Long-term impact of infant immunization on hepatitis B prevalence: a systematic review and meta-analysis.

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hepatitis B 91 Title: Bulletin of the World Health OrganizationLong-term impact of infant immunization on hepatitis B prevalence: a systematic review and meta-analysisImpact à long terme de la vaccination des nourrissons
hepatitis B 356 systématique et méta-analyseImpacto a largo plazo de la inmunización infantil en la prevalencia de la hepatitis B : una revisión sistemática y un meta-análisis التأثير طويل الأجل لعمليات تمنيع
hepatitis B 969 метаанализAlternative Title: Kate Whitford et al.Alternative Title: Towards elimination of hepatitis B Kate WhitfordBette LiuJoanne MicallefJ Kevin YinKristine MacartneyPierre Van DammeJohn M KaldorPublication
hepatitis B 1278 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.MethodsWe searched online databases for articles reporting
hepatitis B 1617 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),
hepatitis B 1698 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
hepatitis B 2886 adolescents and young adults will ensure that elimination efforts are on track.IntroductionInfection with the hepatitis B virus (HBV) is a major global cause of ill health that particularly affects low- and middle-income countries.
hepatitis B 6611 databases of Embase®, MEDLINE®, Web of Science and LILACS to January 2017. The search terms used were: “ hepatitis B ” AND (“vaccination” OR “mass vaccination” OR “immunization” OR “immunization programmes”)
hepatitis B 6958 additional studies.Inclusion criteriaWe included any study addressing the long-term impact of an infant hepatitis B vaccine programme at a population level if it satisfied the following criteria: (i) HBV infection status,
hepatitis B 7091 a population level if it satisfied the following criteria: (i) HBV infection status, as defined by hepatitis B core antibody (HBcAb) or hepatitis B surface antigen (HBsAg) status (or both), was assessed and reported
hepatitis B 7128 the following criteria: (i) HBV infection status, as defined by hepatitis B core antibody (HBcAb) or hepatitis B surface antigen (HBsAg) status (or both), was assessed and reported in the study population; (ii) the
hepatitis B 7846 (referred to as the vaccinated cohort).We categorized infant vaccination programmes as either universal, if hepatitis B vaccine was reported as being available to all newborns; or targeted, if vaccine was available to infants
hepatitis B 11707 included.[21]Fig. 1Flowchart of selection of studies for the meta-analysis of the long-term impact of hepatitis B virus immunization programmes Study characteristicsOf the 26 studies that met the inclusion criteria
hepatitis B 12827 programmes (or both).Table 1Summary of studies included in the meta-analysis of the long-term impact of hepatitis B virus immunization programmesReferenceLocationPopulationStudy designStudy periodStudy sample, no.Sex,
hepatitis B 18743 F: 33UniversalUnvaccinated: 18–22l; universal: 18–22l3.89m; 0.57nNA3.51m; 0.27nF: female; HBV: hepatitis B virus; HBsAg: hepatitis B surface antigen; HIV: human immunodeficiency virus; M: male; NA not applicable.
hepatitis B 18769 18–22l; universal: 18–22l3.89m; 0.57nNA3.51m; 0.27nF: female; HBV: hepatitis B virus; HBsAg: hepatitis B surface antigen; HIV: human immunodeficiency virus; M: male; NA not applicable. a Targeted refers
hepatitis B 19149 to be at high risk for some other reason. Universal refers to infant vaccination programmes in which hepatitis B vaccine was reported as being available to all newborns. Unvaccinated refers to cohorts that had no
hepatitis B 19283 as being available to all newborns. Unvaccinated refers to cohorts that had no universal or targeted hepatitis B immunization programmes.b We only included 15–20 years age group from this study.c Sex distribution
hepatitis B 22943 therefore used random-effects models to estimate combined RPs and CIs.Fig. 2Relative prevalence of hepatitis B surface antigen in the meta-analysis of the long-term impact of immunization programmes: comparison
hepatitis B 23299 Repeat donor.b First-time donor.Notes: The figure shows the number of participants positive for the hepatitis B surface antigen and the total number of participants in the cohort being measured. Totals may not equal
hepatitis B 23554 Table 1, as only age-eligible participants were included in our analysis.Fig. 3Relative prevalence of hepatitis B surface antigen in the meta-analysis of the long-term impact of immunization programmes: comparison
hepatitis B 23876 applicable; RP: relative prevalence. Notes: The figure shows the number of participants positive for the hepatitis B surface antigen and the total number of participants in the cohort being measured. Totals may not equal
hepatitis B 24964 models for estimates and CI due to the highly significant heterogeneity.Fig. 4Relative prevalence of hepatitis B core antibody in the meta-analysis of the long-term impact of immunization programmes: comparison of
hepatitis B 25286 applicable; RP: relative prevalence. Notes: The figure shows the number of participants positive for the hepatitis B surface antigen and the total number of participants in the cohort being measured. Totals may not equal
hepatitis B 25541 Table 1, as only age-eligible participants were included in our analysis.Fig. 5Relative prevalence of hepatitis B core antibody in the meta-analysis of the long-term impact of immunization programmes: comparison of
hepatitis B 25859 applicable; RP: relative prevalenceNotes: The figure shows the number of participants positive for the hepatitis B surface antigen and the total number of participants in the cohort being measured. Totals may not equal
hepatitis B 26249 around the combined RPs (Fig. 6).Fig. 6Funnel plot of publication bias in studies of the prevalence of hepatitis B virus markers in adultsHepatitis B core antibody: HBcAb; HBsAg: hepatitis B surface antigen; RP: relative
hepatitis B 26325 studies of the prevalence of hepatitis B virus markers in adultsHepatitis B core antibody: HBcAb; HBsAg: hepatitis B surface antigen; RP: relative prevalence; SE: standard error.Notes: The relative prevalence is shown.
hepatitis B 28769 comparisons of cohorts at different ages.[28],[29],[31],[33]–[40],[44]–[48]Fig. 7Relative prevalence of hepatitis B surface antigen in the meta-analysis of the long-term impact of immunization programmes: comparison
hepatitis B 29130 applicable; RP: relative prevalence.Notes: The figure shows the number of participants positive for the hepatitis B surface antigen and the total number of participants in the cohort being measured. Totals may not equal
hepatitis B 30955 from another area.[38],[41]DiscussionOur meta-analysis of the long-term impact on infection of infant hepatitis B vaccination programmes at the population level focused on long-term impact by restricting the time period
hepatitis B 35219 studies than those in other areas (83% versus 64%). The early attainment of high newborn coverage of hepatitis B vaccine in Taiwan, China, over 95% by 2002,[11] could explain this observation.The studies we included
hepatitis B 37167 narrow geographical spread of studies. Although many countries have had historically high prevalence of hepatitis B , particularly in the WHO Western Pacific and African regions,[59] most of the published studies that
hepatitis B 39119 2000.[61],[62] Our findings strongly support the importance of the WHO target of 90% coverage of the hepatitis B vaccine in infancy,[15] as low coverage is a potential contributor to residual HBV prevalence. The evidence

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