Evaluation of Immune Response to Hepatitis B Vaccine in Health Care Workers at a Tertiary Care Hospital in Pakistan: an Observational Prospective Study

Overview

Journal BMC Infect Dis

Publisher Biomed Central

Specialty Infectious Diseases

Date 2007 Oct 27

PMID 17961205

Citations 24

Authors

Mohammad Zeeshan

Kauser Jabeen

Anita Nausheen Akbar Ali

Ailia Wilayat Ali

Saadia Z Farooqui

Vikram Mehraj

Afia Zafar

Affiliations

Soon will be listed here.

Abstract

Background: Seroconversion rates reported after Hepatitis B virus (HBV) vaccination globally ranges from 85-90%. Health care workers (HCWs) are at high risk of acquiring HBV and non responders' rates after HBV vaccination were not reported previously in Pakistani HCWs. Therefore we evaluated immune response to HBV vaccine in HCWs at a tertiary care hospital in Karachi, Pakistan.

Methods: Descriptive observational study conducted at Aga Khan University from April 2003 to July 2004. Newly HBV vaccinated HCWs were evaluated for immune response by measuring serum Hepatitis B surface antibody (HBsAb) levels, 6 weeks post vaccination.

Results: Initially 666 employees were included in the study. 14 participants were excluded due to incomplete records. 271 (41%) participants were females and 381(59%) were males. Majority of the participants were young (<25-39 years old), regardless of gender. Out of 652 HCWs, 90 (14%) remained seronegative after six weeks of post vaccination. The percentage of non responders increased gradually from 9% in participants of <25, 13% in 25-34, 26% in 35-49, and 63% in >50 years of age. Male non responders were more frequent (18%) than female (8%).

Conclusion: Seroconversion rate after HBV vaccination in Pakistani HCWs was similar to that reported in western and neighboring population. HCWs with reduced immune response to HBV vaccine in a high disease prevalent population are at great risk. Therefore, it is crucial to check post vaccination HBsAb in all HCWs. This strategy will ensure safety at work by reducing nosocomial transmission and will have a cost effective impact at an individual as well as at national level, which is very much desired in a resource limited country.

Citing Articles

Immune response to GeneVac-B (rDNA I.P. hepatitis B vaccine) in vaccinated persons with a standard schedule in Bobo-Dioulasso, Burkina Faso.

Ouattara N, Sanou A, Napon-Zongo D, Coulibaly A, Korogho S, Dera A IJID Reg. 2024; 13:100483.

PMID: 39639948 PMC: 11618024. DOI: 10.1016/j.ijregi.2024.100483.

Evaluating the Status of Hepatitis B Vaccination in Healthcare Workers at a Central Laboratory in a Tertiary Care Hospital and Research Centre.

Karigoudar R, Wavare S, Bagali S, Shahapur P, Karigoudar M, Sajjan A Cureus. 2024; 16(8):e68069.

PMID: 39347170 PMC: 11438526. DOI: 10.7759/cureus.68069.

Evaluation of Immune Characteristics and Factors Associated with Immune Response following Hepatitis B Vaccination among Ghanaian Adolescents.

Sakyi S, Badu Gyapong J, Aidoo E, Effah A, Koffie S, Mensah O Adv Virol. 2024; 2024:9502939.

PMID: 38827254 PMC: 11142859. DOI: 10.1155/2024/9502939.

Sex-Differential and Non-specific Effects of Vaccines Over the Life Course.

St Clair L, Chaulagain S, Klein S, Benn C, Flanagan K Curr Top Microbiol Immunol. 2023; 441:225-251.

PMID: 37695431 PMC: 10917449. DOI: 10.1007/978-3-031-35139-6_9.

Factors associated with immunization against hepatitis B among primary health care professionals.

Mota G, Fernandes L, Fonseca L, Ferreira M, Mendes V, Lima C Rev Bras Med Trab. 2023; 20(4):563-573.

PMID: 37101436 PMC: 10124812. DOI: 10.47626/1679-4435-2022-790.

