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Lall M, Sen S, Patrikar S, Karade S, Gupta R. Post vaccination antibody titres of hepatitis B surface antigen (anti-HBs) in a mixed cohort of health care workers. Med J Armed Forces India 2022; 78:198-203. [PMID: 35463555 PMCID: PMC9023541 DOI: 10.1016/j.mjafi.2020.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 11/23/2020] [Indexed: 02/08/2023] Open
Abstract
Background Hepatitis B (HepB) is an important vaccine preventable infection among healthcare workers (HCWs). Vaccination against Hep B virus, remains the foremost preventive approach. This study aims to measure the antibody titres to Hep B surface antigen (anti-HBs) in a mixed cohort of HCWs. It also aims to study the association between time since vaccination and the anti-HBs titres thus evaluating the duration of seroprotection. Methods A total of 200 HCWs, including nursing students (n = 112), nursing staff (n = 49), laboratory technicians (n = 30) and doctors (n = 9) who had received all three doses of the Hep B vaccine and met the inclusion criteria of having taken all three doses of vaccine were included in this study. Anti-HBs titres were estimated by bioMérieux mini VIDAS® automated immunoassay based on the principle of enzyme-linked fluorescence assay. Results Two hundred subjects aged 19 to 52 years were included in the study; mean age was 27.29 ± 0.568 years. Duration since vaccination in the study cohort was ≤ 5 years in 149 (74.5.0%), 6-10 years in 20 (10.0%) and >10 years in 31 (15.5%) subjects. Postvaccination antibody titres were > 100 mIU/ml in 85.0%, 10-100 mIU/ml in 11.0% and ≤ 10 mIU/ml in 3.5%. There was a decline noted in antibody titres as duration after vaccination increased. Increasing age was associated with falling protective titres. Conclusion The study revealed that majority of the HCWs had adequate anti-HBs titres and were protected after vaccination.
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Doi H, Kanto T. Factors influencing the durability of hepatitis B vaccine responses. Vaccine 2021; 39:5224-5230. [PMID: 34340855 DOI: 10.1016/j.vaccine.2021.07.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 11/20/2020] [Accepted: 07/05/2021] [Indexed: 12/15/2022]
Abstract
The World Health Organization recommends the implementation of universal hepatitis B (HB) vaccination, and global coverage for this vaccine reached 84% in 2015. In Japan, the policy aimed at preventing mother-to-child transmission of HB virus (HBV) initially commenced as a specific vaccination program for infants born to mothers who were positive for HB surface antigen. In 2016, universal HB vaccination was implemented in this country to cover unvaccinated individuals at risk of horizontal HBV transmission. Although HB vaccination has been shown to be highly efficacious and safe, the issues of vaccine non-responders and of the loss of antibodies directed against HB surface antigen (anti-HBs) in HB vaccine recipients remain. To gain better insight into these problems, we previously performed an immunological analysis on adult vaccine recipients after they received an initial HB vaccination. We found that the course of successful HB vaccination is composed of the following distinct phases: 1) acquisition of anti-HBs antibody, 2) attainment of high anti-HBs antibody titers, and 3) maintenance of acquired anti-HBs antibody levels. In this review, we describe the significance of HB vaccination and suggest a potential means of improving the impact of HB vaccination based on our immunological analysis.
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Affiliation(s)
- Hiroyoshi Doi
- Department of Gastroenterology and Hepatology, Shin-yurigaoka General Hospital, 255 Furusawa Asao-ku, Kawasaki, Kanagawa 215-0026, Japan; The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, 1-7-1 Konodai, Ichikawa, Chiba 272-8516, Japan; Division of Gastroenterology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan.
| | - Tatsuya Kanto
- The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, 1-7-1 Konodai, Ichikawa, Chiba 272-8516, Japan.
