significance of response to hepatitis b recombinant vaccine in subjects with isolated antibody to hepatitis b core antigen
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abstract
background it is important to differentiate whether isolated anti-hbc is due to false positive results or the prior exposure to hepatitis b virus, because individuals with false-positive anti-hbc can benefit from vaccination and their blood can be safely transfused. to distinguish between these two conditions, we evaluated the serologic response to hepatitis b vaccine. methods ninety subjects with isolated anti-hbc (cases) and 100 subjects with totally negative hepatitis b serologic markers (controls) were recruited to receive three doses of hepatitis-b (hb) vaccine. thirty days after the first dose of the vaccine, anti-hbs titers were checked and individuals with anti-hbs titer >50 miu/ml did not receive additional doses of the vaccine. however, others completed the vaccination course, and another blood sample was collected 30 days after the third dose to measure anti-hbs level. results nineteen (21.1%) cases and three (3%) controls had no sero-conversion (anti-hbs titers <10 miu/ml) 30 days after the third dose ( p <0.0001). primary response, defined as the development of anti-hbs antibody titers ≥10 miu/ml 30 days after the third dose, was observed in 43 (47.8%) cases and 92 (92%) controls ( p <0.0001). also, 31.1% of cases developed anti-hbs titers ≥ 50 miu/ml 30 days after the first dose of vaccine, but the rate was significantly lower (5%) in the control group ( p <0.0001). furthermore, half of the individuals with positive isolated anti-hbc developed protective levels of anti-hbs after three doses of hb vaccination. conclusion more than 75% of individuals with positive isolated anti-hbc can benefit from vaccination and can be included in donor pool. also, one fifth seemed to have occult hbv infection. so hb vaccination may be used as a diagnostic tool for clarifying the situation of the subjects with isolated anti-hbc.
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Journal title:
middle east journal of digestive diseasesجلد ۷، شماره ۴، صفحات ۲۳۴-۰
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