anti-HBs Testing Research Articles

Evaluation of Hepatitis B Seroprevalence and Hepatitis B Reactivation Frequency in Rheumatology Patients Using Biological Drug Therapy

Objective: The presence of hepatitis B virus (HBV) infection in patients using biological drug therapy may cause reactivation. There is insufficient data on the frequency of HBV reactivation, especially after the use of new biological drugs such as tofacitinib, tocilizumab, and secukinumab. This study aims to examine HBV seroprevalence in rheumatology patients using biological drug therapy and investigate the frequency of reactivation in patients with previous HBV infection. Methods: The charts of 275 patients who were followed up in the rheumatology department and used biological drug therapy were examined to evaluate the HBsAg, anti-HBc IgG, and anti-HBs test results. The frequency of reactivation was investigated by examining the HBV DNA test results before and after the biological drug therapy and the alanin aminotransferase test results were checked throughout the biological drug therapy in anti-HBc IgG-positive patients. Results: Among the patients, HBsAg was positive in 0.4%, anti-HBs in 34.4%, and anti-HBc IgG in 25.1%. The reactivation frequency was investigated in 53 biological drug therapies applied in 41 patients. The use of prophylactic antiviral drugs, where reactivation was evaluated, was found as 28.6% in TNF inhibitors, 100% in rituximab, 75.0% in tofacitinib, 0% in tocilizumab, 50% in abatacept, and 0% in secukinumab. Reactivation was detected in one of the fifty-three biological drug therapies. The reactivation case was a patient with isolated anti-HBc IgG and initial HBV DNA tests positive, using tocilizumab and cortisone, and not using entecavir prophylactic treatment regularly. Conclusions: The frequency of previous HBV infection is high in patients using biological therapy. Although prophylactic antiviral drug therapy for HBV has not been used frequently during the use of biological drug therapies other than rituximab in anti-HBc IgG positive patients, reactivation is rare. The risk of reactivation may be low in those receiving tofacitinib and secukinumab therapy and high in those receiving tocilizumab therapy.

Frequency of Occult Hepatitis B in Pregnant Women Attending Antenatal Care Unit of a Tertiary Care Hospital

Introduction: Occult infections (OBIs) caused by hepatitis B virus (HBV) are detected by the presence of HBV DNA without surface antigens. The prevalence of HBsAg in general population of Pakistan is around 3%, but there is no data regarding the occurrence of OBIs. Aims & Objectives: The goal of this research was to assess the frequency of occult hepatitis B infection in pregnant females presenting to antenatal care unit of Shaikh Zayed Hospital, Lahore. Place and duration of study: These samples were handled at the Microbiology Department of Shaikh Zayed Hospital, Lahore. The duration of study was one year after the approval of synopsis. Material & Methods: Four hundred and sixty three pregnant women were included in this research. Serum was separated from their blood samples. HBsAg, Anti-HBcand Anti-HBs tests were performed using the ELISA technique on all the samples. Real time PCR was performed to find HBV DNA. Results: The frequency of occult hepatitis B was < 0.25 in this research. Among the 463 women tested during pregnancy, hepatitis B surface antigen was positive in 2 (0.4%) women. These two were excluded from the study. Out of 461 samples, hepatitis B surface antibody was positive in 61 (13.2%) samples and they were negative for hepatitis B core antibody. These 61 samples were also omitted from the research. 25 (5%) samples were positive for both Anti-HBc and Anti-HBs. 11 samples (2%) were Anti-HBc positive and Anti-HBs negative. In 364 (79%) samples, both Anti-HBs and Anti-HBc were absent. Polymerase Chain Reaction was performed on 400 samples. Conclusion: The frequency of occult hepatitis B is very low < 0.25% in pregnant women. It is not recommended to routinely screen pregnant women for hepatitis B virus DNA.

