ArticleBMC infectious diseases2022
A booster hepatitis B vaccine for children with maternal HBsAg positivity before 2 years of age could effectively prevent vaccine breakthrough infections.
Article in BMC infectious diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 9 citations in OpenAlex.
- HBV breakthrough infection in individuals born to mothers with HBV infection: a systematic review and meta-analysis.BMC public health · 2026Pooled it
- Estimates of the global prevalence of occult hepatitis B virus infection in population under 18 years old: a systematic review and meta-analysis.Hepatology international · 2025Pooled it
- [Chinese practice guidelines for the prevention and treatment of mother-to-child transmission of hepatitis B virus (version 2024)].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2024Guideline
- MZB1 expression levels are associated with long-term maintenance of high anti-HBs titers: single-cell RNA-seq with validation by nested case-control and intervention studies.Frontiers in immunology · 2026Article
- Review
- Increased neonatal vaccine dose or booster immunization prevents hepatitis B vaccine breakthrough infection in children from HBsAg and HBeAg positive mothers.NPJ vaccines · 2025Article
- Level of antibody to hepatitis B surface antigen declined below 10 mIU/ml is still protective.NPJ vaccines · 2025Article
- Chinese clinical practice guidelines for the prevention and treatment of mother-to-child transmission of hepatitis B virus (version 2024).Infectious diseases & immunity · 2025Article
- Chinese Clinical Practice Guidelines for the Prevention and Treatment of Mother-to-child Transmission of Hepatitis B Virus (Version 2024).Journal of clinical and translational hepatology · 2024Article
- Comparison of the effectiveness four years after Homo/Hetero prime-boost with 10 μg HP and 20 μg CHO recombinant hepatitis B vaccine at 1 and 6 months in maternal HBsAg-negative children.Frontiers in immunology · 2024Article
- Guidelines for the Prevention and Treatment of Chronic Hepatitis B (version 2022).Journal of clinical and translational hepatology · 2023Article
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Authors and funding
17 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundThe long-term protective effect of hepatitis B vaccine (HepB), the incidence of hepatitis B virus (HBV) vaccine breakthrough infections (VBIs), and whether a booster HepB is necessary remain to be clarified in children born to mothers with chronic HBV infection.
methodsBased on a long-term follow-up prospective cohort of 1177 hepatitis B surface antigen (HBsAg)-positive mothers and their paired infants which was established from 2009 to 2011, total 454 children with immunoprophylaxis success as determined by postvaccination serologic testing (PVST) at 7 months old were included in this study. Among the 454 children, 246 never had a booster HepB, and 208 children received a booster HepB from 1 to 5 years of age. Multivariate logistic regression analysis was used to analyse the risk factors for HBV VBIs.
resultsThe hepatitis B surface antibody (anti-HBs) levels declined sharply from 7 months to 2 years old, and the anti-HBs seronegative rate in the children increased significantly from 2 years old. A total of 31 (6.83%) of the 454 children experienced VBIs, of which 7 had overt and 7 had occult HBV infections. Notably, 14 (45.16%) of the 31 children with VBIs were diagnosed at 2 years old, and all of them had anti-HBs positivity (> 10 mIU/mL) at 1 year old. Maternal hepatitis B e antigen (HBeAg) positivity, higher HBV DNA and HBsAg levels, lower initial infant anti-HBs levels and not receiving a booster HepB were independent risk factors for VBIs. The incidence of VBIs was significantly lower in children with a booster HepB than in nonboosted children (0.50 vs. 11.90%, P < 0.001), and none of the boosted children developed overt or occult HBV infection. The anti-HBs levels of 76.67% for the children with VBIs in the nonboosted group indicated positivity before VBIs was detected.
conclusionsAfter the primary full immunization with HepB, children born to mothers with chronic HBV infection, especially the children with maternal HBeAg positivity, high HBV DNA levels, high HBsAg levels and/or low initial infant anti-HBs levels, were at a high risk of VBIs, and a booster HepB for these children before 2 years old, instead of when their anti-HBs level is < 10 mIU/mL, could reduce the incidence of VBIs.
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