Seroprevalence of hepatitis B and immune response to hepatitis B vaccination in Chinese college students mainly from the rural areas of western China and born before HBV vaccination integrated into expanded program of immunization

Figures & data

Figure 1. Study flowchart.

Table 1. Baseline seropositive rates of HBsAg and anti-HBc and seroprotective rate of anti-HBs by HB vaccination history

Vaccination history	N (%)	HBsAg	Anti-HBc alone	Anti-HBc+anti-HBs both positive	Anti-HBs alone	All negative	Anti-HBs GMC1(IU/L)	Anti-HBs GMC2(IU/L)
Confirmed	226 (11.1)	12 (5.3, 2.8–9.1)	5 (2.2, 0.7–5.1)	73 (32.3, 26.3–38.8)	85 (37.6, 31.3–44.3)	51 (22.6, 17.3–28.6)	41.3 (27.7–61.8)	49.3 (32.9–74.0)
1 or 2 doses	11 (0.5)	0 (0, 0–28.5)	0 (0, 0–28.5)	8 (72.7, 39.0–94.0)	2 (18.2, 2.3–51.8)	1 (9.1, 0.2–41.3)	137.3 (30.7–614.2)	137.3 (30.7–614.2)
3 doses	215 (10.5)	12 (5.6, 2.9–9.5)	5 (2.3, 0.8–5.3)	65 (30.2, 24.2–36.8)	83 (38.6, 32.1–45.5)	50 (23.2, 17.8–29.5)	38.9 (25.7–58.9)	46.7 (30.6–71.1)
Within 24 hr after birth	65 (3.2)	1 (1.5, 0.04–8.3)	1 (1.5, 0.04–8.3)	15 (23.1, 13.5–35.2)	30 (46.2, 33.7–59.0)	18 (27.7, 17.3–40.2)	27.7 (12.9–59.9)	29.7 (13.7–64.1)
Beyond 24 hr after birth	150 (7.3)	11 (7.3, 3.7–12.7)	4 (2.7, 0.7–6.7)	50 (33.3, 25.9–41.5)	53 (35.3, 27.7–43.5)	32 (21.3, 15.1–28.8)	42.8 (26.0–70.5)	52.5 (31.6–87.2)
Unknown	1648 (80.8)	225 (13.6, 12.0–15.4)	29 (1.8, 1.2–2.5)	486 (29.5, 27.3–31.8)	417 (25.3, 23.2–27.5)	491 (29.8, 27.6–32.1)	14.2 (12.2–16.6)	22.2 (18.8–26.1)
None	166 (8.1)	21 (12.6, 8.0–18.7)	8 (4.8, 2.1–9.3)	56 (33.7, 26.6–41.5)	23 (13.8, 9.0–20.1)	58 (34.9, 27.7–42.7)	11.6 (6.9–19.4)	18.3 (10.6–31.6)
Total	2040 (100.0)	258 (12.6, 11.2–14.2)	42 (2.1, 1.5–2.8)	615 (30.1, 28.2–32.2)	525 (25.7, 23.8–27.7)	600 (29.4, 27.4–31.4)	15.7 (13.7–18.1)	24.0 (20.7–27.8)

Data are presented as participant number or value (proportion of participants and/or 95%CI). N, Number of participants with different HB vaccination history; %, proportion of participants with different HB vaccination history among total participants; 95%, 95% confidence interval; GMC1, calculated on all the participants with specific vaccination history; GMC2, calculated on the participants other than HBsAg positive. For HBsAg seropositive rate: P = 0.0019 among the participants with confirmed, unknown or none vaccination history; P = 0.0004, 0.0097, 0.7192 for confirmed vs. unknown, confirmed vs. none, unknown vs. none, respectively; within 24 h vs. beyond 24 h: P = 0.1123. For anti-HBs alone seroprotective rate: P < 0.0001 among the participants with confirmed, unknown or none vaccination history; P < 0.0001, < 0.0001, = 0.0010 for confirmed vs. unknown, confirmed vs. none, unknown vs. none, respectively; within 24 h vs. beyond 24 h: P = 0.1345. For GMC1: P < 0.0001 among the participants with confirmed, unknown or none vaccination history; P < 0.0001, = 0.0002, = 0.5083 for confirmed vs. unknown, confirmed vs. none, unknown vs. none, respectively; within 24 h vs. beyond 24 h: P = 0.3482. For GMC2: P = 0.0014 among the participants with confirmed, unknown or none vaccination history; P = 0.0006, 0.0035, 0.4855 for confirmed vs. unknown, confirmed vs. none, unknown vs. none, respectively; within 24 h vs. beyond 24 h: P = 0.2172. For multiple comparison, Bonferroni adjustment was used with α’ = α/month = 0.05/3 = 0.0167.