Analysis of antibody-negative medical students after hepatitis B vaccination in Japan

ABSTRACT Hepatitis B virus (HBV) vaccination is recommended for health-care professionals because of their frequent contact with blood. At one medical school, new students undergo HBV antibody tests upon admission, and antibody-negative individuals receive the HBV vaccine. We aimed to characterize individuals who remained antibody negative after HBV vaccination. Between 2009 and 2017, we enrolled 1064 first-year students from a medical school where their HBV antibody test and vaccination records remained. We analyzed data regarding the hepatitis B surface antibody (anti-HBs) test record during admission, vaccination record for antibody-negative participants, anti-HBs test result after completing the three vaccination doses, drug name of the vaccine used, sex, body mass index (BMI), and age. We calculated the yearly percentage of antibody-negative individuals and analyzed the characteristics of vaccine-refractory cases by logistic regression analysis. Of the 1064 participants, 999 were initially antibody negative. They were vaccinated with HBV thrice and tested for antibodies after vaccination. The average age of participants was 20.1 y, with 677 males. Although the type of vaccine has been changed since 2016, the average rate of refractoriness from 2009 to 2015 was 6.9% per year and 18.6% after 2016. Logistic regression analyses showed that sex (male vs. female; OR, 1.787), BMI (OR. 1.171), and vaccine type (genotype A vs. genotype C: OR, 3.144) were significant factors associated with antibody-negative individuals. Vaccine type differences altered the proportion of antibody-refractory individuals, with no association with age. The data on vaccine refractoriness will be continuously analyzed in the future while considering other factors.

Prevalence of Non-Responsiveness to an Indigenous Recombinant Hepatitis B Vaccine: A Study among Health Care Workers in A Tertiary Hospital

Background and Aim: Health care workers (HCW) are at higher risk of contracting HBV infection. Non-response to HBV vaccine is one of the major impediments to prevent healthcare associated HBV infection (HAHI). We estimated the prevalence of non-responsiveness to initial 3-dose regimen of an indigenous recombinant HBV vaccine (GeneVac-B) among South Indian HCWs and typed the HLA in non-responders. Study Design and Method: Of the 778 subjects screened over 1 year, 454 completed all three doses of the hepatitis B vaccination. Anti-HBs titers were estimated by microparticle enzyme immunoassay Automated ELISA. HLA typing was done using AllSet+™ Gold SSP. Conclusion: Our findings suggest that non-response to HBV vaccine is not a major impediment to prevent HAHI. Robust seroprotection rates can be achieved using this indigenous HBV vaccine. However, gender and BMI might influence the level of anti-HBs titers. We recommend the use of this cost effective HBV vaccine as well as post vaccination anti-HBs testing to prevent HAHI among HCWs.

Dental auxiliary hepatitis B immunization: a cross-sectional study in the São Paulo state public health system, Brazil, 2018.

to investigate dental auxiliaries (DA) hepatitis B immunization in Brazilian National Health System (SUS) services in nine cities in São Paulo State, Brazil, in 2018. this was a cross-sectional study based on interviews using a questionnaire as well as evaluation of immunity using the anti-HBs test, evaluation of prior testing, test result and interpretation and guidance provided about hepatitis B. of the 70 registered DA, 35 completed the course of vaccinations, 29 had negative anti-HBs test results, 16 had tested previously, and 43 did not correctly understand their result; there was association (p=0.025) between completed course of vaccinations and receipt of guidance. most DA received guidance about hepatitis B; however, a considerable portion did not complete the course of vaccinations and had negative anti-HBs test results; few DA had tested previously nor correctly interpreted the result; evidence was found of an alarming scenario in which there are severe shortcomings in DA hepatitis B immunization.

Hepatitis B Seroprevalence in the Pediatric and Adolescent Population of Florence (Italy): An Update 27 Years after the Implementation of Universal Vaccination.

