Hepatitis B virus infection in Indonesia 15 years after adoption of a universal infant vaccination program: Possible impacts of low birth dose coverage and a vaccine-escape mutant

Priyo Budi Purwono, Juniastuti, Mochamad Amin, Rendra Bramanthi, Nursidah, Erika Maria Resi, Rury Mega Wahyuni, Yoshihiko Yano, Soetjipto, Hak Hotta, Yoshitake Hayashi, Takako Utsumi, Maria Inge Lusida

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)

Abstract

A universal hepatitis B vaccination program for infants was adopted in Indonesia in 1997. Before its implementation, the prevalence of hepatitis B surface antigen (HBsAg)-positive individuals in the general population was approximately 5-10%. The study aimed to investigate the hepatitis B virus (HBV) serological status and molecular profile among children, 15 years after adoption of a universal infant vaccination program in Indonesia. According to the Local Health Office data in five areas, the percentages of children receiving three doses of hepatitis B vaccine are high (73.9-94.1%), whereas the birth dose coverage is less than 50%. Among 967 children in those areas, the seropositive rate of HBsAg in preschool- and school-aged children ranged from 2.1% to 4.2% and 0% to 5.9%, respectively. Of the 61 HBV DNA-positive samples, the predominant genotype/subtype was B/adw2. Subtype adw3 was identified in genotype C for the first time in this population. Six samples (11.5%) had an amino acid substitution within the a determinant of the S gene region, and one sample had T140I that was suggested as a vaccine-escape mutant type. The low birth dose coverage and the presence of a vaccine-escape mutant might contribute to the endemicity of HBV infection among children in Indonesia.

Original languageEnglish
Pages (from-to)674-679
Number of pages6
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume95
Issue number3
DOIs
Publication statusPublished - Sept 2016

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