Durability of Antibody Response Against Hepatitis B Virus in Healthcare Workers Vaccinated as Adults
Naveen Gara,Adil A. Abdalla,Elenita Rivera,Xiongce Zhao,JM Werner,T. Jake Liang,Jay H. Hoofnagle,Barbara Rehermann,Marc G. Ghany +8 more
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TLDR
The rapid and robust response to a booster vaccine suggests a long-lasting amnestic response and Hepatitis B vaccination provides long-term protection against hepatitis B and booster vaccination does not appear to be necessary in HCWs.Abstract:
The implementation of vaccination programs worldwide against hepatitis B virus (HBV) has reduced the morbidity and mortality of acute and chronic HBV infection and the incidence of hepatocellular carcinoma, particularly in endemic regions [1–3]. Vaccination against HBV consists of 3 or 4 intramuscular injections of recombinant hepatitis B surface antigen (HBsAg) at varying schedules [4]. Response rates to primary vaccination are high, with 85%–100% of vaccinees developing antibody to HBsAg (anti-HBs) ≥10 mIU/mL [5], a level that is considered protective [5–9]. Factors found to be associated with nonresponse include male sex, increasing age at vaccination (>40 years old), obesity, alcoholism, smoking, and genetic factors [10–12].
Asymptomatic breakthrough infections (detected by the presence of antibody to hepatitis B core antigen [anti-HBc] or HBV DNA in serum) have been reported in vaccinated persons with a documented initial antibody response [13, 14]. Long-term follow-up studies of persons who were vaccinated as infants have reported absence of anti-HBs in 50%–70% of persons 15–30 years later [13, 15–18]. In contrast, data on the longevity of immunity afforded by hepatitis B vaccine in a healthy adult population are scarce. The few available studies in young adults who initially responded to a past primary vaccine series with antibody concentrations of ≥10 mIU/mL reported that 17%–50% have low or undetectable anti-HBs (reflecting anti-HBs loss) 10–15 years after vaccination [14, 19]. Whether low or undetectable levels of anti-HBs predispose to subsequent infection is unknown. Moreover, whether individuals may respond to a hepatitis B vaccine booster to maintain long-term protection is unknown. Current guidelines do not recommend booster doses, but the duration of long-term protection is unknown [4, 20].
Healthcare workers (HCWs) in the United States are mandated to receive hepatitis B vaccine and are at risk for hepatitis B through occupational exposure. Therefore, they would be an ideal population to assess durability of antibody response and long-term (≥10 years) vaccine protection and to determine response to a booster dose in those who did not maintain the immune response to primary vaccination as adults.read more
Citations
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Successful return to professional men's football (soccer) competition after the COVID-19 shutdown: a cohort study in the German Bundesliga.
Tim Meyer,Dietrich Mack,Katrin Donde,Oliver Harzer,Werner Krutsch,Annika Rössler,Janine Kimpel,Dorothee von Laer,Barbara Gärtner +8 more
TL;DR: Professional football training and matches can be carried out safely during the COVID-19 pandemic despite strict hygiene measures including regular PCR testing, according to a medical perspective.
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Recent advances in vaccination of non-responders to standard dose hepatitis B virus vaccine
TL;DR: In summary, HBV vaccination is a major advance of modern medicine and all individuals at risk should be sought and vaccinated with subsequent adequate titers demonstrated.
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Antibody levels and protection after hepatitis B vaccination: Results of a 15-year follow-up
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The long-term immunogenicity of recombinant hepatitis B virus (HBV) vaccine: contribution of universal HBV vaccination in Italy.
Nicola Coppola,Anna Rita Corvino,Stefania De Pascalis,Giuseppe Signoriello,Eliana Di Fiore,Albert Nienhaus,Evangelista Sagnelli,Monica Lamberti +7 more
TL;DR: Universal HBV vaccination in Italy has been more effective in generating a prolonged protective response in subjects vaccinated at adolescence than in infancy, and students with a low anti-HBs titer should be considered for a booster dose.
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Significance of anti-HBc alone serological status in clinical practice.
TL;DR: According to specific guidelines, nucleoside analogue prophylaxis is recommended in anti-HBc-positive liver allograft recipients and anti- HBc alone individuals who receive chemotherapy or biological therapy and should be continued for 6-12 months after discontinuation of such immunosuppressive therapies to protect against HBV reactivation.
References
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Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children. Taiwan Childhood Hepatoma Study Group.
Mei-Hwei Chang,Chien-Jen Chen,Mei-Shu Lai,Hsu-Mei Hsu,Tzee-Chung Wu,Man-Shan Kong,Der-Cherng Liang,Wen-Yi Shau,Ding-Shinn Chen +8 more
TL;DR: The incidence of hepatocellular carcinoma in children in Taiwan from 1981 to 1994 has declined since the institution of Taiwan's program of universal hepatitis B vaccination, and the corresponding rates of mortality have decreased.
Journal Article
A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) Part II: immunization of adults.
Eric E. Mast,Cindy M. Weinbaum,Anthony E. Fiore,Miriam J. Alter,Beth P. Bell,Lyn Finelli,Lance Rodewald,John M. Douglas,Robert S. Janssen,John W. Ward +9 more
TL;DR: This report, the second of a two-part statement from the Advisory Committee on Immunization Practices (ACIP), provides updated recommendations to increase hepatitis B vaccination of adults at risk for HBV infection.
Journal ArticleDOI
Duration of humoral immunity to common viral and vaccine antigens.
TL;DR: Quantitative analysis of serologic memory for multiple antigens in subjects followed longitudinally over the course of more than one decade suggests that peripheral memory B cells and antibody-secreting plasma cells may represent independently regulated cell populations and may play different roles in the maintenance of protective immunity.
Journal ArticleDOI
Hepatitis B vaccine: demonstration of efficacy in a controlled clinical trial in a high-risk population in the United States.
Wolf Szmuness,Cladd E. Stevens,Edward J. Harley,Edith A. Zang,William R. Oleszko,Daniel C. William,Richard Sadovsky,John Morrison,Aaron Kellner +8 more
TL;DR: In this article, the efficacy of an inactivated hepatitis B vaccine in a randomized, double-blind trial in 1083 homosexual men known to be at high risk for hepatitis B virus infection was evaluated.
Journal ArticleDOI
Long-Term Immunogenicity and Efficacy of Hepatitis B Vaccine in Homosexual Men
Stephen C. Hadler,Donald P. Francis,James E. Maynard,Sumner E. Thompson,Franklyn N. Judson,Dean F. Echenberg,David G. Ostrow,Paul M. O'Malley,Kent A. Penley,Norman L. Altman,Erwin H. Braff,Gregory F. Shipman,Patrick J. Coleman,Eric J. Mandel +13 more
TL;DR: Both antibody loss and the risk of severe disease should be considered when booster-dose strategies for the hepatitis B vaccine are being designed.
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