Background: Hepatitis B still represents a health concern, although safe and effective vaccines have been available since 1982. Italy introduced a program of universal vaccination against hepatitis B in 1991. The aim of this study was to assess the immunity levels towards hepatitis B in a sample of sera from the pediatric and adolescent population in the province of Florence, Central Italy, twenty-seven years after the implementation of universal vaccination. Methods: A total of 165 sera samples were collected from the resident population of Florence aged 1–18 years. The anti-HBs and anti-HBc enzyme-linked immunosorbent Assay (ELISA) tests were performed on all samples. The anamnestic and vaccination status data were also collected. Results: Seroprevalence of anti-HBs was approximately 60%, with children aged 1–5 years having the highest positivity rate (81.6%), and decreasing trends in the older age groups. The zero prevalence of anti-HBc shows that the detected protective immunity is mainly due to vaccination, and natural infection was not reported in the studied population. Conclusions: The seroprevalence of anti-HBs and the lack of anti-HBc in this study highlights that immunity levels have been derived mainly from immunization. This confirms how vaccination dramatically reduced circulation of the hepatitis B virus in Italy in the pediatric and adolescent population twenty-seven years after implementation of the mandatory universal program.

Discordance of hepatitis B vaccination policies for healthcare workers between the USA, the UK, and Germany.

The hepatitisB (HB) vaccine is effective for the prevention of HB virus infection. It has been widely accepted that an anti-HB surface antibody (HBs) level ≥10mIU/mL is protective against HB virus infection. Although transient infection can occur in individuals who attain a peak level of anti-HBs ≥10mIU/mL after primary vaccination, long-term follow-up studies show that successful primary vaccination can prevent individuals from acute clinical hepatitis and chronic infection. Healthcare workers (HCWs) are at-risk individuals. Based on the accumulated data, the USA considers an anti-HBs level ≥10mIU/mL to constitute successful vaccination for HCWs. In contrast, because some anti-HBs assays cannot accurately measure in the low anti-HBs range, including 10mIU/mL, the UK and Germany consider an anti-HBs level ≥100mIU/mL to constitute successful vaccination for HCWs. In the USA and UK, a booster dose is unnecessary for HCWs after successful vaccination. In Germany, anti-HBs testing is recommended for HCWs who are at particularly high individual exposure risk 10years after successful primary immunization, and a booster dose is offered if the anti-HBs level has declined to ˂100mIU/mL. The differences in the goal of HB vaccination, reliability of anti-HBs assays, and use of booster vaccination cause discordance in HB vaccination policies for HCWs.

Significance of Hepatitis B Virus Diagnosis by Real-time Polymerase Chain Reaction over Serological Markers in Hepatitis B Virus Patients

Hepatitis B virus (HBV) is the leading cause of viral hepatitis, as currently over 2 billion people have HBV infection worldwide. Nucleic acid assay and quantitative hepatitis B surface antigen (HBsAg) have been developed for diagnostic and therapeutic monitoring of patients with HBV infection. These tests might also show correlation between HBV DNA and HBs serostatus. The study aimed to find and analyze the frequency and impact of HBsAg seropositivity among patients revealed HBV DNA negative level through quantitative estimation of both seromarkers. Real-time polymerase chain reaction (RT-PCR) and Elecsys assays were used for quantitative estimation of HBV DNA and HBs antigen, respectively. A total of 256 blood samples were used from patients referred for either diagnostic purpose and/or HBV viral load monitoring after antiviral therapy. Blood profile analysis showed 12.26% HBs antigen seropositivity among patients revealed negative for nucleic acid assay for HBV DNA. Positive HBs antigen titers ranged from 1000–50,000 COI, with seronegative anti-HBs antibody test for all samples tested positive for HBs antigen. This study delineated that negative or undetectable quantitation of HBV DNA level does not exclude HBV infection; as the level might fluctuate in different phases of HBV replication. This gives an impression and raising a question about significance of replacing test for HBsAg with quantitation of HBV DNA PCR assay. Thus, the study refers to a special HBV profile outside the classical pattern.

