Journal of Health and Medical Sciences
Published: 22 June 2023
Assessment of Immunity against Hepatitis B Virus among Children Aged 2-17 Years in Nnewi, Anambra State, South-East Nigeria: A Pilot Study
Shirley Nneka Chukwurah, Nonyelum Nnenna Jisieike-Onuigbo, Chinyere Ukamaka Onubogu, Stephen Okorafor Kalu, Chinyelu Uchenna Ufoaroh, Stanley Kenechukwu Onah, George Uchenna Eleje, Victor Ahoma Mbanuzuru, Ogochukwu Ifeanyi Ezejiofor, Chidiebele Malachy Ezeude, Chibuzor Ifeanyi Okpala, Christian Ejike Onah, Ifeyinwa Sussan Nweje, Onyeka Chukwudalu Ekwebene, Kenneth Chukwudi Eze, Ebele Francesca Ugochukwu, Christian Chibuzo Ibe
NAUTH, East Tennessee State University
Download Full-Text Pdf
Keywords: HBV Immunity, Children, Nigeria
Background: Nigeria is one of the hyper-endemic countries for hepatitis B with national prevalence rate of 11%. No study has been done in Nigeria to the best of authors’ knowledge to assess the level of immunity among children vaccinated against HBV. Objective: To assess prevalence of Hepatitis B surface antigen, determine the presence of antibodies to hepatitis B surface antigen (anti-HBs) and determine the titre levels of anti-HBs among those who have anti-HBs. Design: This was a pilot and a cross-sectional study. Methods: Consecutive children aged between 2 and 17 years seen at the outpatient clinic of NAUTH, Nnewi, Nigeria were recruited. Questionnaire was interviewer-administered. Venous blood was collected from each participant, analyzed for HBV serological markers and anti-HBs titre. Results: A total of sixty children were recruited. There was equal male and female distribution. 36.7% were aged 10-14 years. One child did not receive HBV vaccine. There was no incidental finding of HbsAg positivity. 15% of respondents had their immunity assessed after completing vaccination. There was presence of antibodies to HBsAg in19 children, and the anti-HBs titre was protective in 78.9% of those who had antibodies. Conclusion: After 18 years of introduction of the HBV vaccine into the NPI and routine infant immunization against hepatitis B virus in Nigeria, this pilot study has shown immunity against hepatitis B is not usually assessed after immunization and a significant proportion of children who were adequately immunized are not adequately protected against HBV. A large-scale study would be desirable for confirmation.
Alssamei, F. A., Al-Sonboli, N. A., Alkumaim, F. A., Alsayaad, N. S., Al-Ahdal, M. S., Higazi, T. B., &Elagib, A. A. (2017). Assessment of Immunization to Hepatitis B Vaccine among Children under Five Years in Rural Areas of Taiz, Yemen. Hepatitis research and treatment, 2131627. https://doi.org/10.1155/2017/2131627
Baranowska-Nowak, M., IwaŃczak, B., Szczepanik, M., Banasiuk, M., DembiŃski, Ł., Karolewska-Bochenek, K., Dziekiewicz, M., Radzikowski, A., & Banaszkiewicz, A. (2020). Immune response to hepatitis B vaccination in pediatric patients with inflammatory bowel disease. Central-European journal of immunology, 45(2), 144–150. https://doi.org/10.5114/ceji.2020.97902.
Chang M. H. (2007). Hepatitis B virus infection. Seminars in fetal & neonatal medicine, 12(3), 160–167.https://doi.org/10.1016/j.siny.2007.01.013
Chukwuka, J.O., Ezechukwu, C. C. & Egbuonu, I. (2003). Cultural Influences on Hepatitis B Surface Antigen Seropositivity in Primary School in Nnewi. Nigeria Journal of Paediatrics, 30 :140-2.
Dhakal, S., & Klein, S. L. (2019). Host Factors Impact Vaccine Efficacy: Implications for Seasonal and Universal Influenza Vaccine Programs. Journal of virology, 93(21), e00797-19. https://doi.org/10.1128/JVI.00797-19
Federal Ministry of Health. National strategic plan for the control of viral Hepatitis in Nigeria. (2016-2020). Pg 10-11.
He, F., Ma, Y. J., Zhou, T. Y., Duan, J. C., Wang, J.F, Ji, Y.L., Li, H., Zhang, J. Y& Tang, H. (2016). The Serum Anti-HBs Level Among Children Who Received Routine Hepatitis B Vaccination During Infancy in Mianyang City, China: A Cross-Sectional Study. Viral Immunol. Jan-Feb;29(1),40-8. doi: 10.1089/vim.2015.0073. Epub 2015 Nov 13. PMID: 26565951.
Hepatitis B Foundation: Hepatitis B Blood Tests (hepb.org)
Huang, Y. H., Hsiao, L. T.& Hong, Y.C. (2013). Randomized controlled trial of entecavir prophylaxis for rituximab associated hepatitis B virus reactivation in patients with lymphoma and resolved hepatitis B. J Clin Oncology, 31(22),2765–72.
