Suitable hepatitis B vaccine for adult immunization in China: a systematic review and meta-analysis

Figures & data

Figure 1. Flow diagram of the study selection process.

Table 1. Characteristics of the 27 studies included in the meta-analysis.

NO	Author	Design	Year	Age	Gender	No	vaccine	dosage	schedule	population characteristics	Geometric mean titer (IU/L)	seroprotective rate anti-HBs ≥ 10 IU/L
1	Chen W. G. et al.	RCT	2001	18–20	NA	138	CHO	10 µg	0.1.6	seronegative students	NA	100.00%
						149	CHO	10 µg	0.1.2		NA	97.99%
2	Wang C. X. et al.	RCT	2002	18–55	38/55	93	YDV	5 µg	0.1.2	seronegative adults	18.88	68.82%
					35/71	106	YDV	10 µg	0.1.2		54.47	84.91%
3	Yuan Y. B. et al.	RCT	2003	20–60	NA	48	YDV	5 µg	0.1.6	seronegative teachers	193.37	75.00%
						49	YDV	10 µg	0.1.6		315.58	91.84%
						47	YDV	20 µg	0.1.6		477.81	97.87%
4	Chen Y. Z. et al.	RCT	2005	15–60	NA	92	YDV	5 µg	0.1.2	seronegative adults	34.45	72.83%
						85	YDV	10 µg	0.1.2		41.16	77.65%
						91	YDV	5 µg	0.1.6		48.15	83.52%
						85	YDV	10 µg	0.1.6		67.91	89.41%
						159	CHO	10 µg	0.1.2		42.59	84.28%
						190	CHO	20 µg	0.1.2		77.90	90.53%
						170	CHO	10 µg	0.1.6		76.98	88.24%
						192	CHO	20 µg	0.1.6		123.82	97.40%
5	Li W. Q. et al.	RCT	2008	17–21	29/31	60	YDV	10 µg	0.1.6	seronegative students	NA	98.30%
					42/18	60	CHO	10 µg	0.1.6		NA	95.00%
					25/35	60	CHO	20 µg	0.1.6		NA	96.70%
					37/21	58	Engerix-B	20 µg	0.1.6		NA	96.50%
6	Dong M. H. et al.	RCT	2009	20–55	200/101	301	YDV	5 µg	0.1.6	seronegative adults	NA	94.40%
					231/101	332	YDV	10 µg	0.1.6		NA	94.60%
7	Ji X. L. et al.	RCT	2009	＞20	NA	238	CHO	10 µg	0.1.6	seronegative adults	NA	96.20%
						267	YDV	10 µg	0.1.6		NA	95.90%
8	Zhang W. et al.	RCT	2011	18–45	141/180	321	CHO	10 µg	0.1.6	seronegative adults	NA	88.80%
					129/192	321	CHO	20 µg	0.1.6		NA	95.30%
9	Liu C. C. et al.	RCT	2012	18–45	NA	114	CHO	10 µg	0.1.6	seronegative adults	134.57	89.47%
						108	CHO	20 µg	0.1.6		921.11	99.07%
10	Yu S. F. et al.	RCT	2012	16–49	NA	241	YDV	10 µg	0.1.3	seronegative adults	107.97	76.76%
						290	YDV	10 µg	0.1.6		306.90	86.21%
						240	YDV	10 µg	0.1.12		587.49	89.17%
11	Guo Y. H. et al.	RCT	2013	18–74	NA	140	CHO	20 µg	0.1.6	seronegative adults	1230.3	99.40%
						140	Engerix-B	20 µg	0.1.6		602.6	97.00%
12	Chen S. Y. et al.	RCT	2013	16–49	NA	190	YDV	10 µg	0.1.3	seronegative adults	94.96	88.95%
						191	YDV	10 µg	0.1.6		145.12	90.05%
13	Liu J. Y. et al.	RCT	2013	18–49	NA	2011	YDV	20 µg	0.1.6	seronegative adults	NA	85.78%
						2290	CHO	20 µg	0.1.6		NA	90.65%
14	Xu M. Q. et al.	RCT	2013	18–35	NA	60	YDV	10 µg	0.1.6	seronegative adults	NA	75.00%
						60	YDV	20 µg	0.1.6		NA	93.30%
						60	Engerix-B	20 µg	0.1.6		NA	95.00%
15	Xu F. et al.	RCT	2013	16–49	99/267	366	YDV	10 µg	0.1.3	seronegative adults	1863.60	98.36%
					88/174	262	YDV	10 µg	0.1.6		883.85	96.18%
					52/88	140	Engerix-B	20 µg	0.1.3		629.59	97.86%
					72/100	172	Engerix-B	20 µg	0.1.6		993.09	95.35%
