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Reuters Health Information (2009-10-23): Vaccination program cuts HBV infection in children of foreign-born Asian parents


Vaccination program cuts HBV infection in children of foreign-born Asian parents

Last Updated: 2009-10-23 13:01:57 -0400 (Reuters Health)

NEW YORK (Reuters Health) - The hepatitis B virus (HBV) infant vaccination program in the US appears to have reduced chronic infection, morbidity and mortality among populations at high risk, a paper in the October 9th issue of the journal Vaccine suggests.

"In 1988, the Advisory Committee on Immunization Practices (ACIP) recommended hepatitis B surface antigen (HBsAg) screening for all pregnant women," Dr. Carrie M. Shuler, of the Centers for Disease Control and Prevention, Atlanta, and colleagues write.

"In 1991, to prevent horizontal transmission in households and to further reduce missed opportunities to prevent HBV infection, ACIP recommended hepatitis B vaccination for all infants, preferably beginning at birth and regardless of the HBsAg status of the mother," they add.

The researchers performed a follow-up seroprevalence study during 2001 to 2004 in an Asian immigrant community in Georgia to assess the impact of universal maternal HBsAg screening and infant vaccination in preventing HBV infection among U.S.-born children of foreign-born Asian parents. This was modeled after a 1985 study conducted in a similar population during the era before routine infant vaccination.

Inclusion criteria required that households have at least one parent born in Korea, China, Laos, Cambodia, or Vietnam, and at least one U.S.-born child older than 12 months of age (study children).

A total of 989 subjects (563 adults and 426 children) were enrolled in the study. Of these, four adults were U.S.-born and 72 children were foreign-born. Therefore, 354 children were considered study children, and 635 subjects were foreign-born or adult participants (non-study children).

The authors note that 88% of the 354 study children lived in a household with at least one person with serological evidence of chronic or resolved HBV infection. Overall, 25.9% of study children lived in a household with a chronically infected person.

"Although the prevalence of chronic HBV infection among foreign-born adults was 11% in both the 1985 study and this study, only 0.8% of the U.S.-born children in our study had chronic HBV infection, compared with 4.3% of the children in the 1985 study; an 81% reduction," Dr. Shuler and colleagues explain. "The overall HBV infection burden among children decreased as well, with only 1.1% of children born after 1991 having evidence of resolved infection, compared with 12.5% of the children studied in 1985."

After controlling for chronic infection among household members, predictors of infection among study children included being born to a chronically infected mother (adjusted odds ratio 63.2) and being born before 1992 (adjusted OR 9.5). There was no statistical association between infection in study children and having a chronically infected father, other adult, or child in the household.

Compared to children born before the universal infant vaccination recommendation, those born after 1991 were more likely to have received the recommended three doses of the hepatitis B vaccine during infancy.

Vaccine 2009;27:5942-5947.

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