Hepatitis B Vaccine: Assessment of Immunologic Response, Coverage Rate, and Factors Influencing Seroreactivity.

Hepatitis B infection and resulting health sequela is a worldwide health problem. Adults at increased risk of infection are recommended to receive hepatitis B vaccine for protection, followed by postvaccination titer testing to confirm immunity. The aim of this study is to assess coverage rate and immunologic response to hepatitis B vaccine and factors influencing seroreactivity. This was a cross-sectional study carried out among medical doctors of Makkah city, medical interns, and medical students of Umm Al-Qura University, Saudi Arabia. A self-administered questionnaire was used to collect data for evaluation of hepatitis B vaccination coverage, immune status, and associated risk factors. Three hundred twenty-one (79.9%) out of 402 participants received the vaccination. Of those vaccinated 159 (48.3%) had subsequent testing for anti-HBs. One hundred thirty-nine (87.4%) had an appropriate immunologic response to the vaccine (titer ≥ 10 mIU/mL). Factors negatively influencing seroreactivity were male gender, high BMI, smoking, incomplete vaccination series, vaccination schedule non-adherence, and long elapsed time since last vaccination; with p-values of 0.001, 0.000, 0.002, 0.001, 0.037, and 0.000, respectively. Hep B vaccination coverage in our study is considered insufficient. Smoking and obesity were modi-fiable and preventable risk factors negatively affecting the immunologic response. The development and enforcement of better health policies aimed at increasing access and coverage of the HBV vaccination of at-risk populations like medical students, with increased awareness, is recommended.

Antibody response after hepatitis B vaccine boost mapped with peptide-phage display

Recombinant hepatitis B virus vaccines confer protection by eliciting specific antibodies against the hepatitis B surface antigen (HBsAg), known as anti-HBs. However, the performance of rapid anti-HBs diagnostic tests generates concerns regarding consistency. Novel indicators of protection might be developed by monitoring changes in targeted HBsAg-epitope profile after vaccination. In this work, we test the feasibility of our peptide-phage display platform in identifying B-cell epitopes targeted at different time-points after hepatitis B vaccination. We combined this platform with a unique approach for in silico analysis of enriched sequences. Serum samples collected from one single patient who had two boosting immunizations against hepatitis B virus were used in two-rounds of selection experiments. Five epitope candidates from HBsAg were identified in silico; most of them were previously reported in the literature. Our results suggest that the number of recognized HBsAg epitopes is related to the decrease of anti-HBs over time.

Vaccination coverage and immunity against hepatitis B in public health dentists.

Occupational exposure is a major risk factor for hepatitis B (HB) transmission. Vaccination coverage and immunity verification from 64 dentists of the Brazilian Unified Health System were investigated. An immunochromatographic method was used to verify immunity against the disease. Overall, 77.77% of participating dentists completed the vaccination schedule; 37.50% had negative anti-HBs test results. Furthermore, 60.93% of participants never underwent anti-HBs tests and 40% did not know how to correctly interpret results. Numerous dentists were not immune to the disease. Few participants previously performed the test, with many not knowing how to interpret the results.

Safer Blood Supply for Transfusion: Which Algorithm Should Be Used to Determine Occult Hepatitis B Infection in Blood Donors?

