza, RM, Mazaro, J, Lima, KO, Resende, JS, Vieira, IVM, da Silva Mesquita, E, Matos, LO, Dutra, ICS, Palmisano, G, Wrenger, C, Marinho, CRF & do Socorro Uchôa da Silva, R 2021, 'Levels of hepatitis B antibody titers are affected by age and doses gap time in children from a high endemic area of the western Amazon', PLoS One, vol. 16, no. 7, e0253752, pp. e0253752. https://doi.org/10.1371/journal.pone.0253752

@article{a9cea93cce6b4ee0b1fd4a41fc19953a,

title = "Levels of hepatitis B antibody titers are affected by age and doses gap time in children from a high endemic area of the western Amazon",

abstract = "BACKGROUND: Despite completion of the vaccine schedule for hepatitis B virus (HBV), children may display levels of HBV surface antibodies (anti-HBs) that are considered inadequate for sufficient protection (<10 IU/L).AIMS: Our aim was to investigate if age and gap time between HBV vaccine doses may negatively affect the levels of anti-HBs in children, and if these relationships are modified by sex.METHODS: In a high-endemic HBV region of the western Brazilian Amazon we enrolled children who had completed the HBV vaccine schedule. All children underwent analysis of anti-HBs and a clinical examination.RESULTS: We included 522 children (mean age 4.3 ± 0.8 years; 50\% male). Median anti-HBs was 28.4 [interquartile range (IQR) 5.4 to 128.6] IU/L and 32\% had anti-HBs <10 IU/L. The median gap time from last to preceding dose was 2.4 [IQR 2.1 to 3.3] months. Levels of anti-HBs decreased with higher age (-42\% per year increase [95\%CI -56\% to -24\%], p<0.001), but not with longer gap time (+23\% per month increase [95\%CI -16\% to +62\%], p = 0.249). After adjusting for relevant confounders, gap time became significant (p = 0.032) and age remained a significant predictor of anti-HBs (p<0.001).CONCLUSION: One third of assessed children displayed anti-HBs <10 IU/L. Levels of anti-HBs decreased with higher age and increased with longer gap time between the last two doses.",

keywords = "Age Factors, Brazil, Child, Preschool, Cross-Sectional Studies, Endemic Diseases/prevention \& control, Female, Hepatitis B/blood, Hepatitis B Antibodies/blood, Hepatitis B Surface Antigens/immunology, Hepatitis B Vaccines/administration \& dosage, Hepatitis B virus/immunology, Humans, Immunization Schedule, Male, Mass Vaccination, Serologic Tests/statistics \& numerical data, Time Factors",

author = "Gomes, \{Laura Cordeiro\} and Sanson, \{Marina Cordeiro Gomes\} and Philip Brainin and \{da Concei{\c c}{\~a}o Vieira de Melo\}, Maria and \{de Souza\}, \{Rodrigo Medeiros\} and Jana{\'i}na Mazaro and Lima, \{Karine Oliveira\} and Resende, \{J{\'u}nia Silva\} and Vieira, \{Isabelle Vict{\'o}ria Martins\} and \{da Silva Mesquita\}, Edinilson and Matos, \{Luan Oliveira\} and Dutra, \{Isabelle Caroline Silva\} and Giuseppe Palmisano and Carsten Wrenger and Marinho, \{Claudio Romero Farias\} and \{do Socorro Uch{\^o}a da Silva\}, Rita",

note = "Publisher Copyright: {\textcopyright} 2021 Gomes et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2021",

month = jul,

day = "1",

doi = "10.1371/journal.pone.0253752",

language = "English",

volume = "16",

pages = "e0253752",

journal = "PLoS One",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "7",

}

TY - JOUR

T1 - Levels of hepatitis B antibody titers are affected by age and doses gap time in children from a high endemic area of the western Amazon

AU - Gomes, Laura Cordeiro

AU - Sanson, Marina Cordeiro Gomes

AU - Brainin, Philip

AU - da Conceição Vieira de Melo, Maria

AU - de Souza, Rodrigo Medeiros

AU - Mazaro, Janaína

AU - Lima, Karine Oliveira

AU - Resende, Júnia Silva

AU - Vieira, Isabelle Victória Martins

AU - da Silva Mesquita, Edinilson

AU - Matos, Luan Oliveira

AU - Dutra, Isabelle Caroline Silva

AU - Palmisano, Giuseppe

AU - Wrenger, Carsten

AU - Marinho, Claudio Romero Farias

AU - do Socorro Uchôa da Silva, Rita

N1 - Publisher Copyright: © 2021 Gomes et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2021/7/1