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La Fauci V, Riso R, Facciolà A, Ceccio C, Lo Giudice D, Calimeri S, Squeri R. Response to anti-HBV vaccine and 10-year follow-up of antibody levels in healthcare workers. Public Health 2016; 139:198-202. [PMID: 27600791 DOI: 10.1016/j.puhe.2016.08.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 07/14/2016] [Accepted: 08/08/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Despite improvements in public health and antiviral treatments, vaccination is still the most effective means of prevention of hepatitis B virus (HBV) infection. However, little is known about the duration of protection given by the anti-HBV vaccine. Healthcare workers represent a category at risk not only of contracting infection but also of being a source of contagion to patients. OBJECTIVES To assess individual responses to the anti-HBV vaccine and duration of protection 10 years after its administration in a cohort of healthcare workers employed by the University Hospital 'G. Martino' in Messina, Italy. METHODS One hundred and seventy medical staff who had been vaccinated following an incident carrying risk of HBV infection were included in this study. The group was followed over a 10-year period, and HBV antibody levels were assessed using an automated microparticle enzyme immunoassay. RESULTS Protective antibody levels (≥10 mIU/ml) were found in 65% of subjects who had completed the full vaccine schedule (three doses) and in 35% of subjects who had only received one or two doses of anti-HBV vaccine. Moreover, 10 years after vaccination, HBV antibody levels were inversely related to age at vaccination (P < 0.001). No differences were found between males and females. CONCLUSIONS This study, in line with the literature, shows the importance of completing the full vaccine schedule (three doses). Moreover, in order to have an effective and durable antibody response and avoid the risk of contracting HBV after an injury at work, it is important to recommend anti-HBV vaccination at a young age, ideally during childhood in accordance with the national vaccination policy.
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Affiliation(s)
- V La Fauci
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
| | - R Riso
- Postgraduate Medical School in Hygiene and Preventive Medicine, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - A Facciolà
- Postgraduate Medical School in Hygiene and Preventive Medicine, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - C Ceccio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - D Lo Giudice
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - S Calimeri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - R Squeri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
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Yang S, Tian G, Cui Y, Ding C, Deng M, Yu C, Xu K, Ren J, Yao J, Li Y, Cao Q, Chen P, Xie T, Wang C, Wang B, Mao C, Ruan B, Jiang T, Li L. Factors influencing immunologic response to hepatitis B vaccine in adults. Sci Rep 2016; 6:27251. [PMID: 27324884 PMCID: PMC4914839 DOI: 10.1038/srep27251] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 05/12/2016] [Indexed: 12/15/2022] Open
Abstract
Hepatitis B was still a worldwide health problem. This study aimed to conducted a systematic review and meta-analysis to assess a more precise estimation of factors that influence the response to hepatitis B vaccine in adults. Our included studies examined seroprotection rates close to the end of vaccination schedules in healthy adult populations. This meta-analysis including 21053 adults in 37 articles showed that a significantly decreased response to hepatitis B vaccine appeared in adults (age ≥ 40) (RR:1.86, 95% CI:1.55–2.23), male adults (RR:1.40, 95% CI:1.22–1.61), BMI ≥ 25 adults (RR:1.56, 95% CI:1.12–2.17), smoker (RR:1.53, 95% CI:1.21–1.93), and adults with concomitant disease (RR:1.39, 95% CI:1.04–1.86). Meanwhile, we further found a decreased response to hepatitis B vaccine appeared in adults (age ≥ 30) (RR:1.77, 95% CI:1.48–2.10), and adults (age ≥ 60) (RR:1.30, 95% CI:1.01–1.68). However, there were no difference in response to hepatitis B vaccine both in alcoholic (RR:0.90, 95% CI:0.64–1.26) and 0-1-12 vs. 0-1-6 vaccination schedule (RR:1.39, 95% CI:0.41–4.67). Pooling of these studies recommended the sooner the better for adult hepatitis B vaccine strategy. More vaccine doses, supplemental/additional strengthening immunity should be emphasized on the susceptible population of increasing aged, male, BMI ≥ 25, smoking and concomitant disease. The conventional 0-1-6 vaccination schedule could be still worth to be recommended.
