Protective Effect of Hepatitis B Vaccine Combined with Two-Dose Hepatitis B Immunoglobulin on Infants Born to HBsAg-Positive Mothers

Despite the use of hepatitis B (HB) vaccine and hepatitis B immunoglobulin (HBIG), a portion of infants are still non- or low-responders, or even immunoprophylaxis failure. We aimed to determine the immune response in the infants from the mothers being positive for hepatitis B surface antigen (HBsAg), by which the infants received three doses of HB vaccine in combination with two-dose 200 IU HBIG injections.In this retrospective study, 621 infants from HBsAg-positive mothers in Beijing YouAn Hospital between January 2008 and December 2009 were included. All the infants were given three doses of 10 µg HB vaccine (at 0, 1 and 6 months of age) and two-dose of 200 IU HBIG (at birth and in 2 weeks of age). Serum HBsAg and antibody to HBsAg (anti-HBs) in all the infants were determined at 7 months of age.Of the 621 infants, 2.9% were immunoprophylaxis failure (positive for HBsAg), 1.4% were non-responders (anti-HBs undetectable), 95.7% were responders. The 594 responders could be categorized into three subsets, 22 were 10 to 99 IU/L for anti-HBs levels, 191 were 100 to 999 IU/L, and 381 were ≥1000 IU/L. The immunoprophylaxis failure rate was at 0% and 5.2% for the infants of HBeAg-negative and HBeAg-positive mothers(P<0.001). Infants from mothers with detectable HBV DNA had higher incidence of immunoprophylaxis failure than those of mothers without detectable HBV DNA (P = 0.002). The factors including gender, birth weight, gestation weeks, the rates of maternal HBeAg-positive, and detectable HBV DNA did not contribute to the no response to HB vaccination.Through vaccination by three doses of HB and two-dose of HBIG, majority of the infants (95.7%) achieved a protective level of anti-HBs at 7 months of age. Maternal HBeAg-positive and HBV DNA detectable were associated with the immunoprophylaxis failure, but not contribute to the non- or low-response to HB vaccination

Reducing liver cancer risk beginning at birth: experiences of preventing chronic hepatitis B virus infection in China

In China, the death numbers due to primary liver cancer every year account for more than half of this disease burden worldwide. Hepatocellular carcinoma (HCC) represents the major histological type of primary liver cancer. In the Chinese population, at least 85% HCC cases are due to chronic infection with hepatitis B virus (HBV), most of which were acquired in the perinatal period or in early life. As of January 1992, HBV immunization of newborns was introduced to the national Expended Program of Immunization of China. Prior to this program, the Qidong County in China conducted an hepatitis B intervention study, which was a population-based, cluster randomized, controlled trial of HBV vaccination in neonates. The study demonstrated that among young adults &lt; 30 years old, neonatal HBV immunization decreased around 84% risk of HBV-related liver cancer, and 70% risk of mortality due to severe end-stage chronic liver diseases. More than 72% efficacy of neonatal vaccination against chronic HBV infection in adulthood was achieved; however, when catch-up HBV vaccination was given to children at age 10-14 years, the protection efficacy was only 21%. No difference in mortality of HBV-related liver diseases was observed among the young adults &lt; 30 years who received and those who did not receive the catch-up HBV vaccination. These results highlight the crucial importance of HBV vaccination of neonates in reducing the liver cancer risk beginning at birth in highly HBV endemic regions. Due to large numbers of HBV-infected pregnant women with high viremia in China, clinical studies in which antiviral therapy with the nucleot(s)ide analogues was given to HBV-infected pregnant women have provided important evidence that such therapy can reduce the risk of mother-to-child HBV transmission. These clinical data based on cohort studies, randomized clinical trials, and clinical practices in the Chinese population provide important information on prevention of liver cancer, particularly HCC, by preventing chronic HBV infection starting from birth for other populations

Flow chart of the participants enrolled in the study.

<p>A total of 1157 infants of HBsAg-positive mothers from January 2008 to December 2009 in Beijing Youan Hospital were reviewed. Of the 1157 infants, 536 were excluded. Thus, 621 infants were included and analyzed in the study.</p

Baseline characteristics of the infants.

<p>Abbreviations: HBV, hepatitis B virus.</p

Characteristics correlated with response and non-response n (%).

<p>Abbreviations: HBV, hepatitis B virus; ALT, alanine transaminase; HBeAg, hepatitis B e antigen; HBsAg, hepatitis B surface antigen.</p

Distribution of different responders in mothers with different HBeAg status.

<p>Abbreviations: HBeAg, hepatitis B e antigen.</p

Frequency distribution of different responders in mother with different HBV DNA status.

<p>Abbreviations: HBV, hepatitis B virus.</p

Predicting the Glycemic Index of Biscuits Using Static In Vitro Digestion Protocols

In vitro digestion methods that can accurately predict the estimated GI (eGI) values of complex carbohydrate foods, including biscuits, are worth exploring. In the current study, standard commercial biscuits with varied clinical GI values between 9~30 were digested using both the INFOGEST and single-enzyme digestion protocols. The digestion kinetic parameters were acquired through mathematical fitting by mathematical kinetics models. The results showed that compared with the INFOGEST protocol, the AUR180 deduced from digesting using either porcine pancreatin or α-amylase showed the best potential in predicting the eGI values. Accordingly, mathematical equations were established based on the relations between the AUR180 and the GI values. When digesting using porcine pancreatin, GI= 1.834 + 0.009 ×AUCR180 (R2= 0.952), and when digesting using only α-amylase, GI= 6.101 + 0.009 ×AUCR180 (R2=0.902). The AUR180 represents the area under the curve of the reducing-sugar content normalized to the total carbohydrates versus the digestion time in 180 min. The in vitro method presented enabled the rapid and accurate prediction of the eGI values of biscuits, and the validity of the formula was verified by another batch of biscuits with a known GI, and the error rate of most samples was less than 30%