Long-term Antibody Persistence After Hepatitis E Virus Infection and Vaccination in Dongtai, China

Brittany Kmush, Huan Yu, Shoujie Huang, Xuefang Zhang, Ting Wu, Kenrad Nelson, Alain Labrique

Research output: Contribution to journalArticle

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Abstract

Background
Hepatitis E virus (HEV) is of global significance. HEV is a common cause of acute hepatitis in China. One of the major unanswered questions about HEV is the persistence of antibodies after infection and vaccination.
Methods
We examined antibody persistence 6.5 years after HEV exposures through natural infection and vaccination. Ninety-seven vaccine recipients and 70 individuals asymptomatically infected with HEV enrolled in the phase III HEV239 vaccine trial in Dongtai, China, were revisited.
Results
Antibody loss was 23.4% (95% confidence interval [CI], 17.1%–30.5%), with a nonsignificantly higher percentage of loss among those naturally infected (30.0%; 95% CI, 19.6%–42.1%) than those vaccinated (18.6%; 95% CI, 11.4%–27.7%; P = .085). Age and gender were not associated with antibody persistence. Only 2 people (1.2%) self-reported medically diagnosed jaundice or hepatitis-like illness in the last 10 years, both of whom had persistent antibodies. Contact with a jaundice patient and injectable contraceptive use were marginally associated with loss of detectable anti-HEV antibodies (P = .047 and .082, respectively), whereas transfusion was marginally associated with antibody persistence (P = .075).
Conclusions
Antibody loss was more common among those naturally infected compared with those vaccinated. However, none of the characteristics examined were strongly associated with antibody loss, suggesting that factors not yet identified may play a more important role in antibody loss. Long-term postvaccination antibody persistence is currently unknown and will be an important consideration in the development of policies for the use of the highly efficacious HEV vaccine.
ClinicalTrials.gov registration.  NCT01014845.
Original languageEnglish (US)
JournalOpen Forum Infectious Diseases
Volume6
Issue number4
StateE-pub ahead of print - Apr 2019

Fingerprint

Hepatitis E virus
Virus Diseases
China
Vaccination
Antibodies
Vaccines
Confidence Intervals
Jaundice
Hepatitis
Policy Making
Contraceptive Agents
Infection
Anti-Idiotypic Antibodies
Viruses
Injections

Cite this

Long-term Antibody Persistence After Hepatitis E Virus Infection and Vaccination in Dongtai, China. / Kmush, Brittany; Yu, Huan; Huang, Shoujie; Zhang, Xuefang; Wu, Ting; Nelson, Kenrad; Labrique, Alain.

In: Open Forum Infectious Diseases, Vol. 6, No. 4, 04.2019.

Research output: Contribution to journalArticle

Kmush, Brittany ; Yu, Huan ; Huang, Shoujie ; Zhang, Xuefang ; Wu, Ting ; Nelson, Kenrad ; Labrique, Alain. / Long-term Antibody Persistence After Hepatitis E Virus Infection and Vaccination in Dongtai, China. In: Open Forum Infectious Diseases. 2019 ; Vol. 6, No. 4.
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abstract = "BackgroundHepatitis E virus (HEV) is of global significance. HEV is a common cause of acute hepatitis in China. One of the major unanswered questions about HEV is the persistence of antibodies after infection and vaccination.MethodsWe examined antibody persistence 6.5 years after HEV exposures through natural infection and vaccination. Ninety-seven vaccine recipients and 70 individuals asymptomatically infected with HEV enrolled in the phase III HEV239 vaccine trial in Dongtai, China, were revisited.ResultsAntibody loss was 23.4{\%} (95{\%} confidence interval [CI], 17.1{\%}–30.5{\%}), with a nonsignificantly higher percentage of loss among those naturally infected (30.0{\%}; 95{\%} CI, 19.6{\%}–42.1{\%}) than those vaccinated (18.6{\%}; 95{\%} CI, 11.4{\%}–27.7{\%}; P = .085). Age and gender were not associated with antibody persistence. Only 2 people (1.2{\%}) self-reported medically diagnosed jaundice or hepatitis-like illness in the last 10 years, both of whom had persistent antibodies. Contact with a jaundice patient and injectable contraceptive use were marginally associated with loss of detectable anti-HEV antibodies (P = .047 and .082, respectively), whereas transfusion was marginally associated with antibody persistence (P = .075).ConclusionsAntibody loss was more common among those naturally infected compared with those vaccinated. However, none of the characteristics examined were strongly associated with antibody loss, suggesting that factors not yet identified may play a more important role in antibody loss. Long-term postvaccination antibody persistence is currently unknown and will be an important consideration in the development of policies for the use of the highly efficacious HEV vaccine.ClinicalTrials.gov registration.  NCT01014845.",
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AU - Nelson, Kenrad