Transfusion-transmitted hepatitis B virus continues to be a problem despite its significantly reduced prevalence. In this study, in addition to screening for the presence of HBsAg in donors' blood, anti-HBc and anti-HBs markers were investigated using the chemiluminescence immunoassay (CLIA) method, and real-time PCR was used to detect HBV DNA. The study's material involved serum samples of 4,073 blood donors. HBsAg, anti-HBs, anti-HBc tests were undertaken using the CLIA method, and HBV DNA's presence was investigated using the real-time PCR method. HBsAg and anti-HBc tests were negative in 3,331 (81.78%) and positive in 37 (0.90%). For the remaining 705 (17.30%), HBsAg was negative and anti-HBc was positive. According to the results of the anti-HBs test for these samples, HBsAg negativity and anti-HBc and anti-HBs positivity were found in 619 samples (15.19%), while 86 samples (2.11%) were negative for HBsAg and anti-HBs but positive for anti-HBc (isolated anti-HBc positivity). ID-HBV DNA real-time PCR tests were performed on 86 samples. None of the samples was positive for HBV DNA. Recommended tests for screening occult HBV infection include anti-HBc, anti-HBs, and/or HBV DNA. Anti-HBc screening may result in loss of donors and blood products, particularly in countries with moderate endemicity of HBV, such as Turkey.

Protective hepatitis B surface antibody (Anti-HBs) levels among health care workers in Duhok city of Iraq

Objective: This cross sectional study aimed to find the prevalence of protective hepatitis B surface antibodies (anti-HBs) and HBV infection among health care workers in Duhok city. Method: In this cross sectional study, 504 health care workers from Duhok city were studied. The data requested included some demographics and risk factors of exposure. Blood samples were tested for HBsAg, anti-HBc and anti-HBs by enzyme-linked immunosorbent assay (ELISA). Results: The prevalence of protective anti-HBs was higher among vaccinated participants (p<0.001) and was positively associated with the number of vaccine doses (p<0.001). Around 60.0% of participants had received at least one dose of vaccine and 38% were fully vaccinated. Prevalence of postvaccination anti-HBs testing among fully vaccinated participants was 26.7%. The rate of protective anti-HBs levels among fully vaccinated participants was 84.8 %. The rates of HBsAg and overall HBV infection were 1.8%, and 9.5% respectively. HBV infection was significantly associated with occupational exposure to blood (OR=2.38; 95% CI=1.26-4.50) and dental interventions (OR=2.36; 95% CI=1.25-4.46). Conclusion: The rate of protective anti- HBs level among fully vaccinated HCWs is acceptable. Vaccination coverage and post-vaccination testing are still low and there is no post-exposure prophylaxis policy in Duhok health care facilities.

Seroprevalence of Hepatitis B Among HIV-infected Children and Adolescents Receiving Antiretroviral Therapy in the TREAT Asia Pediatric HIV Observational Database.

Hepatitis B (HBV)-HIV coinfection is associated with liver inflammation, which can progress to liver fibrosis/cirrhosis and hepatocellular carcinoma. We determined HBV seroprevalence in children and adolescents participating in the TREAT Asia Pediatric HIV Observational Database. A multisite cross-sectional study was conducted in HIV-infected patients currently <25 years old receiving antiretroviral treatment (ART) who had HBV surface antigen (HBsAg), or HBV surface antibody (anti-HBs) or HBV core antibody (anti-HBc) tested during 2012-2013. HBV coinfection was defined as having either a positive HBsAg test or being anti-HBc positive and anti-HBs negative, reflective of past HBV infection. HBV seroprotection was defined as having a positive anti-HBs test. A total of 3380 patients from 6 countries (Vietnam, Thailand, Cambodia, Malaysia, Indonesia and India) were included. The current median (interquartile range) age was 11.2 (7.8-15.1) years. Of the 2755 patients (81.5%) with HBsAg testing, 130 (4.7%) were positive. Of 1558 (46%) with anti-HBc testing, 77 (4.9%) were positive. Thirteen of 1037 patients with all 3 tests were anti-HBc positive and HBsAg and anti-HBs negative. One child was positive for anti-HBc and negative for anti-HBs but did not have HBsAg tested. The prevalence of HBV coinfection was 144/2759 (5.2%) (95% confidence interval: 4.4-6.1). Of 1093 patients (32%) with anti-HBs testing, 257 (23.5%; confidence interval: 21.0-26.0) had positive tests representing HBV seroprotection. The estimated prevalence of HBV coinfection in this cohort of Asian HIV-infected children and adolescents on ART was 5.2%. The majority of children and adolescents tested in this cohort (76.5%) did not have protective HBV antibody. The finding supports HBV screening of HIV-infected children and adolescents to guide revaccination, the use of ART with anti-HBV activity and future monitoring.

