Objective  To investigate the incidence and influencing factors of non-/low- response to hepatitis B vaccine in infants born to HBsAg-positive mothers.

  Methods   All infants born to HBsAg-positive women in Nansha district of Guangzhou during 2018−2021 were surveyed. Serum markers of hepatitis B virus (HBV) infection in peripheral blood were detected for the infants in follow up, and two structured questionnaires were used to collect the information about related factors that might affect non-/low-response to hepatitis B vaccine in the infants.

  Results   A total of 640 HBsAg-positive mothers and their infants were recruited through telephone interview at 7−12 months after delivery. Two infants (0.31%) were infected with HBV. The incidence of non-/low-response to hepatitis B vaccine was 2.81% (18/640), and the incidence of non-response was 0.31% (2/640), the incidence of low-response was 2.50% (16/640). Univariate analysis found that there were no significant differences in maternal marital status, education level, HBeAg status, HBV DNA level during pregnancy, delivery mode and gestational weeks at delivery, infant birth weight, gender, and whether vaccinated the first dose of hepatitis B vaccine and hepatitis B immunoglobulin within 12 hours after birth between the infants with non-/low-response to hepatitis B vaccine and those with strong-response to hepatitis B vaccine (P>0.05). For the HBeAg-positive mothers or mothers with high levels of HBV DNA during pregnancy, 47.65% (81/170) received antiviral therapy, and the proportions of their infants who received the first dose of hepatitis B vaccine and hepatitis B immunoglobulin within 12 hours after birth were slightly higher than those of infants born to women with negative-HBeAg or low-levels of HBV DNA during pregnancy. There was no significant difference in the incidence of non-/low-response to hepatitis B vaccine between the two groups (P>0.05).

  Conclusion   With the progress of the elimination of mother-to-child transmission of hepatitis B, the incidence rates of the mother-to-child transmission and non-/low-response to hepatitis B vaccine in infants born to HBsAg-positive women decreased significantly. In the future, the timely injections of the first dose of hepatitis B vaccine and hepatitis B immune globulin in newborns should be further strengthened, and antiviral treatment should be started for pregnant women with high levels of HBV DNA or positive-HBeAg.