Evaluation of factors associated the expression of anti-HBs in children in Hunan Province, China

Abstract

Background and objectives: Vaccine is the most essential avenue to prevent hepatitis B virus (HBV) infection in infants and preschool children in China, with the largest populations carrying HBV in the world. This study aimed to evaluate the factors associating the response level of anti-HBs in children, providing instructions for HBV prevention clinically. Methods: The children taking physical examinations in the Third Xiangya Hospital from January 2013 to April 2020 were recruited. Telephone follow-up were adopted to collect further information. Univariate logistic regression was used to analyse the relationship between age and anti-HBs expression. Grouping by age and anti-HBs expression, we used chi-square test and T test to compare qualitative and quantitative data between positive group and negative group in each age subgroup. The meaningful variables (P < 0.10) in chi-square test or T test were further assessed with collinearity and chosen for univariate and multivariate logistic regression analysis by the stepwise backward maximum likelihood method (αin = 0.05, αout = 0.10). Results: A total of 5838 samples (3362 males, 57.6%) were enrolled. In total, the incidence of negative anti-HBs increased with age[OR = 1.037(1.022–1.051)]. Multivariate logistic regression analysis illustrated that anemia[OR = 0.392(0.185–0.835)], age[OR = 2.542(1.961–3.295)] and Vit D[OR = 0.977(0.969–0.984)] in 0.5–2.99 years subgroup, Zinc deficiency[OR = 0.713(0.551–0.923] and age[OR = 1.151(1.028–1.289)] in 3–5.99 years subgroup, Vit D[OR = 0.983(0.971–0.995)] in 12–18 years subgroup had significant association with anti-HBs. Conclusions: This retrospective study illustrated that age, anemia status, zinc deficiency and vitamin D were associated with anti-HBs expression in specific age groups of children, which could serve as a reference for the prevention of HBV.