Persistence of immune memory among adults with normal and high antibody response to primary hepatitis B vaccination: Results from a five-year follow-up study in China

ABSTRACTImmune memory after hepatitis B vaccination among adults is still under investigation. In this study, adults who had normal and high antibody response to the primary series of hepatitis B vaccination (HepB) were followed up at 5 years after the primary immunization. A booster dose was given to those who had low hepatitis B surface antibody (anti-HBs) titers, defined as anti-HBs levels < 10 mIU/mL. Blood samples were collected at two weeks after the booster and anti-HBs levels were measured. We assumed those with ant-HBs levels > = 10 mIU/mL after the booster had anamnestic response. In total, 242 persons completed the booster and the anti-HBs test. The anamnestic response rate was 99.59% (241/242) and geometric mean concentration (GMC) of anti-HBs after the booster was 2989 mIU/mL (95% CI: 255, 35085). Anti-HBs titer after the booster dose had a positive correlation with anti-HBs titers measured right after the primary immunization as well as anti-HBs titers 5 years later just before the booster. After the booster, no significant difference was found in anti-HBs titers between participants who were immunized with the 10μg HepB vaccine and those with the 20μg vaccine. Multivariable analysis showed that 1) vaccine brand used for the primary vaccination, 2) anti-HBs titers after primary vaccination and 3) anti-HBs titers before the booster dose were independently associated with the anti-HBs titers after the booster 1) β = -0.21, 95% CI: -0.33, -0.09, P = 0.001; 2) β = 0.07, 95% CI: 0.05, 0.09, P < 0.001; 3) β = 0.04, 95% CI: 0.02, 0.07, P < 0.001). In summary, anamnestic response exists among almost all adults at five years after HepB primary immunization. Vaccine brand used for primary vaccination, initial anti-HBs titers after primary immunization and anti-HBs titers before the booster were the independent predictive factors of HepB anamnestic response titers.

Development of a Rapid Automated Fluorescent Lateral Flow Immunoassay to Detect Hepatitis B Surface Antigen (HBsAg), Antibody to HBsAg, and Antibody to Hepatitis C.

BackgroundAccurate, rapid, and cost-effective screening tests for hepatitis B virus (HBV) and hepatitis C virus (HCV) infection may be useful in laboratories that cannot afford automated chemiluminescent immunoassays (CLIAs). We evaluated the diagnostic performance of a novel rapid automated fluorescent lateral flow immunoassay (LFIA).MethodsA fluorescent LFIA using a small bench-top fluorescence reader, Automated Fluorescent Immunoassay System (AFIAS; Boditech Med Inc., Chuncheon, Korea), was developed for qualitative detection of hepatitis B surface antigen (HBsAg), antibody to HBsAg (anti-HBs), and antibody to HCV (anti-HCV) within 20 minutes. We compared the diagnostic performance of AFIAS with that of automated CLIAs—Elecsys (Roche Diagnostics GmbH, Penzberg, Germany) and ARCHITECT (Abbott Laboratories, Abbott Park, IL, USA)—using 20 seroconversion panels and 3,500 clinical serum samples.ResultsEvaluation with the seroconversion panels demonstrated that AFIAS had adequate sensitivity for HBsAg and anti-HCV detection. From the clinical samples, AFIAS sensitivity and specificity were 99.8% and 99.3% for the HBsAg test, 100.0% and 100.0% for the anti-HBs test, and 98.8% and 99.1% for the anti-HCV test, respectively. Its agreement rates with the Elecsys HBsAg, anti-HBs, and anti-HCV detection assays were 99.4%, 100.0%, and 99.0%, respectively. AFIAS detected all samples with HBsAg genotypes A-F and H and anti-HCV genotypes 1, 1a, 1b, 2a, 2b, 4, and 6. Cross-reactivity with other infections was not observed.ConclusionsThe AFIAS HBsAg, anti-HBs, and anti-HCV tests demonstrated diagnostic performance equivalent to current automated CLIAs. AFIAS could be used for a large-scale HBV or HCV screening in low-resource laboratories or low-to middle-income areas.

