Objective: A prospective study was conducted to explore the influence of neonatal modes of HBV marker (HBVM) on non-/hypo-response to hepatitis B vaccine in infants.
Methods: From July 2011 to July 2013, a total of 386 pregnant women who showed serum HBsAg positive with their neonates at birth and another 227 infants at 12 months admitted in the Third People' s Hospital of Taiyuan in Shanxi province, China. All infants received hepatitis B vaccine with the 0-1-6 month schedule. Maternal, neonatal and infantile HBsAg, anti-HBs, HBeAg, anti-HBe and anti-HBc were measured by chemiluminescence-immunoassay. The neonatal/infantile PBMC TLR3 expression level and the quantities of T cell subsets, B cells, DCs were measured by Flow Cytometry. The neonatal/infantile Th1/Th2 cytokines were measured by ELISA.
Results: Four types of common neonatal modes of HBVM appeared as " HBeAg(+) anti-HBe(+) " , "HBsAg(+)HBeAg (+) anti-HBe(+) " , "HBsAg(+) " and "HBVM(-)" , respectively. The overall rate of non-/hypo-response to hepatitis B vaccine in neonatal mode of " HBeAg(+) anti-HBe(+) " was 5.2%, lower than that seen in the other three types of mode (20.0%, 40.0% and 22.5%, respectively). The frequencies of circulating CD4(+) T cells and CD8(+) T cells were significantly different among four common modes of HBVM in infants. Meanwhile, the level of IL-6 in mode of " HBeAg(+) anti-HBe(+) " was higher than that in the mode of " HBVM(-)" at two points. There was a positive correlation appeared between the level of IL-6 and the level of anti-HBs. It was quite unlikely to show non-/hypo-response to hepatitis B vaccine, when neonates were at the level as IL-6> 1 112.0 pg/ml (OR=0.386, 95% CI: 0.266-0.561, P<0.001).
Conclusions: Neonates who were with the mode of " HBeAg (+) anti-HBe (+) " and high level of IL-6 showed a lower non-/hyporesponse rate on hepatitis B vaccine. It is necessary to further study the relationship between neonatal mode of HBVM and the immune status.