Isolated Presence of Antibody to Hepatitis B Core Antigen in Injection Drug Users: Do They Need to Be Vaccinated?

Quaglio, Gianluca; Lugoboni, Fabio; Vento, Sandro; Lechi, Alessandro; Accordini, Augusto; Bossi, Carlo; Faccini, Marco; Mecenero, Valerio; Pani, A; Pantalena, M.; Residori, Margherita; Mezzelani, Paolo

doi:10.1086/320162

Cited by 21 publications

(14 citation statements)

References 7 publications

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“…Because this study is restricted to drug users, the findings may not be applicable to other populations such as clients of STD clinics or vaccination programs that are linked with primary health care services. IDUs may also have biologically plausible different characteristics than NIDU for non-response or impaired response to hepatitis B vaccine (commonly exhibiting anti-HBc in the absence of other HBV markers), but follow-up after a mean of 49 months in one study indicates that IDUs with isolated anti-HBc do not require vaccination [43]. The mean age of the participants was 43 years (SD+/− 9.0) and these findings cannot be generalized to younger drug users.…”

Section: Discussionmentioning

confidence: 99%

Effect of age and frequency of injections on immune response to hepatitis B vaccination in drug users

Tran¹,

Grimes²,

Lai³

et al. 2012

Vaccine

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Despite the high immunogenicity of the hepatitis B vaccine, evidence suggests that immunological response in drug users is impaired compared to the general population. A sample of not-in-treatment adult drug users from two communities in Houston, Texas, USA, susceptible to hepatitis B virus (HBV), was sampled via outreach workers and referral methodology. Participants were randomized to either the standard multi-dose hepatitis B vaccine schedule (0, 1, 6 month) or to an accelerated (0, 1, 2 month) schedule. The participants were followed for one year. Antibody levels were measured at 2, 6 and 12 months after enrollment in order to determine the immune responses. At 12 months, cumulative adequate protective response was achieved in 65% of the HBV susceptible subgroup using both the standard and accelerated schedules. The standard group had a higher mean antibody titer (184.6 vs 57.6 mIU/mL). But at six months, seroconversion at the adequate protective response was reached by a higher proportion of participants and the mean antibody titer was also higher in the accelerated schedule group (104.8 vs. 64.3 mIU/mL). Multivariate analyses indicated a 63% increased risk of non-response for participants 40 years or older (p=0.046). Injecting drugs more than once a day was also highly associated with the risk of non-response (p=0.016). Conclusions from this research will guide the development of future vaccination programs that anticipate other prevalent chronic conditions, susceptibilities, and risk-taking behaviors of hard-to-reach populations.

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Section: Discussionmentioning

confidence: 99%

Effect of age and frequency of injections on immune response to hepatitis B vaccination in drug users

Tran¹,

Grimes²,

Lai³

et al. 2012

Vaccine

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show abstract

“…Some surveys found that patients with isolated anti-HBc exhibited strong resistance to reinfection and did not require vaccination, 13 while others suggested that a reasonable approach would be to recommend that such subjects be vaccinated against hepatitis B and then to assess their response to vaccination. Some studies had shown that preventive antibody levels can be achieved after HBV vaccination in most isolated anti-HBc individuals.…”

Section: Introductionmentioning

confidence: 99%

Responses to hepatitis B vaccine in isolated anti-HBc positive adults

Yao

Ren

Chen

et al. 2016

Human Vaccines & Immunotherapeutics

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Immune responses of isolated anti-HBc subjects are not well characterized in populations in China. This study aimed to evaluate immune responses to hepatitis B vaccination in isolated anti-HBc positive subjects. A cohort of 608 subjects were selected and separated into isolated anti-HBc (negative for HBsAg and anti-HBs, positive for anti-HBc) and control (negative for HBsAg, anti-HBs, and anti-HBc) groups, who were matched by age and sex. All subjects received 3 doses of hepatitis B vaccine (20mg) at months 0, 1, and 3, followed by testing for serological responses 1 month after the third vaccination. The positive seroprotection rate and geometric mean titer (GMT) for hepatitis B surface antibody (anti-HBs) of isolated anti-HBc subjects were significantly lower than those in the control group(86.2% vs.92.1%, P D 0.02; 47.26 vs.97.81 mIU/mL, P < 0.001). When stratified by age, positive seroprotection rate in the isolated antiHBc group were 92%, 88.5% and 79.4% in the 20-34, 35-49, and 50-60 y old subgroups, respectively (x2 D 5.919, P D 0.04). Additionally, the GMT level for anti-HBs in the isolated anti-HBc group for different age subgroups were 104.43, 47.87 and 31.79 mIU/mL respectively (x2 D 19.44, P < 0.001). The GMT level for anti-HBc before vaccination were negatively correlated with GMT for anti-HBs after 3 doses of hepatitis B vaccine (r D ¡0.165, P < 0.001). In conclusion, isolated anti-HBc positive subjects can achieve good immune responses after hepatitis B vaccination, and the positive seroprotection rate and GMT level for anti-HBs were lower than the control group. Better responses could be observed in young adults, and significant negative correlations were found between GMT of anti-HBc before vaccination and GMT of anti-HBs after vaccination.

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“…(3) occult chronic HBV infection with undetectable HBsAg; or (4) a false-positive test result [4,5]. Whether individuals who test positive for isolated anti-HBc antibodies should be vaccinated against hepatitis B is uncertain.…”

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confidence: 99%

Serologic Response to Hepatitis B Vaccination in HIV‐Infected Patients with Isolated Positivity for Antibodies to Hepatitis B Core Antigen

et al. 2010

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We assessed the safety and immunogenicity of hepatitis B vaccination among 40 human immunodeficiency virus-infected patients with isolated positivity for antibodies to hepatitis B core antigen. No baseline factors were found to be predictive of an anamnestic response, which occurred in 32.5% of the patients. The overall response rate among patients without an anamnestic response was 74.0% after 3-6 vaccine doses.

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Isolated Presence of Antibody to Hepatitis B Core Antigen in Injection Drug Users: Do They Need to Be Vaccinated?

Cited by 21 publications

References 7 publications

Effect of age and frequency of injections on immune response to hepatitis B vaccination in drug users

Effect of age and frequency of injections on immune response to hepatitis B vaccination in drug users

Responses to hepatitis B vaccine in isolated anti-HBc positive adults

Serologic Response to Hepatitis B Vaccination in HIV‐Infected Patients with Isolated Positivity for Antibodies to Hepatitis B Core Antigen

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