Differences in hepatitis B markers between clinical and preclinical health care personnel.
10
Citation
0
Reference
10
Related Paper
Citation Trend
Abstract:
Hepatitis B virus (HBV) infection is an occupational risk for health care personnel (HCP). Vaccination is an important preventive measure but high cost of vaccination limits the feasibility of giving vaccine to all HCP. To find an optimum approach for vaccination we conducted a study on HCP in Maulana Azad Medical College and associated LNJPN hospital. A total of 162 subjects were screened. Eight were excluded because of prior vaccination against HBV. Two groups of subjects were selected namely preclinical and clinical. The preclinical group comprised first year medical students and the clinical group comprised of HCP who have been exposed to clinical departments. The subjects were screened for HBsAg, anti HBs and anti HBc viral markers. 86 subjects were screened in the preclinical group. Two (2.3%) were positive for HBsAG; 16 (18%) and 9 (10.4%) were positive for anti HBs and anti HBc respectively. In the clinical group a total of 68 subjects were screened. Amongst them 1.4% were positive for HBsAg; 47 (69%) and 38 (55%) were positive for anti HBs and anti HBc respectively. The study revealed that there was a significant difference in the titre of the viral markers in the preclinical group as compared to the clinical group. Seventy (82%) of preclinical subjects were at high risk for the infection as they moved into clinical departments. Few subjects will be excluded from the vaccination schedule based on anti HBs screening and hence screening prior to vaccination is not cost effective. However in the clinical group 69% will be excluded from the vaccination schedule based on anti HBs positivity and screening will save up to 60% of cost involved in vaccination.Keywords:
Hepatitis B
Cite
Background: Hepatitis B virus (HBV) is a severe public health problem in Iran. This study was conducted to investigate the intrafamilial transmission of HBV in vaccinated children whose one or both parents were positive for hepatitis B surface antigen (HBsAg). Methods: In a study with retrospective cohort design, 110 exposed cases with HBsAg-positive parent(s) were compared with 110 unexposed controls of the same sex and age groups. The participants were directly asked about demographic characteristics, medical history, and vaccinations. Blood samples were collected and analyzed for HBV infection markers using the ELIZA method. Results: Overall, 1.8% HBsAg (P = 0.15) and 13.6% hepatitis B core antibody (HBcAb) (P < 0.0001) positivity rates were detected in the exposed group. The hepatitis B surface antibody titer (HBsAb) showed that 34.5% of cases and 56.3% of controls had HBsAb levels > 10 IU/L. There was a significant difference in the protective HBsAb level between the two groups (P < 0.0001). There were significant associations between HBsAb level and gender in the exposed group and decreased HBsAb levels and age. Conclusions: The high rate of positive HBcAb and HBsAg and decreasing HBsAb levels with age in this study indicate that routine childhood vaccination programs are inadequate in preventing HBV transmission and vaccine routes changing or further booster vaccination is essential. Effective case finding in vaccinated children with HBsAg-positive parents, intradermal vaccination, and hepatitis B immunoglobulin in newborns with HBsAg-positive fathers are suggested.
Hepatitis B
Cite
Citations (0)
Abstract BackgroundNeonatal hepatitis B vaccination program at birth has been implemented nationwide since 1992 in China, which may impact HBV safety in blood donations actively. The true prevalence of HBV, HBsAg, and OBI between vaccinated blood donors and non-vaccinated blood donors should be explored. Study design and methodsThe samples of blood donors were collected and detected for serologic markers of HBV in the Shenzhen Blood Center between Feb 2016 and Jun 2016. The discrepant results were tested with commercial electrochemiluminescence immunoassay (ELCI), alternative MPX ID NAT, nested PCR, sequencing, and a quantitative real-time polymerase chain reaction (PCR) assay. HBsAg and anti-HBs were quantified. The serological and molecular characteristics of HBV infected blood donors were analyzed, and the effects on blood safety for donors born before and after the implementation of universal HBV vaccination were compared. ResultsTotal of 242 reactive by NAT and/or HBsAg ELISA samples from 26318 candidate donors, 192 (0.73%, [95%CI, 0.63-0.84]) HBV+, 131 (0.49%, [95%CI, 0.43-0.59]) HBsAg+, 58 (0.22%, [95%CI,0.17-0.28]) OBI were confirmed respectively. The HBV+ rate in vaccinated donors is lower than in non-vaccinated donors (P<0.05). The HBsAg titers of vaccinated infected blood donors are much higher than non vaccinated infected blood donors. The OBI yield rates in the vaccinated blood donors were 0.11% (7/6422), and significantly lower than 0.26% (51/19898) in the non vaccinated blood donors (P<0.05). 102/124 (82.3%) samples are genotype B, 22/124 (17.7%) are genotype C total. There is no significant difference in the distribution of genotype in the non vaccinated blood donors (B/C,86/17) and the vaccinated blood donors (B/C,23/6) (P>0.05). High frequency of vaccine escape mutation M133L (32.4%) and E164G in S region of genotype B strains and substitution L175S (40.9%) related to vaccine escape in S region of genotype C strains identified.ConclusionThe universal HBV vaccination program markedly reduces the risk of HBV infection in blood donors, and provides a significant guarantee for the safety of blood transfusion. Several important mutations detected related vaccine escape and notable mutations needed further investigated.
