Serum Antibody Analysis Following Hepatitis B Vaccination for Occupational Risk Assessment Among Dental Students

Abstract

Background & Objectives: Hepatitis B is the most important infectious occupational disease for the health care workers. Dental surgeons are frequently in contact with blood and saliva and hence are at high risk for Hepatitis B Virus (HBV) exposure. HBV infection is a major public health problem in India, as there are 45 million estimated carriers. Immunization against HBV reduces the risk of transmission of HBV to dental personnel and from dental personnel to patients. The present study was aimed to evaluate the serum levels of anti-HBs in vaccinated dental health care workers. Methods: In this study, estimation of serum levels of Anti- HBs in 40 dental students vaccinated against HBV was done. Data was obtained regarding vaccination data, age, sex, weight, height and smoking history. Anti-HBs level was evaluated two years after the 1st dose of vaccination. Low responders were given booster vaccination and post booster anti HBs assay was done. Results: The study included 110 hepatitis B vaccinated dental students. Out of 110 students only 40 students had documented history of complete vaccination and volunteered to be a part of the study. Among these 40 students, three students (7.5%) had less than 100 IU/L anti–HBs level and 37 students (92.5%) had more than 100 IU/L anti–HBs level. Anti- HBS level above 100 IU/L is identified to be protective. Following booster vaccination, low responders showed anti -HBs titre more than 100 IU/L. Conclusion: In this study majority dental students had desirable immune response to the HBV vaccine. Male gender and positive smoking history could have attributed to low anti-HBs titre in subjects who had inadequate levels in our study. Hence, all Health Care Workers, in particular dental surgeons with contributory factors like smoking habit, male gender should undergo periodic assessment of anti-HBs titre.

Estimation of Anti-HBs Titer in Health Care Professionals of a Tertiary Care Centre of Southern Assam

“…The fact observed in this study that Smoking of tobacco is not significantly associated with low level of anti-HBs IgG has been in discordance with studies of Shruti Hegde et al [18] from Karnataka in South India and Lakshmanan et al [14] from Agartala in North east India as they have found smoking to be a significant attribute for low levels of anti-HBs IgG titer in medical students and health care workers respectively.…”

“…Unlike the study of Shruti Hegde et al [18] in dental students of Mangalore and that of Syed Rahamathulla et al [15] in vaccinated doctors in Andhra Pradesh where male gender has been attributed to low anti-HBs titer, no such statistically significant gender predilection has been found with low anti HBs IgG in our study Anti-HBs IgG titer has been said to wane with time elapsed after vaccination and so has been found in our study where passage of >10 years post vaccination has been found to have been significantly associated with inadequate protective anti-HBs. Similar observation has been made in the study of Dr V K Kataria et al [16] in their study on healthcare professionals from New Delhi.…”

“…Sarman Singh et al [8] in a study conducted on vaccinated healthcare professionals of AIIMS New Delhi found that 79% of them had protective antiboby titer (>10IU/L). Studies carried out in South Indian states like that of T.V Rao et al [17] from Thrissur Kerala, Shruti Hegde et al [18] from Mangalore Karnataka and Reshmi Gopalkrishnan et al [9] from Calicut Kerala found protective anti-HBs titer in 89%, 92% and 100% of the completely vaccinated healthcare professionals respectively.…”

Serologic Hepatitis B Immunity in Vaccinated Health Care Workers

“…(1) Gender based information in the present study revealed higher immunity in females 114 (77.55%) compared to males 79 (65.28%), similar to studies of Ganczak (79.5%), Chathuranga and Shruthi hedge. (11,8,12) According to Varsha singhal, 5-10% of the adult population will not respond to standard HBV vaccination. (13) Risk factor for vaccine nonresponse include: male sex, older age, cigarette smoking, obesity, immunodeficiency, chronic diseases, certain HLA halotypes ,celiac disease, etc.…”

“…Inclusion criteria was vaccinated persons and exclusion criteria was non vaccinated persons. Doctors (113), medical and nursing students (62), nurses (59), technicians (15), group D workers (12) and others (07) formed the study group. Age, gender, occupation and details of vaccination schedule of each individual (dose and duration) were taken.…”