Document Type : Original Article
Authors
1 National Drug Clinical Trial Institution of Women and Children’s Hospital, Qingdao University, No. 6 Tongfu Road, Shibei District, Qingdao City, Shandong Province, China.
2 Department of Immunology, Basic Medical College of Qingdao University, No.308 Ningxia Road, Shinan District, Qingdao City, Shandong Province, China.
3 Department of Hospital Infection Control, Qingdao Municipal Hospital, No.5 Donghai Middle Road, Shinan District, Qingdao City, Shandong Province, China.
Abstract
Background: The extent to which maternal antibodies against the hepatitis B surface antigen (HBsAb) acquired transplacentally affect the immune responses to the hepatitis B vaccine (HBVac) in infants is still uncertain.
Objective: To explore the impact of the HBsAb on the immune response to the HBVac in a mouse model.
Methods: According to the doses of the HBVac (2, 5 μg) injected, 267 BALB/c mice were divided into two groups. Each group was subdivided into 3 subgroups based on the doses of the hepatitis B immunoglobulin (HBIG) (0, 25, 50 IU) administered. The HBsAb titers were detected 4 weeks after completing the HepB vaccination.
Results: Among all the mice, 40 had an HBsAb titer <100 mIU/mL (non- or low-response to the HBVac). The rates of the HBsAb titer <100 mIU/mL in 0, 25 and 50 IU HBIG groups were 1.1%, 23.1%, and 20.7%, respectively. Multivariate logistic regression analysis showed that the risk factors for low- or non-response to the HBVac were injection with the HBIG, low HBVac dose, and hypodermic injection. The mean HBsAb titers (log10) reduced gradually in the 0, 25 and 50 IU HBIG groups (P<0.001).
Conclusion: The HBIG administration has negative impacts on the peak level of the HBsAb and the rate of an effective immune response. This implies that the maternal HBsAb acquired transplacentally might inhibit the immune responses to the HBVac in infants.
Keywords
- Hepatitis B vaccines prepared from yeast by recombinant DNA techniques: memorandum from a WHO meeting. Bull World Health Organ. 1985;63:57-61.
- Organization WH. Global health sector strategy on Viral hepatitis 2016–2021. Towards endingviral hepatitis, June 2016 (WHO/HIV/2016.06).
- Hyams KC. Risks of chronicity following acute hepatitis B virus infection: a review. Clin Infect Dis. 1995;20:992-1000.
- 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;54:1-31.
- Liang X, Bi S, Yang W, Wang L, Cui G, Cui F, et al. Reprint of: Epidemiological serosurvey of Hepatitis B in China--declining HBV prevalence due to Hepatitis B vaccination. Vaccine. 2013;31 Suppl 9:J21-28.
- Zhang L, Gui XE, Teter C, Zhong H, Pang Z, Ding L, et al. Effects of hepatitis B immunization on prevention of mother-to-infant transmission of hepatitis B virus and on the immune response of infants towards hepatitis B vaccine. Vaccine. 2014;32:6091-6097.
- Ding Y, Sheng Q, Ma L, Dou X. Chronic HBV infection among pregnant women and their infants in Shenyang, China. Virol J. 2013;10:17.
- Roopenian DC, Akilesh S. FcRn: the neonatal Fc receptor comes of age. Nat Rev Immunol. 2007;7:715-725.
- Hu Y, Wu Q, Xu B, Zhou Z, Wang Z, Zhou YH. Influence of maternal antibody against hepatitis B surface antigen on active immune response to hepatitis B vaccine in infants. Vaccine. 2008;26:6064-6067.
- Wang Z, Zhang S, Luo C, Wu Q, Liu Q, Zhou YH, et al. Transplacentally acquired maternal antibody against hepatitis B surface antigen in infants and its influence on the response to hepatitis B vaccine. PLoS One. 2011;6:e25130.
- Junqueira AL, Tavares VR, Martins RM, Frauzino KV, Silva AM, Rodrigues IM, et al. Presence of maternal anti-HBs antibodies does not influence hepatitis B vaccine response in Brazilian neonates. Mem Inst Oswaldo Cruz. 2011;106:113-116.
- Wang C, Wang C, Jia ZF, Wu X, Wen SM, Kong F, et al. Protective effect of an improved immunization practice of mother-to-infant transmission of hepatitis B virus and risk factors associated with immunoprophylaxis failure. Medicine (Baltimore). 2016;95:e4390.
- Marsac D, Puaux AL, Riviere Y, Michel ML. In vivo induction of cellular and humoral immune responses by hybrid DNA vectors encoding simian/human immunodeficiency virus/hepatitis B surface antigen virus particles in BALB/c and HLA-A2-transgenic mice. Immunobiology. 2005;210:305-319.
- Devasahayam M. Factors affecting the presentation of exogenous hepatitis B virus core antigen. Indian J Exp Biol. 2007;45:689-695.
- Parasuraman S, Raveendran R, Kesavan R. Blood sample collection in small laboratory animals. J Pharmacol Pharmacother. 2010;1:87-93.
