Abstract
BackgroundAbout 10% of Hepatitis B vaccinated individuals mount no protective antibody levels against the hepatitis B surface antigen (HBs-Ag). Older age at primary immunization, obesity and smoking have previously been reported as risk factors associated with vaccine non-response. Here we tested whether these factors alone may allow selecting subjects that benefit from individualized immunization schedules.MethodsRetrospective database analysis screening > 15,000 individual anti-HBs-IgG measurements. Non-responders (NR; anti-HBs-IgG < 10 IU/L) and low-responders (LR; anti-HBs-IgG 10–100 IU/L) were identified. Vaccine type, demographics, lifestyle, and immunological factors (leucocyte subset counts) were compared between NR, LR, and responders (R).ResultsWe identified 113 LR/NR and compared them to 134 vaccine responders. We confirmed higher median age at primary vaccination (24.0 (R) vs. 30.5 (NR) vs. 31 (LR) years, p = 0.001), higher median BMI (23.2 kg/m2 (R) vs. 23.4 kg/m2 (NR) vs. 25.1 kg/m2 (LR), p = 0.001) and being a smoker (% smokers: 30.8% (R) vs. 57.1% (NR) vs. 52.5% (LR), p = 0.01) as factors negatively associated with anti-HBs-IgG levels. In a ROC analysis including these factors in a 6-point score, a high score predicted non-response with a specificity of 85% but at low sensitivity (47%).ConclusionA simple clinical risk score based on age, obesity, and smoking identifies individuals with a high likelihood of vaccine failure. Non-responders with a low score are candidates for in-depth analyses to better understand the immunological causes of HBV vaccine non-response.
Highlights
About 10% of Hepatitis B vaccinated individuals mount no protective antibody levels against the hepatitis B surface antigen (HBs-Hepatitis B surface antigen (Ag))
The reason for the failure to adequately respond to Hepatitis B virus (HBV) vaccination in subjects without classical risk factors has been attributed to genetic factors (MHC), reduced T cell activation or failure of the T cells to recognize the HBs Ag (‘hole in the repertoire’) [16]
We studied a group of hepatitis B vaccine non-responders and tested, if a simple score based on age, and -the potentially modifiable life-style factorsBMI and smoking status may allow selecting subjects with a high likelihood for vaccine failure
Summary
About 10% of Hepatitis B vaccinated individuals mount no protective antibody levels against the hepatitis B surface antigen (HBs-Ag). Older age at primary immunization, obesity and smoking have previously been reported as risk factors associated with vaccine non-response. Several epidemiological studies have established that age at immunization, overweight, gender, smoking status, co-morbidities and immunosuppression affect the vaccine response [6,7,8,9,10,11,12,13,14,15]. The reason for the failure to adequately respond to HBV vaccination in subjects without classical risk factors has been attributed to genetic factors (MHC), reduced T cell activation or failure of the T cells to recognize the HBs Ag (‘hole in the repertoire’) [16]. We studied a group of hepatitis B vaccine non-responders and tested, if a simple score based on age, and -the potentially modifiable life-style factorsBMI and smoking status may allow selecting subjects with a high likelihood for vaccine failure
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
