Long-term impact of infant immunization on hepatitis B prevalence: a systematic review and meta-analysis.
Bull World Health Organ
; 96(7): 484-497, 2018 Jul 01.
Article
em En
| MEDLINE
| ID: mdl-29962551
ABSTRACT
OBJECTIVE:
To conduct a systematic review and meta-analysis of the long-term impact of infant vaccination on the prevalence of hepatitis B virus (HBV) infection at the population level.METHODS:
We searched online databases for articles reporting comparisons between population cohorts aged ≥ 15 years who were exposed or unexposed to infant HBV immunization programmes. We categorized programmes as universal or targeted to infants whose mothers were positive for hepatitis B surface antigen (HBsAg). We included studies reporting prevalence of hepatitis B core antibody (HBcAb), HBsAg, or both. We evaluated the quality of the study methods and estimated the relative reduction in the prevalence of infection.FINDINGS:
Of 26 studies that met the inclusion criteria, most were from China (20 studies). The prevalence of HBV infection in unvaccinated and universally vaccinated cohorts ranged from 0.6% (116 of 20 305 people) to 16.3% (60/367) and from 0.3% (1/300) to 8.5% (73/857), respectively. Comparing cohorts with universal vaccination to those without vaccination, relative prevalences were 0.24 (95% confidence interval, CI 0.16-0.35) for HBsAg and 0.23 (95% CI 0.17-0.32) for HBcAb. For populations with targeted vaccination, relative prevalences were 0.32 (95% CI 0.24-0.43) and 0.33 (95% CI 0.23-0.45), respectively.CONCLUSION:
The residual burden of infection in cohorts offered vaccination suggests that longer-term evaluations of vaccination coverage, timeliness and other aspects of programme quality are needed. As HBV-vaccinated infant cohorts reach adulthood, ongoing analysis of prevalence in adolescents and young adults will ensure that elimination efforts are on track.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Imunização
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Vacinação
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Vacinas contra Hepatite B
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Hepatite B
Tipo de estudo:
Prevalence_studies
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Risk_factors_studies
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Systematic_reviews
Limite:
Adolescent
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Adult
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Child
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Female
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Humans
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Infant
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Male
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Newborn
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Pregnancy
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article