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Affiliation(s)
- Shigui Yang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Guo Tian
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Yuanxia Cui
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Cheng Ding
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Min Deng
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Chengbo Yu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Kaijin Xu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Jingjing Ren
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Jun Yao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Yiping Li
- Zhejiang Institute of Medical-care Information Technology, Hangzhou 311112, China
| | - Qing Cao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Ping Chen
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Tiansheng Xie
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Chencheng Wang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Bing Wang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Chen Mao
- Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, Hong Kong, The Chinese University of Hong Kong, China.,Shenzhen Municipal Key Laboratory for Health Risk Analysis, Shenzhen Research Institute of The Chinese University of Hong Kong Shenzhen, Guangdong ProvinceChina
| | - Bing Ruan
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Tian'an Jiang
- Department of Ultrasound, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Lanjuan Li
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
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Grosso G, Mistretta A, Marventano S, Ferranti R, Mauro L, Cunsolo R, Proietti L, Malaguarnera M. Long-term persistence of seroprotection by hepatitis B vaccination in healthcare workers of southern Italy. HEPATITIS MONTHLY 2012; 12:e6025. [PMID: 23087756 PMCID: PMC3475028 DOI: 10.5812/hepatmon.6025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Revised: 05/17/2012] [Accepted: 07/28/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND The impact of hepatitis B virus (HBV) vaccination campaigns on HBV epidemiology needs to be evaluated, in order to assess the long-term immunity offered by vaccines against HBV. OBJECTIVES To evaluate the current status of anti-HBV vaccine coverage among healthcare workers (HCWs) in Southern Italy, and to determine the long-term persistence of antibodies to hepatitis B surface antigens (anti-HBs) in such a cohort of subjects. PATIENTS AND METHODS A longitudinal, retrospective seroepidemiological survey was conducted among 451 HCWs, who were working at or visiting, the Occupational Health Department of a city hospital, in Catania, Italy, between January 1976 and December 2010. RESULTS At the 30-year follow-up (mean follow-up 10.15 ± 5.96 years, range 0.74-30), 261 HCWs had detectable anti-HBs titers indicating a persistence of seroprotection of 89.4% (out of 292 anti-HBs positive results, three months after vaccination). An inadequate vaccination schedule was the strongest predictor of antibody loss during follow-up (OR = 8.37 95% CI: 5.41-12.95, P < 0.001). A Kaplan-Maier survival curve revealed that the persistence of anti-HBs 30 years after vaccination, was 92.2% for high responders, while it was only 27.3% for low responders (P = 0.001). CONCLUSIONS A good level of seroprotection persisted in 57.9% of the subjects after 30 years. Factors related to this immunization status confirmed the importance of vaccinating HCWs early in their careers and ensuring an adequate vaccination schedule. However, with particular reference to the low rate of hepatitis B vaccine coverage among HCWs in Southern Italy, the implementation of a new educational intervention as part of an active vaccination program is needed.
