The Impact of Universal Infant Hepatitis B Immunization on Reducing the Hepatitis B Carrier Rate in Pregnant Women

• Published in: The Journal of infectious diseases 2019-08, Vol.220 (7), p.1118-1126
• Main Authors: Su, Wei-Ju, Chen, Shu-Fong, Yang, Chin-Hui, Chuang, Pei-Hung, Chang, Hsiu-Fang, Chang, Mei-Hwei
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Antigens; Carrier State - microbiology; Cohort analysis; Cohort Studies; Cross-Sectional Studies; Female; Genetic crosses; Hepatitis; Hepatitis B; Hepatitis B - prevention & control; Hepatitis B - transmission; Hepatitis B e antigen; Hepatitis B e Antigens - immunology; Hepatitis B surface antigen; Hepatitis B Surface Antigens - immunology; Hepatitis B Vaccines - therapeutic use; Hepatitis B virus - immunology; Hepatitis B virus - isolation & purification; Humans; Immunization; Infant; Infant, Newborn; Infectious Disease Transmission, Vertical - prevention & control; Middle Aged; Pregnancy; Pregnancy Complications, Infectious - virology; Treatment Outcome; Vaccination; Vaccination - methods; Womens health; Young Adult
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jiy706

Abstract Background The hepatitis B virus (HBV) status of pregnant women affects HBV vaccine failure in their offspring. This study is aimed to investigate the impact of the universal infant HBV vaccination program on the long-term hepatitis B surface antigen (HBsAg) rate in pregnant women. Methods Using the National Immunization Information System, we examined a 32-year period of cross-sectional data on a maternal HBsAg and hepatitis B e antigen (HBeAg) screening program launched in July 1984. An age-period-cohort model analysis of 940 180 pregnant women screened for July 1996–June 1997 and the years 2001, 2006, 2011, and 2016 was applied. Results The annual HBsAg- and HBeAg-seropositive rates decreased from 13.4% and 6.4%, respectively, for the period 1984–1985 to 5.9% and 1.0% in 2016 (P for both trends < .0001). Pregnant women with birth years after July 1986 (the HBV vaccination cohort) had the lowest relative risk (0.27 [95% confidence interval, .26–.28]) of HBsAg positivity compared with birth years before June 1984. Conclusions The birth cohort effect in relation to the universal infant HBV immunization program has effectively reduced the HBV carrier rate in pregnant women and the burden of perinatal HBV infection on the next generation. Hepatitis C virus (HBV) vaccination is responsible for the long-term decline in both the hepatitis B surface antigen–seropositive rate among pregnant women and the burden of perinatal HBV infection on the next generation.