Rakesh Aggarwal1, J J Babu, R Hemalatha, Anumulu Venkateshar Reddy, Divyanshu Sharma, Tarun Kumar. 1. Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow; and *National Institute of Nutrition, Hyderabad, India. Correspondence to: Dr Rakesh Aggarwal, Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226 014, India.
Abstract
OBJECTIVE: To assess the effectiveness of hepatitis B immunization program in a field setting in India. DESIGN: Serological survey of retrospective cohorts of children, vaccinated or not vaccinated with hepatitis B vaccine. SETTING: Rural field areas of five districts in Andhra Pradesh state, where childhood hepatitis B immunization began in 2003. PARTICIPANTS: Children aged 5-11 years who had received HB immunization (n=2674; 1357 boys) or not received such immunization (n=2350; 1236 boys). MAIN OUTCOME MEASURES: Serum HBsAg, anti-HBc and anti-HBs (quantitative) using automated enzyme-immunoassays in the year 2010. RESULTS: Anti-HBs positivity was higher among immunized than in unimmunized children (53% vs.18%; P<0.001), and anti-HBc positivity was lower (1.1% vs 10.8%: P<0.01). HBsAg positivity was low in both the groups (0.15% and 0.17%; P=0.855). Anti-HBs positivity rate declined with increasing age. CONCLUSIONS: Administration of hepatitis B vaccine as part of Universal immunization program led to anti-HBs in a large proportion of children and a reduction in anti-HBc positivity, a marker of hepatitis B virus infection. These data provide evidence supporting efficacy of hepatitis B immunization program in an Indian field setting, justifying the decision to include it in the universal immunization program.
OBJECTIVE: To assess the effectiveness of hepatitis B immunization program in a field setting in India. DESIGN: Serological survey of retrospective cohorts of children, vaccinated or not vaccinated with hepatitis B vaccine. SETTING: Rural field areas of five districts in Andhra Pradesh state, where childhood hepatitis B immunization began in 2003. PARTICIPANTS: Children aged 5-11 years who had received HB immunization (n=2674; 1357 boys) or not received such immunization (n=2350; 1236 boys). MAIN OUTCOME MEASURES: Serum HBsAg, anti-HBc and anti-HBs (quantitative) using automated enzyme-immunoassays in the year 2010. RESULTS: Anti-HBs positivity was higher among immunized than in unimmunized children (53% vs.18%; P<0.001), and anti-HBc positivity was lower (1.1% vs 10.8%: P<0.01). HBsAg positivity was low in both the groups (0.15% and 0.17%; P=0.855). Anti-HBs positivity rate declined with increasing age. CONCLUSIONS: Administration of hepatitis B vaccine as part of Universal immunization program led to anti-HBs in a large proportion of children and a reduction in anti-HBc positivity, a marker of hepatitis B virus infection. These data provide evidence supporting efficacy of hepatitis B immunization program in an Indian field setting, justifying the decision to include it in the universal immunization program.
Authors: Dharmendra Kumar; Sharad Srivastava; M S Tevatia; Kanwaljit Kaur; Amit Sood; Manish Manrai; Reema Mukerjee Journal: Med J Armed Forces India Date: 2020-11-06
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