- Lu IC, Jean MC, Lin CW, Chen WH, Perng DS, Lin CW, et al. Predictive factors for anti-HBs status after 1 booster dose of hepatitis B vaccine. Medicine (Baltimore). 2016;95:e5023.
- Habib S, Shaikh OS. Hepatitis B immune globulin. Drugs Today (Barc). 2007;43:379-394.
- Zuckerman JN. Review: hepatitis B immune globulin for prevention of hepatitis B infection. J Med Virol. 2007;79:919-921.
- Hepatitis B vaccines. Wkly Epidemiol Rec. 2009;84:405-419.
- Wei KP, Zhu FC, Liu JX, Yan L, Lu Y, Zhai XJ, et al. The efficacy of two different dosages of hepatitis B immunoglobulin combined with hepatitis B vaccine in preventing mother-to-child transmission of hepatitis B virus: A prospective cohort study. Vaccine. 2018;36:256-263.
- Wang F, Zhang G, Zheng H, Miao N, Shen L, Wang F, et al. Post-vaccination serologic testing of infants born to hepatitis B surface antigen positive mothers in 4 provinces of China. Vaccine. 2017;35:4229-4235.
- Shouval D, Ilan Y, Adler R, Deepen R, Panet A, Even-Chen Z, et al. Improved immunogenicity in mice of a mammalian cell-derived recombinant hepatitis B vaccine containing pre-S1 and pre-S2 antigens as compared with conventional yeast-derived vaccines. Vaccine. 1994;12:1453-1459.
- Ughachukwu P, Okonkwo P, Unekwe P, Ogama J. Effect of methylprednisolone injection on interleukin-4 and interferon-gamma expression following hepatitis B vaccination in mice. Turk J Med Sci. 2016;46:1540-1545.
- Morrey JD, Motter NE, Chang S, Fairman J. Breaking B and T cell tolerance using cationic lipid--DNA complexes (CLDC) as a vaccine adjuvant with hepatitis B virus (HBV) surface antigen in transgenic mice expressing HBV. Antiviral Res. 2011;90:227-230.
- Li Y, Chen JH, Shu XG, Chen JH, Xia QH, Yuan WZ, et al. A study of immune response to HBsAg mediated by CD4+ memory T lymphocytes in immunized HBV transgenic mice. Zhonghua Gan Zang Bing Za Zhi. 2016;24:897-901.
- Yin D, Liang W, Xing S, Gao Z, Zhang W, Guo Z, et al. Hepatitis B DNA vaccine-polycation nano-complexes enhancing immune response by percutaneous administration with microneedle. Biol Pharm Bull. 2013;36:1283-1291.
- Yang YJ, Liu CC, Chen TJ, Lee MF, Chen SH, Shih HH, et al. Role of hepatitis B immunoglobulin in infants born to hepatitis B e antigen-negative carrier mothers in Taiwan. Pediatr Infect Dis J. 2003;22:584-588.
- Pongpipat D, Suvatte V, Assateerawatts A. Hepatitis B immunization in high risk neonates born from HBsAg positive mothers: comparison between plasma derived and recombinant DNA vaccine. Asian Pac J Allergy Immunol. 1989;7:37-40.
- Duval B, Gilca V, Boulianne N, De Wals P, Masse R, Trudeau G, et al. Comparative long term immunogenicity of two recombinant hepatitis B vaccines and the effect of a booster dose given after five years in a low endemicity country. Pediatr Infect Dis J. 2005;24:213-218.
- Wu JS, Hwang LY, Goodman KJ, Beasley RP. Hepatitis B vaccination in high-risk infants: 10-year follow-up. J Infect Dis. 1999;179:1319-1325.
- Weeratna RD, Brazolot Millan CL, McCluskie MJ, Siegrist CA, Davis HL. Priming of immune responses to hepatitis B surface antigen in young mice immunized in the presence of maternally derived antibodies. FEMS Immunol Med Microbiol. 2001;30:241-247.
- Schillie S, Murphy TV, Sawyer M, Ly K, Hughes E, Jiles R, et al. CDC guidance for evaluating health-care personnel for hepatitis B virus protection and for administering postexposure management. MMWR Recomm Rep. 2013;62:1-19.
- Siegrist CA. Neonatal and early life vaccinology. Vaccine. 2001;19:3331-3346.
- Agladioglu S, Beyazova U, Camurdan AD, Sahin F, Atak A. Immunogenicity of recombinant hepatitis B vaccine: comparison of two different vaccination schedules. Infection. 2010;38:269-273.
- Cáceres VM, Strebel PM, Sutter RW. Factors determining prevalence of maternal antibody to measles virus throughout infancy: a review. Clin Infect Dis. 2000;31:110-119.
- Masters NB, Wagner AL, Ding Y, Zhang Y, Boulton ML. Assessing measles vaccine failure in Tianjin, China. Vaccine. 2019;37:3251-3254.
- Al Mahtab M. Elimination of Hepatitis Viruses: Bangladesh Scenario. Euroasian J Hepatogastroenterol. 2017;7:40-42.