Lasting immune memory against hepatitis B in children after primary immunization with 4 doses of DTPa-HBV-IPV/Hib in the first and 2nd year of life

• Published in: BMC infectious diseases Vol. 10; no. 1; p. 9
• Main Authors: Steiner, Michael, Ramakrishnan, Gunasekaran, Gartner, Britta, Van Der Meeren, Olivier, Jacquet, Jeanne-Marie, Schuster, Volker
• Format: Journal Article
• Language: English
• Published: London BioMed Central 15.01.2010; BMC
• Subjects: Antibodies, Bacterial - blood; Antibodies, Viral - blood; Antibody Formation; Child, Preschool; Diphtheria-Tetanus-acellular Pertussis Vaccines - administration & dosage; Diphtheria-Tetanus-acellular Pertussis Vaccines - immunology; Female; Follow-Up Studies; Germany; Haemophilus Vaccines - administration & dosage; Haemophilus Vaccines - immunology; Humans; Immunization, Secondary; Immunologic Memory; Infectious Diseases; Internal Medicine; Male; Medical Microbiology; Medicine; Medicine & Public Health; Parasitology; Poliovirus Vaccine, Inactivated - administration & dosage; Poliovirus Vaccine, Inactivated - immunology; Research Article; Tropical Medicine; Vaccines, Combined - administration & dosage; Vaccines, Combined - immunology; Germany; Immune Memory; Combination Vaccine; Primary Vaccination; Challenge Dose; Booster Vaccination
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/1471-2334-10-9

Background Few studies have assessed long term persisting immunity against hepatitis B virus (HBV) in children vaccinated during infancy with combined vaccines containing recombinant HBV surface antigen (HBs). We assessed antibody persistence and immune memory in children 4-5 years of age, previously vaccinated with four doses of combined hexavalent DTPa-HBV-IPV/Hib vaccine ( Infanrix hexa ™). Methods Immune memory was assessed in 301 children through administration of a challenge dose of monovalent HBV vaccine. Results At 4-5 years of age, 85.3% of subjects had persisting anti-HBs antibody concentrations ≥ 10 mIU/mL, rising to 98.6% after the HBV challenge dose. All but 12 subjects (95.8%) achieved post-challenge anti-HBs concentrations ≥ 100 mIU/mL. The post-challenge anti-HBs GMC rose by 100-fold compared to pre-challenge concentrations. An anamnestic response to the HBV vaccine challenge was observed in 96.8% of subjects, including 17/21 (81.0%) of children with initially undetectable antibodies (<3.3 mIU/mL). All but 4 of 42 subjects (90.5%) with anti-HBs antibodies <10 mIU/mL prior to the challenge dose, achieved seroprotective levels afterwards. A 4-fold rise in antibody concentration after the challenge dose was observed in 259/264 (98.1%) of initially seropositive subjects. The magnitude of the post-challenge responses was proportional to pre-challenge anti-HBs levels. No serious adverse events were reported during the study. Conclusion The combined DTPa-HBV-IPV/Hib vaccine induced lasting immune memory against hepatitis B. Long term protection afforded by DTPa-HBV-IPV/Hib is likely to be similar to that observed following priming with monovalent HBV vaccines. Trial registration http://www.clinicaltrials.gov 106789 NCT00411697