Figure 2. Anti-HBs seroprotective rate after HB vaccination given at month 0, 1, and 6 among participants seronegative for HBsAg, anti-HBs, and anti-HBc at baseline.

Table 2. Anti-HBs response after HB vaccination given at month 0, 1, and 6 among participants seronegative for HBsAg, anti-HBs, and anti-HBc at baseline

Time after dosing	vaccination history	<10 IU/L	10–100 IU/L	≥100 IU/L	GMC (IU/L)
Month 1	All (n = 414)	287 (69.3, 64.6–73.7)	37 (8.9, 6.4–12.1)	90 (21.7, 17.9–26.0)	4.4 (3.3–5.9)
	None (n = 43)	33 (76.7, 61.4–88.2)	3 (7.0, 1.5–19.1)	7 (16.3, 6.8–30.7)	3.3 (1.5–7.5)
	Confirmed (n = 41)	25 (61.0, 44.5–75.8)	5 (12.2, 4.1–26.2)	11 (26.8, 14.2–42.9)	8.4 (3.0–23.3)
	Unknown (n = 330)	229 (69.4, 64.1–74.3)	29 (8.8, 6.0–12.4)	72 (21.8, 17.5–26.7)	4.3 (3.1–5.9)
	P value	P1 = 0.6333	P = 0.3029
Month 6	All (n = 407)	33 (8.1, 5.6–11.2)	166 (40.8, 36.0–45.7)	208 (51.1, 46.1–56.1)	95.8 (81.7–112.5)
	None (n = 41)	5 (12.2, 4.1–26.2)	16 (39.0, 24.2–55.5)	20 (48.8, 32.9–64.9)	85.4 (48.7–149.9)
	Confirmed (n = 40)	4 (10.0, 2.8–23.7)	16 (40.0, 24.9–56.7)	20 (50.0, 33.8–66.2)	96.5 (58.8–158.2)
	Unknown (n = 326)	24 (7.4, 4.8–10.8)	134 (41.1, 35.7–46.7)	168 (51.5, 46.0–57.1)	97.1 (81.2–116.2)
	P value	P2 = 0.7910	P = 0.8945
Month 7	All (n = 406)	4 (1.0, 0.3–2.5)	12 (3.0, 1.5–5.1)	390 (96.1, 93.7–97.7)	742.6 (680.5–810.2)
	None (n = 41)	0 (0, 0.0–8.6)	5 (12.2, 4.1–26.2)	36 (87.8, 73.8–95.9)	611.6 (446.6–837.6)
	Confirmed (n = 41)	0 (0, 0.0–8.6)	1 (2.4, 0.1–12.9)	40 (97.6, 87.1–99.9)	815.0 (677.6–980.4)
	Unknown (n = 324)	4 (1.2, 0.3–3.1)	6 (1.9, 0.7–4.0)	314 (96.9, 94.4–98.5)	752.1 (680.8–830.9)
	P value	P > 0.9999	P = 0.0066	P = 0.0325	P = 0.2957
Month 20	All (n = 399)	10 (2.5, 1.2–4.6)	66 (16.5, 13.0–20.6)	323 (81.0, 76.7–84.7)	308.1 (268.2–354.0)
	None (n = 32)	0 (0, 0.0–10.9)	6 (18.8, 7.2–36.4)	26 (81.3, 63.6–92.8)	444.8 (293.5–674.1)
	Confirmed (n = 37)	0 (0, 0.0–9.5)	6 (16.2, 6.2–32.0)	31 (83.8, 68.0–93.8)	325.4 (211.4–500.9)
	Unknown (n = 330)	10 (3.0, 1.5–5.5)	54 (16.4, 12.5–20.8)	266 (80.6, 75.9–84.7)	295.6 (252.8–345.5)
	P value	P3 = 0.9266	P = 0.2852

Data are presented as participant number or value (proportion of participants and/or 95%CI). P1, P2, P3: comparison of anti-HBs distribution among the participants with confirmed, unknown or none vaccination history. At month 7 for 10–100 IU/L: P = 0.5689, 0.2012, 0.0039 for confirmed vs. unknown, confirmed vs. none, unknown vs. none, respectively. At month 7 for ≥100 IU/L: P > 0.9999, = 0.2012, = 0.0180 for confirmed vs. unknown, confirmed vs. none, unknown vs. none, respectively. For multiple comparison, Bonferroni adjustment was used with α = α/month = 0.05/3 = 0.0167.

Figure 3. Anti-HBs response after HB vaccination given at month 0, 1, and 6 among participants seropositive for anti-HBc alone at baseline.