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27 septembre 2012 4 27 /09 /septembre /2012 07:04
Citation: Emerging Microbes & Infections (2012) 1, e27; doi:10.1038/emi.2012.28 Published online 19 September 2012 Emerging hepatitis B virus infection in vaccinated populations: a rising concern? Tung-Hung Su1,2,3 and Pei-Jer Chen1,2,3 1Department of Internal Medicine, National Taiwan University Hospital, Taipei 10002, Taiwan 2Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei 10002, Taiwan 3Hepatitis Research Center, National Taiwan University Hospital, Taipei 10002, Taiwan Correspondence: PJ Chen, E-mail: peijerchen@ntu.edu.tw Received 22 March 2012; Revised 3 July 2012; Accepted 6 July 2012 Abstract Hepatitis B infection, especially by perinatal transmission, is endemic in Asian countries. After the first successful universal hepatitis B virus (HBV) vaccination programme for newborns in Taiwan, it became feasible to prevent HBV transmission and the resultant hepatocellular carcinoma in endemic countries. However, a small subset of vaccinated people have a suboptimal immunological response to vaccination, and the immunity of some young adults who were vaccinated as infants seems to have waned over time. Despite this loss, recent studies suggest that anamnestic anti-HBs antibody responses rapidly resume and eliminate acute HBV infection acquired through sexual contact or blood transfusion, even though the anti-HBs antibody titre has decreased below a protective level. These observations indicate prolonged protection by the HBV vaccine. Therefore, for people with a low infection risk, a universal booster vaccination is not currently recommended, but it should be considered for high-risk groups. However, we still advocate close monitoring of acute hepatitis B among patients who lack a protective level of anti-HBs antibody and suggest a wait-and-see policy to determine the necessity for booster vaccines. Keywords: anamnestic effect; anti-HBs antibody; immunity; hepatitis B; vaccination

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