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

The prevalence of hepatitis B surface antigen (HBsAg) in a population aged 15 y or older was high in China, but an immunization strategy for this population was unavailable. We investigated the seroprevalence of hepatitis B and immune response to HBV vaccine in Chinese college students (n = 2040 participants), 11.1%, 80.8%, and 8.1% had confirmed, unknown and no HBV vaccination history, respectively. The seropositive rates for HBsAg, anti-HBs sole and antiHBs plus anti-HBc were 12.6%, 25.7%, and 30.1%, respectively. The HBsAg seropositive rate was significantly lower in participants with confirmed HBV vaccination history than in those with unknown or no vaccination history (5.3%, 13.6%, and 12.6%, respectively, P = 0.0019). The anti-HBs alone seropositive rate was significantly higher in participants with confirmed HBV vaccination history than in those with unknown or no vaccination history (37.6%, 25.3%, and 13.8%, respectively, P < 0.0001). Participants negative for HBsAg, anti-HBs, and anti-HBc at baseline (n = 600) were given three doses of recombinant HBV vaccine (GlaxoSmithKline) at month 0, 1, and 6. Robust immune response was elicited after two and three doses (seroprotective rate: 91.9% and 99.0%, respectively, and geometric mean concentration [ GMC]: 95.8 and 742.6 IU/L, respectively). Fourteen months after the third dose, the anti-HBs seroprotective rate of the group remained more than 97%. The seroprotective rates and GMCs did not differ significantly by vaccination history. This study suggested that three doses of 20 g HBV vaccine were needed for college students negative for HBsAg, anti-HBs, and antiHBc to ensure high seroprotective rates and concentrations.