16	Huang X. Y. et al.	RCT	2014	17–59	NA	65	YDV	10 µg	0.1.6	seronegative adults	202.99	89.04%
						72	CHO	10 µg	0.1.6		201.98	91.14%
17	Song J. P. et al.	RCT	2014	≥ 16	NA	591	YDV	20 µg	0.1.6	seronegative adults	575.40	99.15%
						254	YDV	10 µg	0.1.6		422.30	96.46%
18	Fu Q. P. et al.	RCT	2015	≥ 16	NA	479	YDV	10 µg	0.1.6	seronegative adults	718.86	98.96%
						523	YDV	20 µg	0.1.6		1112.34	98.66%
19	Zhou Y. et al.	RCT	2015	16–49	NA	217	CHO	20 µg	0.1.3	seronegative adults	31.99	63.59%
						218	CHO	20 µg	0.1.12		893.53	95.87%
20	Li J. et al.	RCT	2015	20–46	66/93	159	YDV	10 µg	0.1.3	seronegative adults	91.69	88.05%
					30/71	101	YDV	20 µg	0.1.3		290.23	94.06%
21	Zhang L. et al.	RCT	2015	18–49	59/59	118	YDV	20 µg	0.1.6	seronegative adults	88.14	88.14%
					65/68	133	CHO	20 µg	0.1.6		90.23	90.22%
22	Zhou B. Q. et al.	RCT	2015	16–49	NA	151	YDV	10 µg	0.1.3	seronegative adults	807.98	98.01%
						174	YDV	10 µg	0.1.6		930.68	99.43%
						189	YDV	10 µg	0.1.12		720.28	93.65%
23	Guo M. J. et al.	RCT	2015	16–49	NA	254	YDV	10 µg	0.1.3	seronegative adults	128.75	99.61%
						212	YDV	10 µg	0.1.6		381.27	100.00%
						200	Engerix-B	20 µg	0.1.3		249.70	99.50%
						182	Engerix-B	20 µg	0.1.6		498.09	100.00%
24	Cao Y. et al.	RCT	2016	18–21	361/289	650	YDV	20 µg	0.1.3	seronegative students	486.96	89.70%
					361/289	650	YDV	20 µg	0.1.6		407.91	95.70%
25	Wang H. et al.	RCT	2016	25–55	125/168	293	YDV	20 µg	0.1.6	seronegative adults	1033.38	93.17%
					126/163	289	YDV	20 µg	0.1.6		600.75	97.23%
					126/167	293	CHO	20 µg	0.1.6		1627.05	98.98%
26	Yang L. N. et al.	RCT	2016	16–50	99/144	243	YDV	10 µg	0.1.6	seronegative adults	304.11	100.00%
					50/101	151	YDV	10 µg	0.1.6		906.07	100.00%
					107/143	250	CHO	10 µg	0.1.6		330.33	99.60%
					65/86	151	Engerix-B	10 µg	0.1.6		453.25	100.00%
					51/59	110	CHO	20 µg	0.1.6		142.98	99.10%
					48/83	131	Engerix-B	20 µg	0.1.6		1335.45	96.90%
27	Wen Q. et al.	RCT	2017	18–55	NA	160	YDV	20 µg	0.1.3	seronegative adults	NA	98.13%
						160	YDV	20 µg	0.1.6		NA	97.50%

RCT: randomized controlled trial; NA: not available; YDV: yeast-derived recombinant vaccines; CHO: recombinant hepatitis vaccine made by Chinese hamster ovary cells; Engerix-B: a hepatitis B vaccine made by Glaxo Smith Klin.

Figure 2. Forest plot. (a) The relative risks of the response to the HBV vaccine comparing the 20 μg and 10 μg doses. (b) The relative risks of the response to the HBV vaccine comparing the 5 μg and 10 μg doses.

Figure 3. Forest plot. (a) The relative risks of the response to the HBV vaccine comparing CHO and YDV. (b) The relative risks of the response to the HBV vaccine comparing the domestic and imported vaccines.

Figure 4. Forest plot. (a) The relative risks of the response to the HBV vaccine comparing the 0, 1, and 2 or 3 month schedule and the 0, 1, and 6 month schedule. (b) The relative risks of the response to the HBV vaccine comparing the 0, 1, and 12 month schedule and the 0, 1, and 6 month schedule.