Immune response to hepatitis B vaccine in health-care workers

[Guest guest]

FULL TEXT:

http://www.sjkdt.org/article.asp?issn=1319-2442;year=2011;volume=22;issue=1;spag\

e=179;epage=184;aulast=Zamani

RENAL DATA FROM ASIA-AFRICA

Year : 2011 | Volume : 22 | Issue : 1 | Page : 179-184

Immune response to hepatitis B vaccine in health-care workers

Farhad Zamani1, Farahnaz Fallahian1, Forough Hashemi1, Zeinab Shamsaei1,

Seyed-Moayed Alavian2

1 Gastroenterintestinal and Liver Disease Research Center, Iran University of

Medical Sciences, Tehran, Iran

2 Baqiyatallah Research Center for Gastroenterology and Liver Disease, Firuzgar

Hospital, Tehran, Iran

Abstract

This study was performed to study the immune response to hepatitis B virus (HBV)

vaccine in health-care workers. Through a cross-sectional study, relevant

information and blood samples from 151 healthcare workers at the Firuzgar

hospital were studied. The age range of the study individuals was 20-59 years,

with the mean and standard deviation being 35.11 and 10.06, respectively. There

were 24 males (15.9%) and 127 females (84.1%). The mean and median of months

after HBV vaccination was 63.42 and 49.00, respectively. The mean and median of

anti­HBs titer in those who received HBV vaccination was 164.81 and 200 milli

international units per milliliter (mIU/mL), respectively. Of the 129

HBV-vaccinated subjects, 103 (68.2%) had anti­HBs titer >10 and 26 (17.2%) had

anti-HBs titer <10. There was no association between gender and anti-HBs titer,

but vaccination and adequate completion of its courses were associated with

higher anti-HBs titer (P < 0.05). Also, the logistic regression method showed

that the association between duration after vaccination and age with anti-HBs

titer was not statistically significant. Our study suggests that the HBV vaccine

immunization program had obtained excellent efficacy. There is need for further

investigation among subjects who are not vaccinated against HBV but are positive

for anti-HBs as well as in HBV-vaccinated subjects with low anti-HBs titers,

about possible low-level viremia and other causes of lower vaccine efficacy,

particularly in health-care workers.

How to cite this article:

Zamani F, Fallahian F, Hashemi F, Shamsaei Z, Alavian S. Immune response to

hepatitis B vaccine in health-care workers. Saudi J Kidney Dis Transpl

2011;22:179-84

How to cite this URL:

Zamani F, Fallahian F, Hashemi F, Shamsaei Z, Alavian S. Immune response to

hepatitis B vaccine in health-care workers. Saudi J Kidney Dis Transpl [serial

online] 2011 [cited 2011 Jan 17];22:179-84. Available from:

http://www.sjkdt.org/text.asp?2011/22/1/179/74350

Introduction

In a study, a model was developed to calculate the age-specific risk of

acquiring hepatitis B virus (HBV) infection, acute hepatitis B (ill­ness and

death) and progression to chronic HBV infection. The effect of hepatitis B

vacci­nation was calculated from vaccine efficacy and vaccination series

coverage, with and with­out the administration of the first dose of vac­cine

within 24 hours of birth (i.e., birth dose) to prevent perinatal HBV infection.

For the year 2000, the model estimated that 620,000 per­sons died worldwide from

HBV-related causes: 580,000 (94%) from chronic infection-related cirrhosis and

hapatocellular carcinoma and 40,000 (6%) from acute hepatitis B. In the

surviving birth cohort for the year 2000, the model estimated that, without

vaccination, 64.8 million would become HBV infected and 1.4 million would die

from HBV-related disease. Routine infant HBV vaccination, with 90% co­verage and

the first dose administered at birth, would prevent 84% of the global

HBV-related deaths. [1]