Hepatitis B
Cite
Citations (0)
Abstract Background The short-term 0–1–2-month hepatitis B virus (HBV) vaccination schedule was previously implemented in the adult population; however, its long-term immune effect remains unclear. The present study aimed to investigate (1) the 2-month and 2-year immune effects of HBV vaccination and (2) the compliance rate between the 0–1–2-month and 0–1–6-month vaccination schedules in adults. Method A total of 1281 subjects tested for hepatitis B surface antigen HBsAg(−) and hepatitis B surface antibody (anti-HBs)(−) were recruited. Participants from two distant counties were inoculated with the hepatitis B yeast vaccine at 10 µg per dose, with vaccination schedules of 0, 1, and 2 months (n = 606) and 0, 1, and 6 months (n = 675); sequential follow-up was performed at 2 months and 2 years after the 3rd injection. Results There were no significant differences in the anti-HBs seroconversion rates between the those in the 0–1–2-month and 0–1–6-month vaccination schedule groups at 2 months (91.96% vs. 89.42%, p = 0.229) and 2 years (81.06% vs. 77.14%, p = 0.217). The quantitative anti-HBs level in those in the 0–1–2-month vaccination schedule group was not different from that in those in the 0–1–6-month vaccination schedule group at 2 months (anti-HBs 1 ) (342.12 ± 378.42 mIU/ml vs. 392.38 ± 391.96 mIU/ml, p = 0.062), but it was higher at 2 years (anti-HBs 2 ) (198.37 ± 286.44 mIU/ml vs. 155.65 ± 271.73 mIU/ml, p = 0.048). According to the subgroup analysis, the 0–1–2-month vaccination schedule induced better maintenance (p = 0.041) and longer reinforcement (p = 0.019) than the 0–1–6 vaccination schedule. The 0–1–2-month vaccination schedule group also had a higher 3rd injection completion rate (89.49% vs. 84.49%, p = 0.010). Conclusion The 0–1–2-month vaccination schedule was associated with a similar short-term immune effect and might induce better long-term immune memory and a higher completion rate in the adult population. Trial registration None
Medical microbiology
Parasitology
Tropical Medicine
Vaccination schedule
Cite
Citations (4)
Hepatitis B virus (HBV) infection is an occupational risk for health care personnel (HCP). Vaccination is an important preventive measure but high cost of vaccination limits the feasibility of giving vaccine to all HCP. To find an optimum approach for vaccination we conducted a study on HCP in Maulana Azad Medical College and associated LNJPN hospital. A total of 162 subjects were screened. Eight were excluded because of prior vaccination against HBV. Two groups of subjects were selected namely preclinical and clinical. The preclinical group comprised first year medical students and the clinical group comprised of HCP who have been exposed to clinical departments. The subjects were screened for HBsAg, anti HBs and anti HBc viral markers. 86 subjects were screened in the preclinical group. Two (2.3%) were positive for HBsAG; 16 (18%) and 9 (10.4%) were positive for anti HBs and anti HBc respectively. In the clinical group a total of 68 subjects were screened. Amongst them 1.4% were positive for HBsAg; 47 (69%) and 38 (55%) were positive for anti HBs and anti HBc respectively. The study revealed that there was a significant difference in the titre of the viral markers in the preclinical group as compared to the clinical group. Seventy (82%) of preclinical subjects were at high risk for the infection as they moved into clinical departments. Few subjects will be excluded from the vaccination schedule based on anti HBs screening and hence screening prior to vaccination is not cost effective. However in the clinical group 69% will be excluded from the vaccination schedule based on anti HBs positivity and screening will save up to 60% of cost involved in vaccination.
Hepatitis B
Cite
Citations (10)
Hepatitis B
Regimen
Vaccination schedule
Cite
Citations (18)
Objective This study was conducted to evaluate the 16-year efficacy of hepatitis B virus (HBV) vaccine in healthcare workers of Oil Company Hospital, Tehran, Iran. Methods Two hundred healthcare workers were enrolled in the study in 1989. All HBV markers were tested and those with positive HBV markers, positive antihepatitis C virus or anti-HIV were excluded from the study. The remaining participants received three doses of HBV vaccine and again all of our participants were reevaluated in 2005. Hepatitis B surface antigen (HBsAg), antihepatitis B surface antibody (anti-HBsAb), and antihepatitis B core antibody (anti-HBcAb) were checked in all participants and those with anti-HBcAb above 10 IU/l were excluded from the final evaluation. Results No participant was positive for HBsAg in either 1989 or 2005. Protective levels of anti-HBsAb were absent in all participants in 1989, but present in 67 (80.7%) participants in 2005 (P<0.001). Anti-HBsAb titer after vaccination was significantly higher in female participants than in male participants (P=0.01). Mean anti-HBsAb titer was 640±411.7 IU/l (range: 2–1000 IU/l) and the lowest protective titer was 12 IU/l. Conclusion According to our results, 80.7% of our participants had a protective titer of anti-HBsAb 16 years after vaccination. Although all anti-HBc positive participants were free of clinical hepatitis and were negative for HBsAg, hepatitis B vaccination was proved to be highly effective in preventing clinically significant infection and chronic carrier status up to 16 years after the primary vaccination. Hence, HBV revaccination may not be mandatory in healthcare workers, according to their sufficient long-term level of anti-HBsAb.