Vaccine uptake and immune responses to HBV infection amongst vaccinated and non-vaccinated healthcare workers, household and sexual contacts to chronically infected HBV individuals in the South West Region of Cameroon.

BackgroundHBV infection affects about 257 million people globally and Sub-Saharan Africa has the highest burden. The disease still constitutes a major public health problem despite the advent of preventive measures like the HBV vaccine. This study was aimed at identifying factors that influence vaccine uptake and the efficacy of administered vaccines among people at high risk of HBV infection.MethodsThis was a cross-sectional study conducted between January 2016 and December 2017. A pretested semi-structured questionnaire was used to capture information on sociodemographic and vaccination status from healthcare workers, household and sexual contacts to HBV infected people. HBV serological panel as well as quantitative anti-HBs ELISA test was done for all participants. Additional information was obtained from the institutions that administered the vaccines.ResultsA total of 265 participants with a mean age of 32.1±8.7 were enrolled. Eighty (30.2%) of them had received at least 1 dose of the HBV vaccine while 185 (69.8%) were unvaccinated. Healthcare workers were the most vaccinated (37%). Ignorance, negligence, fear of injection and the cost of the vaccine all contributed to poor vaccine uptake in the study population. Natural immunity was seen in 9 (3.4%) of the participants. Only 64.9% of the vaccinated participants attained the desirable level of anti-HBs (≥10mIU/ml) 1–2 months after ≥ 3 doses of the vaccine. Age, gender, obesity, alcohol and smoking were not significantly associated with poor immune responses. No standardized protocol was followed by the institutions administering the vaccine.ConclusionThis study revealed very poor vaccine uptake and poor immune responses to the HBV vaccine in the study population and this should urge the health sector in Cameroon to intensify their sensitization on HBV vaccine, standardize the protocol for storing and administering the vaccine, subsidize the cost of the vaccine especially amongst healthcare workers and encourage anti-HBs post vaccination testing.

Prophylactic hepatitis B immunization in chronic kidney disease patients, Oran, Algeria

Background It is estimated that > 2 billion people worldwide have been infected with HBV. Of these, approximately 360 million individuals are chronically infected and at-risk of serious illness and death, mainly from liver cirrhosis and hepatocellular carcinoma (HCC). Algeria is situated in areas of intermediate endemicity (prevalences of endemicity of HBsAg 2–7%). Patients suffering from chronic kidney disease (CKD) are at particular risk of infection with HBV, they are associated with reduced immunogenicity following vaccine administration. Because of that, these patients have been offered schedules containing more than 3 doses and larger doses of the vaccine (schedule containing 4 double doses of standard hepatitis B vaccine). Those found to have anti-HBs concentrations Aim Determine the efficacy of the four double doses schedule of hepatitis B vaccine in preventing infection up postvaccination of chronic renal failure patients. Patients and methods It is a retrospective descriptive study including 209 chronic kidney disease patients. All patients had received hepatitis B vaccine with follow-up at epidemiology service of Oran university hospital (EHUO), during a period 2011–2012. Patients have been offered immunization schedule containing double doses (40 μg) of monovalant recombinant hepatitis B vaccine. The primary immunization series consists of 4 doses of vaccine (at 0, 1, 2, 6 month) followed by anti-HBs testing. People who do not respond (anti-HBs antibody titres Results The average age of patients is 61.2 ± 1.1 years old with a sex ratio of 1.1. Non-dialyzed CKD patients accounted for 78.9%. Vaccine seroprotection was obtained in 82% of non-hemodialysis CKD patients and in 76% of CKD hemodialysis patients after primary vaccination. Nevertheless, 12% of non-hemodialysis CKD patients and 12.5% of CKD hemodialysis patients are low responders (10 ≤ AC-HBS Conclusion The four doses of 40 μg vaccine schedule has proven its effectiveness with good seroprotection in chronic kidney disease patients. The vaccination against hepatitis B represents a considerable advance in the prophylaxis of this disease but unfortunately no regulatory text governs this vaccination in CKD patients in our country. Early vaccination (before dialysis) is recommended.

