Behind the Paper

We are now on track to achieve HBV elimination by 2030

The fight against chronic hepatitis B infection caused by the hepatitis B virus (HBV) is still ongoing. For this reason, WHO organizes campaigns on hepatitis B every year.

The striking theme of the campaigns, “One life, one liver,” draws attention to hepatitis B (1). Although hepatitis B (Hep B) vaccine is generally administered to newborns in the world, what is the level of access to the vaccine in economically low-income countries?

With the hope that this issue will be addressed on other platforms, I would like to touch on the protection of the vaccine here. previous studies, the protection rates of Hep B (Anti-HBs titer ≥ 10 mIU/mL) were at different levels; rates such as 85-90% (2), 24.9% (3), 52.4% (4) were found 10-31 years after HBV vaccination.

In our recent study, this rate was 55.4% 18-26 years after the first HBV vaccination series(5).

In the meantime, if we want to briefly touch on our study process, we can say the following:
Of course, since our region is a relatively more common area in terms of HBV, we felt like taking action. What was this curiosity? An average of 26 years had passed since the first HBV vaccination series in our country.

In this case, the question of whether protection against HBV still continued came to mind. For this, the maximum age group we could reach was 26 and the minimum age group was 18.

Of course, there were important problems here.

The most important of these are the exclusion of those who had previously received an additional dose of HBV vaccine from the study, whether they adapted to the additional vaccination during the study period, and the invitation of individuals back to the study center to determine their antibody levels within 4-6 weeks after the additional dose of vaccination.

For this, all individuals had to be invited by phone, and in case of any miscommunication, they had to be reminded again.

For all this, we were dividing the workload and cooperating as study managers. Each of us would inform the other, either face to face, by phone or via E-mail.

In the meantime, it is necessary to establish close communication with the central laboratory for serum samples. We can say that the most important thing is strong communication, progress within a program and discipline so that there are no problems or deficiencies.

Studies on the protection provided by the Hep B vaccine after 20-30 or 40 years are ongoing. It is suggested that if the Anti-HBs titer reaches ≥ 10 mIU/mL after vaccination in infancy, the protection will continue for life, but additional Hep B vaccination is recommended especially for healthcare workers, physicians or dentists at low titers (Anti-HBs titer < 10 mIU/mL).

If the recommendation of the Centers for Disease Control and Prevention to have Hep B serology tested at least once starting at the age of 18, especially for those living in regions with medium-high HBV prevalence, is followed, individuals at risk will be provided with the opportunity to receive additional HBV vaccination when necessary (6).

Thus, success can be achieved in the fight against HBV in regions where HBV is relatively more prevalent, and the WHO's goal of "Hep B elimination" in 2030 will be achieved.

1-WHO. Hepatitis B, Fact sheets n.d. (2022) https://www.who.int/news-room/fact-sheets/detail/hepatitis-b. Accessed 9 October 20242-Chiara F, M et al (2013) Hepatitis B vaccination at three months of age: a successful strategy? Vaccine 31:1696–1700.
3-Bruce MG, et al (2016) Antibody levels and protection after hepatitis B vaccine: results of a 30-year follow-up study and response to a booster dose. J Infect Dis 214:16–22
4-Ma JC, et al (2020) Long-term protection at 20–31 years after primary vaccination with plasma-derived hepatitis B vaccine in a Chinese rural community. Hum Vaccin Immunother 16:16–20.
5-Erdoğdu HI, et al. "Anti-HBs Levels 18–26 Years After the Initial Hepatitis B Vaccination Series in a Low-to-Medium Prevalence Region: Is a Booster Dose or a Second Vaccine Series Necessary?." Current Microbiology 82.5 (2025): 223.
6-Schillie S, et al (2013) Centers for Disease Control and Prevention (CDC). CDC guidance for evaluating health-care personnel for hepatitis B virus protection and for administering postexposure management. MMWR Recomm Rep 62:1–19