Open Access Research article

Lasting immune memory against hepatitis B in children after primary immunization with 4 doses of DTPa-HBV-IPV/Hib in the first and 2nd year of life

Michael Steiner1, Gunasekaran Ramakrishnan2, Britta Gartner3, Olivier Van Der Meeren4, Jeanne-Marie Jacquet4 and Volker Schuster5*

Author Affiliations

1 Medical Practice, Werderstr. 3, 88348 Bad Saulgau, Germany

2 Clinical Statistics, GlaxoSmithKline Biologicals, Bangalore, India

3 Med. Fachbereich Impfstoffe, GlaxoSmithKline Biologicals, Munich, Germany

4 Clinical Department, GlaxoSmithKline Biologicals, Rixensart, Belgium

5 University Hospital for Children and Adolescents, Leipzig, Germany

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BMC Infectious Diseases 2010, 10:9  doi:10.1186/1471-2334-10-9

Published: 15 January 2010



Few studies have assessed long term persisting immunity against hepatitis B virus (HBV) in children vaccinated during infancy with combined vaccines containing recombinant HBV surface antigen (HBs). We assessed antibody persistence and immune memory in children 4-5 years of age, previously vaccinated with four doses of combined hexavalent DTPa-HBV-IPV/Hib vaccine (Infanrix hexa™).


Immune memory was assessed in 301 children through administration of a challenge dose of monovalent HBV vaccine.


At 4-5 years of age, 85.3% of subjects had persisting anti-HBs antibody concentrations ≥ 10 mIU/mL, rising to 98.6% after the HBV challenge dose. All but 12 subjects (95.8%) achieved post-challenge anti-HBs concentrations ≥ 100 mIU/mL. The post-challenge anti-HBs GMC rose by 100-fold compared to pre-challenge concentrations. An anamnestic response to the HBV vaccine challenge was observed in 96.8% of subjects, including 17/21 (81.0%) of children with initially undetectable antibodies (<3.3 mIU/mL). All but 4 of 42 subjects (90.5%) with anti-HBs antibodies <10 mIU/mL prior to the challenge dose, achieved seroprotective levels afterwards. A 4-fold rise in antibody concentration after the challenge dose was observed in 259/264 (98.1%) of initially seropositive subjects. The magnitude of the post-challenge responses was proportional to pre-challenge anti-HBs levels. No serious adverse events were reported during the study.


The combined DTPa-HBV-IPV/Hib vaccine induced lasting immune memory against hepatitis B. Long term protection afforded by DTPa-HBV-IPV/Hib is likely to be similar to that observed following priming with monovalent HBV vaccines.

Trial registration webcite 106789 NCT00411697