Serologic Hepatitis B Immunity in Vaccinated Health Care Workers

Abstract

Twenty-nine percent of the health care workers who were vaccinated against hepatitis B showed no serologic evidence of hepatitis B immunity. It is unclear whether these subjects are nonresponders, lost immunity, or retained anamnestic potential. Booster vaccination response in 6 of 6 subjects suggests immunity. We recommend (1) postvaccination testing within 1 to 2 months to document immunity, (2) periodic anti-HBs monitoring, and (3) booster vaccination to maintain protective titer levels.

Immune Response and Immunologic Memory in Medical Personnel Vaccinated with Hepatitis B Vaccine

“…The right strategy would require that vaccination should be done before admission to medical college/university or beginning work at medical departments (prior to the contact with blood or blood products). 3 The evidence in the available literature points to 5-10% of the adult population that does not respond to standard HBV vaccination 3,16 , and among medical personnel the share of non-responders may reach considerably higher levels of 5-32% 17 . The absence of seroconversion in 7.2% of the investigated subjects after the fi rst immunologic response may be partially related to the existing compromising factors.…”

“…Many other researchers have found decrease of the antibodies concentration below the detectable threshold in 10-50% of the subjects immunized 10-15 years prior. 8,11,13,16,17 It is worth noting that the absence of antibodies (anti-HBs < 10 mIU/ml) in previously immunized subjects does not prove absence of protection. 18,19 There have been studies demonstrating that postvaccinal immunity against hepatitis B is not only humoral, but it has been detected that immunologic memory determined by HBsAg -specifi c T-lymphocytes persists long time after vaccination in recipients with serum antibodies < 10 mIU/ml.…”

Immunogenicity in humans of an edible vaccine for hepatitis B

“…It is relevant that use of the commercial HBsAg parenteral vaccine, which does include an adjuvant (alum), does not always lead to successful immunization. Nonresponsiveness remains a problem for a group of vaccinees (18)(19)(20)(21), and booster vaccination to maintain protective titer levels has been discussed (22,23). Moreover, oral delivery in human subjects of a recombinant adenovirus containing the HBsAg gene failed to stimulate serum anti-HBs (24), although that construct may have been compromised by deletion of an important adenovirus gene.…”

Liver Injury Induced by High-Dose Methylprednisolone Therapy: A Case Report and Brief Review of the Literature

“…The patients in this latter group (the nonimmunized group) were statistically similar to patients with incomplete vaccinations in terms of antibody titer level (P < 0.002).This measurements were 81%, 88.1%, and 35% in Goldberg et al, Room et al, and Barash's studies, respectively [10][11][12], and the figures in other studies in Iran were 86.4% and 96.3% in Khosravi et al in Fars Province and Allami et al in Qazvine, respectively [13][14]. Our results showed a significant relationship between age and hepatitis B antibody level similar to the level noted in Bonanni et al in Italy.…”