Prevalence of non-responsiveness to an indigenous recombinant hepatitis B vaccine: A study among South Indian health care workers in a tertiary hospital.
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Date
2015-02
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Abstract
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 AxSYM AUSAB, (Abbott, Germany). HLA typing was done using SSP-PCR assay
AllSet+™ Gold SSP (Invitrogen, USA). Results: The overall seroconversion rate (anti-HBs > 10 mIU/mL) was 98.89%
wherein 90.8% had titers >1000mIU/mL, 7.6% had titers 100–1000mIU/mL, 0.43% had titers < 100 mIU/mL and 1.1%
were non-responsive (<10 mIU/mL) to the initial 3-dose regimen. Antibody titers <1000 mIU/mL were signifi cantly
associated with the highest quartile of body mass index (BMI) (P < 0.001). We found no signifi cant difference in
seroprotection rate between gender (P = 0.088). There was no difference in seroprotection rates among various ethnic
groups (P = 0.62). Subjects who were non-responsive in our study had at least one HLA allele earlier known to be
associated with non-responsiveness to the vaccine. Conclusion: Our fi ndings 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 infl uence the level of anti-HBs titers. We recommend the use of this cost
effective HBV vaccine as well as postvaccination anti-HBs testing to prevent HAHI among HCWs.
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Keywords
Hepatitis B vaccine, health care workers, non-responders
Citation
Thomas R J, Fletcher G J, Kirupakaran H, Chacko M P, Thenmozhi S, Eapen C E, Chandy G, Abraham P. Prevalence of non-responsiveness to an indigenous recombinant hepatitis B vaccine: A study among South Indian health care workers in a tertiary hospital. Indian Journal of Medical Microbiology. 2015 Feb ; 33 (5_Suppl):s32-36.