A mass campaign of immunization against hepatitis B was undertaken for those

born from 1989 to March 2007 in Iran. During this cam­paign, 1,320,000 people

were vaccinated and about 90% coverage was reached. Hepatitis B vaccination

takes years if not decades to show effectiveness in the community. In 2002,

con­sidering the country's health needs and prio­rities, the program also

recommended vacci­nating people with high-risk occupations like firefighters,

workers of city hall, etc. It was con­cluded that 12% of the first target group

was already vaccinated against HBV. The health infrastructure to expand the

coverage for more vaccination is accessible in Iran, and this ap­proach will

decrease the incidence rate in the Iranian population, especially if followed by

these considerations: educating the people, es­pecially the at-risk group;

implementing stra­tegies to prevent transmission to others and screening and

finding the patients in early stages and asymptomatic phase. [2]

Although protective anti-HBs response rates after HBV vaccination typically

exceed 90%, a number of factors can impede an adequate an­tibody response.

Smoking, obesity, injection into the buttock, chronic liver disease, presence of

human leukocyte antigens (HLA)-DR3, DR7 and DQ2 alleles, absence of the HLA-A2

allele and extremes of age may be associated with reduced immunogenicity. The

response rates are also lower in immunocompromised patients, such as transplant

recipients, patients receiving chemotherapy and those with end-stage liver

disease. Patients with chronic kidney disease should be vaccinated early in the

course of their disease, before the renal disease progresses, to ensure optimal

response to vaccination. [3]

In Iran, Cuban hepatitis B vaccine became available approximately in 1994 and

mass vac­cination of neonates and children was incor­porated in the national

vaccination scheme. [4] Healthcare workers (HCWs) are at a high risk of

acquiring HBV. The seroconversion rate after HBV vaccination in Pakistani HCWs

was similar to that reported in the western and neighboring populations. HCWs

with a reduced immune response to HBV vaccine in a high­disease-prevalent

population are at greater risk. Therefore, it is crucial to check

post-vacci­nation HBsAb in all the HCWs. This strategy will ensure safety at

work by reducing noso­comial transmission and will have a cost­effective impact

at an individual as well as a national level, which is very much desired in a

resource-limited country. [5]

In this manuscript, the immune response to HBV vaccine in HCWs at the Firuzgar

Hos­pital, who had been immunized by HBV vac­cine, is studied.

[Guest guest]

FULL TEXT:

http://www.sjkdt.org/article.asp?issn=1319-2442;year=2011;volume=22;issue=1;spag\

e=179;epage=184;aulast=Zamani

RENAL DATA FROM ASIA-AFRICA

Year : 2011 | Volume : 22 | Issue : 1 | Page : 179-184

Immune response to hepatitis B vaccine in health-care workers

Farhad Zamani1, Farahnaz Fallahian1, Forough Hashemi1, Zeinab Shamsaei1,

Seyed-Moayed Alavian2

1 Gastroenterintestinal and Liver Disease Research Center, Iran University of

Medical Sciences, Tehran, Iran

2 Baqiyatallah Research Center for Gastroenterology and Liver Disease, Firuzgar

Hospital, Tehran, Iran

Abstract

This study was performed to study the immune response to hepatitis B virus (HBV)

vaccine in health-care workers. Through a cross-sectional study, relevant

information and blood samples from 151 healthcare workers at the Firuzgar

hospital were studied. The age range of the study individuals was 20-59 years,

with the mean and standard deviation being 35.11 and 10.06, respectively. There

were 24 males (15.9%) and 127 females (84.1%). The mean and median of months

after HBV vaccination was 63.42 and 49.00, respectively. The mean and median of

anti­HBs titer in those who received HBV vaccination was 164.81 and 200 milli

international units per milliliter (mIU/mL), respectively. Of the 129

HBV-vaccinated subjects, 103 (68.2%) had anti­HBs titer >10 and 26 (17.2%) had

anti-HBs titer <10. There was no association between gender and anti-HBs titer,

but vaccination and adequate completion of its courses were associated with

higher anti-HBs titer (P < 0.05). Also, the logistic regression method showed

that the association between duration after vaccination and age with anti-HBs

titer was not statistically significant. Our study suggests that the HBV vaccine

immunization program had obtained excellent efficacy. There is need for further

investigation among subjects who are not vaccinated against HBV but are positive

for anti-HBs as well as in HBV-vaccinated subjects with low anti-HBs titers,

about possible low-level viremia and other causes of lower vaccine efficacy,

particularly in health-care workers.