Y1 - 2021/7/1

N2 - BACKGROUND: Despite completion of the vaccine schedule for hepatitis B virus (HBV), children may display levels of HBV surface antibodies (anti-HBs) that are considered inadequate for sufficient protection (<10 IU/L).AIMS: Our aim was to investigate if age and gap time between HBV vaccine doses may negatively affect the levels of anti-HBs in children, and if these relationships are modified by sex.METHODS: In a high-endemic HBV region of the western Brazilian Amazon we enrolled children who had completed the HBV vaccine schedule. All children underwent analysis of anti-HBs and a clinical examination.RESULTS: We included 522 children (mean age 4.3 ± 0.8 years; 50% male). Median anti-HBs was 28.4 [interquartile range (IQR) 5.4 to 128.6] IU/L and 32% had anti-HBs <10 IU/L. The median gap time from last to preceding dose was 2.4 [IQR 2.1 to 3.3] months. Levels of anti-HBs decreased with higher age (-42% per year increase [95%CI -56% to -24%], p<0.001), but not with longer gap time (+23% per month increase [95%CI -16% to +62%], p = 0.249). After adjusting for relevant confounders, gap time became significant (p = 0.032) and age remained a significant predictor of anti-HBs (p<0.001).CONCLUSION: One third of assessed children displayed anti-HBs <10 IU/L. Levels of anti-HBs decreased with higher age and increased with longer gap time between the last two doses.

AB - BACKGROUND: Despite completion of the vaccine schedule for hepatitis B virus (HBV), children may display levels of HBV surface antibodies (anti-HBs) that are considered inadequate for sufficient protection (<10 IU/L).AIMS: Our aim was to investigate if age and gap time between HBV vaccine doses may negatively affect the levels of anti-HBs in children, and if these relationships are modified by sex.METHODS: In a high-endemic HBV region of the western Brazilian Amazon we enrolled children who had completed the HBV vaccine schedule. All children underwent analysis of anti-HBs and a clinical examination.RESULTS: We included 522 children (mean age 4.3 ± 0.8 years; 50% male). Median anti-HBs was 28.4 [interquartile range (IQR) 5.4 to 128.6] IU/L and 32% had anti-HBs <10 IU/L. The median gap time from last to preceding dose was 2.4 [IQR 2.1 to 3.3] months. Levels of anti-HBs decreased with higher age (-42% per year increase [95%CI -56% to -24%], p<0.001), but not with longer gap time (+23% per month increase [95%CI -16% to +62%], p = 0.249). After adjusting for relevant confounders, gap time became significant (p = 0.032) and age remained a significant predictor of anti-HBs (p<0.001).CONCLUSION: One third of assessed children displayed anti-HBs <10 IU/L. Levels of anti-HBs decreased with higher age and increased with longer gap time between the last two doses.

KW - Age Factors

KW - Brazil

KW - Child, Preschool

KW - Cross-Sectional Studies

KW - Endemic Diseases/prevention & control

KW - Female

KW - Hepatitis B/blood

KW - Hepatitis B Antibodies/blood

KW - Hepatitis B Surface Antigens/immunology

KW - Hepatitis B Vaccines/administration & dosage

KW - Hepatitis B virus/immunology

KW - Humans

KW - Immunization Schedule

KW - Male

KW - Mass Vaccination

KW - Serologic Tests/statistics & numerical data

KW - Time Factors

UR - https://www.scopus.com/pages/publications/85110364126

U2 - 10.1371/journal.pone.0253752

DO - 10.1371/journal.pone.0253752

M3 - Journal article

C2 - 34197516

AN - SCOPUS:85110364126

SN - 1932-6203

VL - 16

SP - e0253752

JO - PLoS One

JF - PLoS One

IS - 7

M1 - e0253752

ER -

Levels of hepatitis B antibody titers are affected by age and doses gap time in children from a high endemic area of the western Amazon

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