References

Ni Y, Chang M, Huang L, Chen H, Hsu H, Chiu T . Hepatitis B virus infection in children and adolescents in a hyperendemic area: 15 years after mass hepatitis B vaccination. Ann Intern Med. 2001; 135(9):796-800. DOI: 10.7326/0003-4819-135-9-200111060-00009. View

Wood R, MacDonald K, White K, Hedberg C, Hanson M, Osterholm M . Risk factors for lack of detectable antibody following hepatitis B vaccination of Minnesota health care workers. JAMA. 1993; 270(24):2935-9. View

Platkov E, Shlyakhov E, Glick Y, Khalemsky S, Fischbein A . Immunologic evaluation of hepatitis B vaccine application in hospital staff. Int J Occup Med Environ Health. 2003; 16(3):249-53. View

Jack A, Hall A, Maine N, Mendy M, Whittle H . What level of hepatitis B antibody is protective?. J Infect Dis. 1999; 179(2):489-92. DOI: 10.1086/314578. View

Averhoff F, Mahoney F, Coleman P, Schatz G, HURWITZ E, Margolis H . Immunogenicity of hepatitis B Vaccines. Implications for persons at occupational risk of hepatitis B virus infection. Am J Prev Med. 1998; 15(1):1-8. DOI: 10.1016/s0749-3797(98)00003-8. View

Shrestha S, Bhattarai M . Study of hepatitis B among different categories of health care workers. J Coll Physicians Surg Pak. 2006; 16(2):108-11. DOI: 2.2006/JCPSP.108111. View

Yen Y, Chen C, Wang J, Lee C, Changchien C, Lu S . Study of hepatitis B (HB) vaccine non-responsiveness among health care workers from an endemic area (Taiwan). Liver Int. 2005; 25(6):1162-8. DOI: 10.1111/j.1478-3231.2005.01157.x. View

Lanphear B, Linnemann Jr C, CANNON C, DeRonde M . Decline of clinical hepatitis B in workers at a general hospital: relation to increasing vaccine-induced immunity. Clin Infect Dis. 1993; 16(1):10-4. DOI: 10.1093/clinids/16.1.10. View

. Immunization of health-care workers: recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee (HICPAC). MMWR Recomm Rep. 1998; 46(RR-18):1-42. View

10.

Mahoney F, Stewart K, Hu H, Coleman P, Alter M . Progress toward the elimination of hepatitis B virus transmission among health care workers in the United States. Arch Intern Med. 1998; 157(22):2601-5. View

11.

Rosen E, Rudensky B, Paz E, Isacsohn M, Jerassi Z, Gottehrer N . Ten-year follow-up study of hepatitis B virus infection and vaccination status in hospital employees. J Hosp Infect. 1999; 41(3):245-50. DOI: 10.1016/s0195-6701(99)90023-3. View

12.

Saberifiroozi M, Gholamzadeh S, Serati A . The long-term immunity among health care workers vaccinated against hepatitis B virus in a large referral hospital in southern Iran. Arch Iran Med. 2006; 9(3):204-7. View

13.

Louther J, Feldman J, Rivera P, Villa N, DeHovitz J, Sepkowitz K . Hepatitis B vaccination program at a New York City hospital: seroprevalence, seroconversion, and declination. Am J Infect Control. 1998; 26(4):423-7. DOI: 10.1016/s0196-6553(98)70039-2. View

14.

Mujeeb S, Khatri Y, Khanani R . Frequency of parenteral exposure and seroprevalence of HBV, HCV, and HIV among operation room personnel. J Hosp Infect. 1998; 38(2):133-7. DOI: 10.1016/s0195-6701(98)90066-4. View

15.

Roome A, Walsh S, Cartter M, Hadler J . Hepatitis B vaccine responsiveness in Connecticut public safety personnel. JAMA. 1993; 270(24):2931-4. View

16.

Kane A, Lloyd J, Zaffran M, Simonsen L, Kane M . Transmission of hepatitis B, hepatitis C and human immunodeficiency viruses through unsafe injections in the developing world: model-based regional estimates. Bull World Health Organ. 1999; 77(10):801-7. PMC: 2557740. View

17.

Dannetun E, Tegnell A, Torner A, Giesecke J . Coverage of hepatitis B vaccination in Swedish healthcare workers. J Hosp Infect. 2006; 63(2):201-4. DOI: 10.1016/j.jhin.2006.01.014. View

18.

Ali N, Jamal K, Qureshi R . Hepatitis B vaccination status and identification of risk factors for hepatitis B in health care workers. J Coll Physicians Surg Pak. 2005; 15(5):257-60. DOI: 05.2005/JCPSP.257260. View

19.

Hollinger F . Factors influencing the immune response to hepatitis B vaccine, booster dose guidelines, and vaccine protocol recommendations. Am J Med. 1989; 87(3A):36S-40S. DOI: 10.1016/0002-9343(89)90530-5. View

20.

Gunson R, Shouval D, Roggendorf M, Zaaijer H, Nicholas H, Holzmann H . Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in health care workers (HCWs): guidelines for prevention of transmission of HBV and HCV from HCW to patients. J Clin Virol. 2003; 27(3):213-30. DOI: 10.1016/s1386-6532(03)00087-8. View