Jack, A. D., Hall, A. J., Maine, N., Mendy, M., & Whittle, H. C. (1999). What level of hepatitis B antibody is protective? The Journal of infectious diseases, 179(2), 489–492.https://doi.org/10.1086/314578
Jiang, M., Zhu, B., Yao, Q., Lou, H., & Zhang, X. (2021). Anti-HBs levels in children under the age of two years born to HBV carrier mothers after immunoprophylaxis: a multicenter cross-sectional study. BMC pediatrics, 21(1), 492.https://doi.org/10.1186/s12887-021-02967-8
Kissou, S.A., Sidibé, K., Sourabié, Y., Cessouma, K.R., Ouedraogo, A.S., Sawadogo, A., Nacro, B. &Bazie, W. W. (2018). Post-Vaccine Immunity against Hepatitis B in Burkina Faso children. Journal of Gastroenterology, Pancreatology & Liver Disorders. 6(1),1-4.
Li, X., Xu, Y., Dong, Y., Yang, X., Ye, B., Wang, Y., & Chen, Y. (2018). Monitoring the efficacy of infant hepatitis B vaccination and revaccination in 0- to 8-year-old children: Protective anti-HBs levels and cellular immune responses. Vaccine, 36(18), 2442–2449. https://doi.org/10.1016/j.vaccine.2018.03.044
Lô, G., Sow-Sall, A., Diop-Ndiaye, H., Babacar, N., Diouf, N. N., Daffé, S. M., Ndao, B., Thiam, M., Mbow, M., Soumboundou, M. B., Lemoine, M., Sylla-Niang, M., Ndiaye, O., Boye, C. S., Mboup, S., & Touré-Kane, N. C. (2019). Hepatitis B virus (HBV) infection amongst children in Senegal: current prevalence and seroprotection level. The Pan African medical journal, 32, 140. https://doi.org/10.11604/pamj.2019.32.140.14485
Musa, B. M., Bussell, S., Borodo, M. M., Samaila, A. A., & Femi, O. L. (2015). Prevalence of hepatitis B virus infection in Nigeria, 2000-2013: a systematic review and meta-analysis. Nigerian journal of clinical practice, 18(2), 163–172. https://doi.org/10.4103/1119-3077.151035
Ndako, J.A., Echeonwu, G.O., Olabode, A.O., Nwankiti, O.O., Aimakhu, S.O., Onovoh, E., Chukwuekezie, J., Banda, J.M., & Paul, G. (2010). Seroprevalence of Hepatitis B Surface Antigen (HBsAg) among Children of Primary School Age in a Community, North-Central, Nigeria.Sierra Leone journal of biomedical researchhttps://doi.org/10.4314/SLJBR.V2I1.56600
Odusanya, O.O. (2008). Hepatitis B Virus Vaccine: The Nigerian Story. Journal of the Obafemi Awolowo University Medical Student's Association (IFEMED). 14. 10.4314/ifemed.v14i1.41725.
Olakunde, B. O., Adeyinka, D. A., Olakunde, O. A., Ogundipe, T., Oladunni, F., & Ezeanolue, E. E. (2022). The coverage of hepatitis B birth dose vaccination in Nigeria: Does the place of delivery matter? Transactions of the Royal Society of Tropical Medicine and Hygiene, 116(4), 359–368. https://doi.org/10.1093/trstmh/trab129
Post-Vaccination Testing for Hepatitis B - Viral Hepatitis and Liver Disease
Schillie, S., Murphy, T. V., Sawyer, M., Ly, K., Hughes, E., Jiles, R., de Perio, M. A., Reilly, M., Byrd, K., Ward, J. W., & Centers for Disease Control and Prevention (CDC) (2013). CDC guidance for evaluating health-care personnel for hepatitis B virus protection and for administering postexposure management. MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports, 62(RR-10), 1–19.
Sernia, S., Ortis, M., Antoniozzi, T., Maffongelli, E., & La Torre, G. (2015). Levels of anti-HBs antibody in HBV-vaccinated students enrolled in the faculty of medicine, dentistry and health professions of a large Italian University. BioMed research international, 2015, 712020.https://doi.org/10.1155/2015/712020
Thomas, K. M., Zakari, H., Lar, P. M.& Em, T. S. (2021). Evaluation of Hepatitis B vaccine Immunogenicity in Relation to ABO and Rhesus Blood Group in vaccinated subjects in Bauchi State, Nigeria.Umyu journal of microbiology research, Volume 6 Number 2, December, pp 142 - 148
Welker, M.W&Zeuzem S. (2016). Pre- and post-transplant antiviral therapy (HBV, HCV). Visc Med. 32(2), 105- 109.
Wiedermann, U., Garner-Spitzer, E and Wagner, A. (2016). Primary Vaccine Failure to Routine Vaccines: Why and what to do? Human Vaccine and Immunotherapeutic, 12(1), 239-243
World Population Review, http://worldpopulationreview.com/countries/nigeria-population/cities/ Accessed on 19/02/2022.
Zimmermann, P., & Curtis, N. (2019). Factors That Influence the Immune Response to Vaccination. Clinical microbiology reviews, 32(2), e00084-18.https://doi.org/10.1128/CMR.00084-18