Strategy to control occupational risk for Hepatitis B: impact on the vaccination and seroconversion rates in dentistry students

ABSTRACT Objective: To describe the development of a dentistry school strategy in order to reduce the occupational risk related to hepatitis B. Methods: The academic registration documents of 242 students entering the institution between the years 2006 and 2013, were evaluated, among which were of copies of the updated vaccination cards and anti-HBs serologic testing. Demographic variables and others related to the vaccination status of hepatitis B and seroconversion were considered. Results: One hundred percent of the students were found to be vaccinated, and 87.2% had vaccination records of three doses. The results of anti-HBs tests proved seroconversion in 91.3% of the students. From 2011, the dental school was able to institutionalize the follow-up behavior of the students who had anti-HBs non-reactive. Of the twenty individuals whose serology was negative, nine students (45% of the total and all of the 2011-2013 class) were followed-up and repeated the basic vaccination and anti-HBs test; eight seroconverted and one was considered a non-responder, increasing the percentage of immune students to 95%. Eleven (55%) had other unregistered behavior or the documents analyzed showed no data on them. Conclusion: The procedure of following-up the registration in vaccination records required by the Biosafety Committee of the institution was shown to be effective in reducing the occupational risk of hepatitis B among the students.

Will Infant Hepatitis B Vaccination Protect Into Adulthood?: Extended Canadian Experience After a 2-, 4- and 6-month Immunization Schedule.

Hepatitis B virus (HBV) vaccination programs generally target infants to prevent chronic HBV infection and/or preadolescents to reduce transmission in adulthood. To assess whether infant HBV immunization can potentially accomplish both objectives, we measured residual immunity 10-16 years after vaccination in Canadian children. A prospective, parallel group, single center study enrolled adolescents given HBV vaccine at 2, 4 and 6 months of age. Exclusion criteria included prior HBV infection and additional vaccinations. At follow-up anti-HBs testing, participants were 10-11 or 15-16 years old; those with <12 mIU/mL anti-HBs by the assay used were challenged with HBV vaccine to assess immune memory-based responsiveness. A total of 137 tested participants were 10-11 and 213 were 15-16 years old, respectively; none had evidence of prior HBV infection. At baseline, 78% of younger and 64% of older participants had <12 mIU/mL anti-HBs (P = 0.006) and were challenged with vaccine: 103/106 (97.2%) younger and 123/135 (91.1%) older participants developed ≥12 mIU/mL anti-HBs (P = 0.06), with geometric mean antibody concentration of 590 (95% confidence interval: 473-737) and 319 mIU/mL (95% confidence interval: 229-445; P = 0.004), respectively. Immune memory loss may have occurred in 3 younger (2.2%) and 12 older children (5.6%; P = 0.06) who were nonresponsive to first but not second vaccine challenge. After HBV vaccination at 2, 4 and 6 months of age, most adolescents had little or no residual antibody but nearly all responded to HBV challenge, confirming immune memory persistence. However, anamnestic responses were weaker in 15- to 16-year olds and lost in some. Booster responses in 10- to 11-year olds were vigorous in comparison. Extended evaluation of protection is warranted.