Hepatitis B
Cite
Citations (16)
Hepatitis B virus infection is an important public health problem with significant morbidity and mortality. Recombinant hepatitis B vaccination for the prevention of hepatitis B virus infection is in practice in different parts of the world since its availability in 1986. Government of Bangladesh has also included hepatitis B vaccine in EPI schedule since 2005. This study was carried out to assess the seroconversion status among hepatitis B vaccinated individuals. A total of 190 individuals including 150 vaccinated persons and 40 non-vaccinated apparently healthy individuals were included as study population. Sources of vaccinated persons were from both EPI and non-EPI schedule of vaccination. Age and sex matched non-vaccinated individuals served as controls for the study. All individuals constituting the study population were screened for HBsAg by Immunochromatographic strip test and only HBsAg-negative persons were included for estimation of their anti-HBs titer. Out of 150 vaccinated individuals, 133(88.67%) were found to have anti-HBs titer in the protective level (e"10 IU/L), while 17(11.33%) individuals had anti-HBs titer below the protective level (<10 IU/L). All non-vaccinated controls had anti- HBs titers below the protective level. Immune response developed among vaccinated individuals, 67.78%, 23.33% and 8.89% were good-responders, hypo-responders and non-responders respectively. Mean titer of anti-HBs was found significantly higher among recipients who received booster dose than those who received 3 doses schedule (863.39 IU/L vs. 262.40 IU/L), indicating high antibody titer develops after booster dose. Vaccinated group included 85 (56.67%) men and 65 (43.33%) women with protective level of anti-HBs titer found in 85.88% male and 92.31% female individuals. doi: 10.3329/jom.v10i2.2817 J MEDICINE 2009; 10 : 67-76
Seroconversion
Booster dose
Hepatitis B
Antibody titer
Vaccination schedule
Cite
Citations (9)
Efficacy of HBV vaccine in long term prevention of HBV infection was evaluated at 3 years after vaccination in 38 children and 61 adults. All vaccinees were negative for all HBV markers (HBsAg, anti-HBs and anti-HBc) before vaccination. Vaccines (Hevac B) were given for 3 doses, one month apart, to 38 children aged 1 month - 14 years and 61 adults aged 15-45 years. After 3 years of vaccination, blood specimens were collected for the determination of HBsAg, anti-HBs and anti-HBc. The results revealed that no HBsAg antigenemia was found in all 99 vaccinees. Anti-HBs could not be detected in 4 children and 11 adults and this occurred only in the group of subjects who had initial anti-HBs less than 100 mlU/ml at 2 months after the last dose of vaccination. At three years after the first course of vaccination, 89.4 percent of children and 83.4 percent of adults still have anti-HBs above protective level (more than 10 mlU/ml) with geometric mean titers of 101 and 35 mlU/ml in children and in adult groups, respectively. The anti-HBc was detected in 2 out of 38 children and 10 out of 61 adults, but none of them became chronic hepatitis B carriers or developed clinical disease. It is recommended that everyone with anti-HBs values below 100 mlU/ml two months after the last dose of vaccine should be revaccinated with a booster dose within 6 months. Those with anti-HBs levels higher than 100 mlU/ml, should be checked up at 3 years; if the anti-HBs is less than 10 mlU/ml, they should be revaccinated.
Hepatitis B
Booster dose
Hepatitis B vaccine
Cite
Citations (4)
In haemodialysis patients, hepatitis B virus infection has higher mortality and is more likely to result in the carrier state. Although Hepatitis B vaccine is effective in producing protection against HBV infection, the antibody response may be variable. In this study, seroprotection rate of hepatitis B vaccine in maintenance haemodialysis patients was studied after primary vaccination and after completion of the full vaccine regime. 50 unvaccinated patients on maintenance haemodialysis were included in this study. Patients negative for HBsAg, Anti-HBc (total) and Anti-HCV were vaccinated with 40μg of Engerix B following a schedule of 0, 1, and 2 months. The antibody titer was tested at 3rd month and if the titer was <10 or between 10-100 mIU/ml, they were given another 4th dose of vaccine at 6th month, and their antibody titer was tested again at 7th month. In maintenance haemodialysis patients, the response rate to HBV vaccine was 44% after the primary vaccination and 80% after completion of the full vaccine regime. DOI: http://dx.doi.org/10.3329/bmrcb.v37i3.9119 BMRCB 2011; 37(3): 88-91
Antibody titer
Hepatitis B vaccine
Hepatitis B
Vaccination schedule
Cite
Citations (9)
Vaccination schedule
Hepatitis B
Booster dose
Booster (rocketry)
Cite
Citations (25)