Factors Affecting the Long-Term Protection Against Hepatitis B Immunization in Infancy: A Meta-Analysis

Introduction: Hepatitis B virus (HBV) infection is a major global health issues and one of the most dangerous viral infections with a high mortality rate. Newborns and infant vaccination against chronic HBV infection are crucial for preventing mother-to-child transmission (MTCT). This study aimed to conduct a meta-analysis to investigate the factors affecting long-term protection against Hepatitis B Immunization in infancy. Material and Methods: Our literature searches are from PubMed, Science Direct, Web of Science, and ProQuest publications between January 2000 and December 2021. The included literature assessed the risk of bias using the Newcastle Ottawa Quality Assessment Scale. We identify Hepatitis B surface antibodies (anti-HBs) ≥ 10 mIU/mL as being protective against HBV infection. The results are combined with a random effect or fixed effect model. Results: Eighteen eligible observational studies with a total of 16,642 participants were included. Analysis of factors affecting long-term protection status by assessing anti-HBs titers showed significant results on several factors, including gestational age for anti-HBs titers (OR 2.5; 95% CI 1.62-3.85; p<0.0001), weight for age to anti-HBs titers (OR 1.36; 95% CI 1.06-1.75; p=0.02), length for age to anti-HBs titers (OR 0.01; 95% CI 0.01-0.02; p<0.00001), and immunization status based on the number of vaccine doses (4 doses vs 3 doses) to anti-HBs titers (p<0.00001). Conclusions: Anti-HBs titers of hepatitis B immunization were significantly affected by gestational age, weight for age, length for age, and vaccine doses. Parents of newborns must be informed about basic immunization and provide adequate nutritional intake to the mother and babies to prevent HBV infection.