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Immune responses of hepatitis B vaccination among very low birth weight infant

Korean Journal of Pediatrics 2006;49(8):857-863.
Published online August 15, 2006.
Immune responses of hepatitis B vaccination among very low birth weight infant
Young-Deuk Kim, Myung-Ki Han, Ai-Rhan E. Kim, Ki-Soo Kim, Soo-Young Pi
Department of Pediatrics, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Kore
극소 저출생체중아의 영아기 B형 간염 항체 생성률 조사
김영득, 한명기, 김애란, 김기수, 피수영
울산대학교 의과대학 서울아산병원 소아과
Correspondence: 
Ai-Rhan E. Kim, Email: arkim@amc.seoul.kr
Abstract
Purpose
: To evaluate the immunogenicity of hepatitis B vaccine among very low birth weight infants(VLBWI) who were vaccinated at 0, 1, 6 months of chronological age and to determine the factors associated with antibody formations.
Methods
: A total of 243 VLBWI admitted to Seoul and Gangneung Asan Medical Center neonatal intensive care units from 1997 to 2004 were included. Of 243, 13 infants were born to HBs Ag positive mother. All infants were given DNA recombinant vaccine at 0, 1, and 6 months of chronological age. Infants born to HBs Ag positive mothers received hepatitis B immunoglobulin at birth and a total of 4 doses of vaccinations. An antibody level over 10 mIU/mL, tested at 3-4 months after last vaccination, was regarded as a positive seroconversion.
Results
: The seroconversion rates were 84.4 percent and 84.5 percent for VLBWI and extremely low birth weight infants(ELBWI), respectively. Of 28 seronegative infants who were given revaccinations, 60.7 percent seroconverted, resulting in 95.3 percent, 97.5 percent seroconversion rates for VLBWI and ELBWI, respectively. 76.9 percent of infants born to HBsAg positive mothers seroconverted and none became hepatitis B carriers. Factors such as gestational age, sex, various neonatal illness, and kinds of vaccinations did not influence the formation of the hepatits B antibody, however, the higher the weight at time of first vacciation yielded better seroconversion rate.
Conclusion
: Revaccination of seronegative VLBWI after 3 doses of hepatitis B vaccinaton is very effective. Therefore, testing the immune status after the hepatitis B vaccination, a practice not routinely done, is highly recommended.
Key Words: HBs Ab , Seroconversion , Very low birth weight infants


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