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Affiliation(s)
- Giuseppe Grosso
- G.F. Ingrassia Department, Section of Hygiene and Public Health, University of Catania, Catania, Italy
| | - Antonio Mistretta
- G.F. Ingrassia Department, Section of Hygiene and Public Health, University of Catania, Catania, Italy
- Corresponding author: Antonio Mistretta, G.F. Ingrassia Department, Section of Hygiene and Public Health, University of Catania, Via Santa Sofia 87, 95123, Catania, Italy. Tel.: +39-953782182, Fax: +39-953782177, E-mail:
| | - Stefano Marventano
- G.F. Ingrassia Department, Section of Hygiene and Public Health, University of Catania, Catania, Italy
| | - Roberta Ferranti
- G.F. Ingrassia Department, Section of Hygiene and Public Health, University of Catania, Catania, Italy
| | - Luisa Mauro
- G.F. Ingrassia Department, Section of Hygiene and Public Health, University of Catania, Catania, Italy
| | - Rosario Cunsolo
- Rosario Cunsolo, Vittorio Emanuele Hospital of Catania Health Direction, Catania, Italy
| | - Lidia Proietti
- Department of Internal Medicine and Systemic Diseases, University of Catania, Catania, Italy
| | - Mariano Malaguarnera
- The Great Senescence Research Center, University of Catania, Ospedale Cannizzao, Catania, Italy
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Chaudhari CN, Bhagat MR, Shah T, Misra RN. Antibody to Hepatitis B Surface Antigen in Vaccinated Health Care Workers. Med J Armed Forces India 2008; 64:329-32. [PMID: 27688569 PMCID: PMC5035263 DOI: 10.1016/s0377-1237(08)80013-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2007] [Accepted: 01/26/2008] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Health care workers (HCWs) in Armed Forces are immunised against Hepatitis B virus (HBV), however they are not subjected to anti-HBs (antibody to Hepatitis B surface antigen) assessment after primary vaccination. The present study was undertaken to determine the protection offered by HBV vaccine in HCW. METHODS Cross-sectional study was carried out at tertiary care hospital. A total 146 HBV vaccine compliant HCW were evaluated for quantitative anti-HBs by enzyme immune assay. RESULT 129 (88.4%) subjects had protective levels of anti-HBs. Higher age at vaccination was an important risk factor in low vaccine response. Decline in anti-HBs with time was evident. Anti-HBs levels were more than 10mIU/ml in subjects even after 11 years of primary vaccination. There was no difference in protection in booster and non booster groups. CONCLUSION Age is the most important factor in HBV vaccine response. Booster dose of HBV vaccine is not necessary in healthy HCW for atleast ten years after primary vaccination. The study recommends early primary vaccination of HCW and 'initial' anti-HBs assay for confirmation of vaccine response.
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Affiliation(s)
- CN Chaudhari
- Classified Specialist (Microbiology), INHS Jeevanti, Vasco-Da-Gama-403802
| | - MR Bhagat
- Senior Advisor (Medicine & Gastroenterology), Command Hospital (CC), Lucknow
| | - T Shah
- Microbiologist, Yashoda Hospital, Hyderabad
| | - RN Misra
- Commanding Officer, INHS Kalyani, Visakhapatnam
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Komarova NL. Viral reproductive strategies: How can lytic viruses be evolutionarily competitive? J Theor Biol 2007; 249:766-84. [PMID: 17945261 DOI: 10.1016/j.jtbi.2007.09.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2007] [Revised: 09/08/2007] [Accepted: 09/10/2007] [Indexed: 10/22/2022]
Abstract
Viral release strategies can be roughly classified as lytic (the ones that accumulate inside the host cell and exit in a burst, killing the cell), and budding (the ones that are produced and released from the host cell gradually). Here we study the evolutionary competition between the two strategies. If all the parameters, such as the rate of viral production, cell life-span and the neutralizing capacity of the antibodies, were the same for lytic and budding viruses, the budding life-strategy would have a large evolutionary advantage. The question arises what makes lytic viruses evolutionarily competitive. We propose that it is the different removal capacity of the antibodies against budding and lytic virions. The latter exit the cell in a large burst such that the antibodies are "flooded" and a larger proportion of virions can escape the immune system and spread to new cells. We create two spatial models of virus-antibody interaction and show that for realistic parameter values, the effect of antibody flooding can indeed take place. We also argue that the lytic life cycle, including a relatively large burst-size, has evolved to promote survival in the face of antibody attack. According to the calculations, in the absence of efficient antibodies, the optimal burst size of lytic viruses would be only a few virus particles, as opposed to the observed 10(2)-10(5) viral particles. Similarly, there is an evolutionary pressure to extend the life-span as a response to antibody action.
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Affiliation(s)
- Natalia L Komarova
- Department of Mathematics, University of California, Irvine, CA 92697, USA.
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