AU - Labrique, Alain

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N2 - BackgroundHepatitis E virus (HEV) is of global significance. HEV is a common cause of acute hepatitis in China. One of the major unanswered questions about HEV is the persistence of antibodies after infection and vaccination.MethodsWe examined antibody persistence 6.5 years after HEV exposures through natural infection and vaccination. Ninety-seven vaccine recipients and 70 individuals asymptomatically infected with HEV enrolled in the phase III HEV239 vaccine trial in Dongtai, China, were revisited.ResultsAntibody loss was 23.4% (95% confidence interval [CI], 17.1%–30.5%), with a nonsignificantly higher percentage of loss among those naturally infected (30.0%; 95% CI, 19.6%–42.1%) than those vaccinated (18.6%; 95% CI, 11.4%–27.7%; P = .085). Age and gender were not associated with antibody persistence. Only 2 people (1.2%) self-reported medically diagnosed jaundice or hepatitis-like illness in the last 10 years, both of whom had persistent antibodies. Contact with a jaundice patient and injectable contraceptive use were marginally associated with loss of detectable anti-HEV antibodies (P = .047 and .082, respectively), whereas transfusion was marginally associated with antibody persistence (P = .075).ConclusionsAntibody loss was more common among those naturally infected compared with those vaccinated. However, none of the characteristics examined were strongly associated with antibody loss, suggesting that factors not yet identified may play a more important role in antibody loss. Long-term postvaccination antibody persistence is currently unknown and will be an important consideration in the development of policies for the use of the highly efficacious HEV vaccine.ClinicalTrials.gov registration.  NCT01014845.

AB - BackgroundHepatitis E virus (HEV) is of global significance. HEV is a common cause of acute hepatitis in China. One of the major unanswered questions about HEV is the persistence of antibodies after infection and vaccination.MethodsWe examined antibody persistence 6.5 years after HEV exposures through natural infection and vaccination. Ninety-seven vaccine recipients and 70 individuals asymptomatically infected with HEV enrolled in the phase III HEV239 vaccine trial in Dongtai, China, were revisited.ResultsAntibody loss was 23.4% (95% confidence interval [CI], 17.1%–30.5%), with a nonsignificantly higher percentage of loss among those naturally infected (30.0%; 95% CI, 19.6%–42.1%) than those vaccinated (18.6%; 95% CI, 11.4%–27.7%; P = .085). Age and gender were not associated with antibody persistence. Only 2 people (1.2%) self-reported medically diagnosed jaundice or hepatitis-like illness in the last 10 years, both of whom had persistent antibodies. Contact with a jaundice patient and injectable contraceptive use were marginally associated with loss of detectable anti-HEV antibodies (P = .047 and .082, respectively), whereas transfusion was marginally associated with antibody persistence (P = .075).ConclusionsAntibody loss was more common among those naturally infected compared with those vaccinated. However, none of the characteristics examined were strongly associated with antibody loss, suggesting that factors not yet identified may play a more important role in antibody loss. Long-term postvaccination antibody persistence is currently unknown and will be an important consideration in the development of policies for the use of the highly efficacious HEV vaccine.ClinicalTrials.gov registration.  NCT01014845.

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