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AIM:To assess the effectiveness of hepatitis B virus(HBV) vaccination program among fully vaccinated children.METHODS:A national community based crosssectional study was carried out in 6 governorates representing Egypt. A total of 3600 children aged from 9 mo to 16 years who were fully vaccinated with HBV vaccine during infancy were recruited. Face to face interviews were carried out and sera were evaluated for hepatitis B surface antigen(HBsA g),anti-HBV core antibodies(total) and quantitative detection of hepatitis B surface antibody using enzyme linked immunoassays techniques. Samples positive to HBs Ag/anti-HBV core antibodies were subjected to quantitative HBV-DNA detection by real time polymerase chain reaction with 3.8 IU/L detection limit. RESULTS:Sero-protection was detected among 2059 children(57.2%) with geometric mean titers 75.4 ± 3.6 IU/L compared to 3.1 ± 2.1 IU/L among nonseroprotected children. Multivariate logistic analysis revealed that older age and female gender were the significant predicting variables for having non seroprotective level,with adjusted odds ratio 3.3,9.1and 14.2 among children aged 5 to < 10,10 to < 15 and ≥ 15 years respectively compared to those < 5 years and 1.1 among girls compared to boys with P < 0.01. HBs Ag was positive in 0.11% and breakthrough infection was 0.36% and 0.39% depending on positivity of anti-HBc and DNA detection respectively. The prevalence of HBV infection was significantly higher among children aged ≥ 7 years(0.59%) compared to 0.07% among younger children with odds ratio equal to 8.4(95%CI:1.1-64.2) and P < 0.01.The prevalence was higher among girls(0.48%) than boys(0.29%) with P > 0.05. C ON C LU S I ON :T he E gy pt ian c ompuls or y H B V vaccination program provides adequate protection. Occult HBV infection exists among apparently healthy vaccinated children. Adherence to infection control measures is mandatory.
AIM: To assess the effectiveness of hepatitis B virus (HBV) vaccination program among fully vaccinated children. METHODS: A national community based cross-sectional study was carried out in 6 governorates representing Egypt. A total of 3600 children ages from 9 mo to 16 years who were fully vaccinated with HBV vaccine during infancy were recruited. Face to face interviews were carried out and sera were evaluated as hepatitis B surface antigen (HBsA g), anti-HBV core antibodies (total) and quantitative detection of hepatitis B surface antibody using enzyme ELISA was performed on HBV-DNA detection by real time polymerase chain reaction with 3.8 IU / L detection limit. RESULTS: Sero-protection was detected among 2059 children (57.2% ) with geometric mean titers of 75.4 ± 3.6 IU / L compared to 3.1 ± 2.1 IU / L among nonseroprotected children. Multivariate logistic analysis revealed that older age and female gender were the significant predicting variables for having non seroprotective levels, with adjusted odds ratio 3.3, 9.1 and 14.2 among children aged 5 to <10,10 to <15 and ≥ 15 years respectively compared to those <5 years and 1.1 among girls compared to boys with P <0.01. HBs Ag was positive in 0.11% and breakthrough infection was 0.36% and 0.39% depending on positivity of anti-HBc and DNA detection respectively. The prevalence of HBV infection was significantly higher among children aged ≥ 7 years (0.59% ) compared to 0.07% among children with odds ratio equal to 8.4 (95% CI: 1.1-64.2) and P <0.01. prevalence was higher among girls (0.48%) than boys (0.29%) with P> 0.05. C ON C LU SI ON: T he E gy pt ian c ompuls or y HBV vaccination program provide adequate protection. Occult HBV infection exists among apparently healthy vaccinated children. Adherence to infection control measures is mandatory.