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Year : 2020  |  Volume : 33  |  Issue : 1  |  Page : 15-19

Anti-Hepatitis B surface antibody response and levels in hepatitis B vaccinated children in diyala province, Iraq

1 Department of Community Medicine, College of Medicine, University of Diyala, Baquba, Diyala Province, Iraq
2 Diyala Directory of Health, Iraqi Ministry of Health, Baquba, Diyala Province, Iraq

Correspondence Address:
Abdulrazak S H. Hasan
Department of Medicine Microbiology, College of Medicine, University of Diyala, Baquba, Diyala Province
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/IRJCM.IRJCM_5_20

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Background: Hepatitis B virus (HBV) vaccination was one of the success stories of the 20th century. It is highly effective and safe and was incorporated into national immunization programs of countries worldwide. Objectives: The objective of the study as to explore the response rate and titers of anti-HBs antibodies among children 1–14 years old immunized with HB vaccine in Baquba city Diyala province. Vaccinees and Methods: This cross-sectional study was conducted in Baquba City, the center of Diyala province, Iraq for the period July 20, 2016–March 20, 2017. A total of 452 children were enrolled, 247 (54.6%) were males and 205 (45.4%) were females, with an age range of 1–14 years. All were previously immunized with genetically engineered HBV vaccine (Euvax B, Korea), with a dose of 10 μg of HBsAg/0.5 ml intramuscularly. Venous blood samples were collected aseptically; sera were separated and subjected for the detection of HBsAg, anti-HBs antibody titer, HBe Ag, and total antibody and anti-HBc total antibody using Enzyme-Linked Immunosorbant assays (ACON, Foresight-USA). A preconstructed questionnaire form was prepared including information of sociodemographic, health, and vaccination status. Statistical analysis was done using the Statistical Package for the Social Science (SPSS), Version 23. P < 0.05 was considered statistically significant. Results: The overall anti-HBs Ab positivity rate was 75.66% (95% confidence interval was 71.5%–79.6%), with a mean anti-HBs Ab titers range (10.1–673.4 mIU/ml). However, the titer was failed to reach the protective level in 110 (24.34%) vaccinees. The highest anti-HBs Ab positivity rate among children received 1 or 2 vaccine dose is significantly higher among those after <1-year duration (80.0%, P = 0.043), while the mean anti-HBs Ab titer is insignificantly highest among the same group of children (43.7 mIU/ml, P = 0.24). The highest anti-HBs Ab positivity rate among children received three vaccine doses is significantly higher among those after <1-year duration (91.3%, P = 0.003), and similarly the highest mean of anti-HBs Ab titer is insignificant higher among the same children group (81.3 IU/ml, P = 0.2). Regarding those children received four vaccine doses, the anti-HBs Ab positivity rate and the mean anti-HBs Ab titer are significantly higher among children after <1 year (89.9%, P = 0.004 and 97.7 IU/ml, P < 0.001), respectively. Finally, the anti-HBs Ab positivity rate after five vaccine doses was insignificantly higher after 1–3-year duration (72.4%, P = 0.15), while the highest mean anti-HBs Ab titer was significantly higher among those with <1-year duration (55.0 IU/ml, P < 0.041). Conclusion: Universal hepatitis B vaccination is generally produce high rate of protection among children and the highest anti-HBs antibody titer was achieved through 3 or 4 doses after <1-year postvaccination.

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