How to cite this article:

Zamani F, Fallahian F, Hashemi F, Shamsaei Z, Alavian S. Immune response to

hepatitis B vaccine in health-care workers. Saudi J Kidney Dis Transpl

2011;22:179-84

How to cite this URL:

Zamani F, Fallahian F, Hashemi F, Shamsaei Z, Alavian S. Immune response to

hepatitis B vaccine in health-care workers. Saudi J Kidney Dis Transpl [serial

online] 2011 [cited 2011 Jan 17];22:179-84. Available from:

http://www.sjkdt.org/text.asp?2011/22/1/179/74350

Introduction

In a study, a model was developed to calculate the age-specific risk of

acquiring hepatitis B virus (HBV) infection, acute hepatitis B (ill­ness and

death) and progression to chronic HBV infection. The effect of hepatitis B

vacci­nation was calculated from vaccine efficacy and vaccination series

coverage, with and with­out the administration of the first dose of vac­cine

within 24 hours of birth (i.e., birth dose) to prevent perinatal HBV infection.

For the year 2000, the model estimated that 620,000 per­sons died worldwide from

HBV-related causes: 580,000 (94%) from chronic infection-related cirrhosis and

hapatocellular carcinoma and 40,000 (6%) from acute hepatitis B. In the

surviving birth cohort for the year 2000, the model estimated that, without

vaccination, 64.8 million would become HBV infected and 1.4 million would die

from HBV-related disease. Routine infant HBV vaccination, with 90% co­verage and

the first dose administered at birth, would prevent 84% of the global

HBV-related deaths. [1]

A mass campaign of immunization against hepatitis B was undertaken for those

born from 1989 to March 2007 in Iran. During this cam­paign, 1,320,000 people

were vaccinated and about 90% coverage was reached. Hepatitis B vaccination

takes years if not decades to show effectiveness in the community. In 2002,

con­sidering the country's health needs and prio­rities, the program also

recommended vacci­nating people with high-risk occupations like firefighters,

workers of city hall, etc. It was con­cluded that 12% of the first target group

was already vaccinated against HBV. The health infrastructure to expand the

coverage for more vaccination is accessible in Iran, and this ap­proach will

decrease the incidence rate in the Iranian population, especially if followed by

these considerations: educating the people, es­pecially the at-risk group;

implementing stra­tegies to prevent transmission to others and screening and

finding the patients in early stages and asymptomatic phase. [2]

Although protective anti-HBs response rates after HBV vaccination typically

exceed 90%, a number of factors can impede an adequate an­tibody response.

Smoking, obesity, injection into the buttock, chronic liver disease, presence of

human leukocyte antigens (HLA)-DR3, DR7 and DQ2 alleles, absence of the HLA-A2

allele and extremes of age may be associated with reduced immunogenicity. The

response rates are also lower in immunocompromised patients, such as transplant

recipients, patients receiving chemotherapy and those with end-stage liver

disease. Patients with chronic kidney disease should be vaccinated early in the

course of their disease, before the renal disease progresses, to ensure optimal

response to vaccination. [3]

In Iran, Cuban hepatitis B vaccine became available approximately in 1994 and

mass vac­cination of neonates and children was incor­porated in the national

vaccination scheme. [4] Healthcare workers (HCWs) are at a high risk of

acquiring HBV. The seroconversion rate after HBV vaccination in Pakistani HCWs

was similar to that reported in the western and neighboring populations. HCWs

with a reduced immune response to HBV vaccine in a high­disease-prevalent

population are at greater risk. Therefore, it is crucial to check

post-vacci­nation HBsAb in all the HCWs. This strategy will ensure safety at

work by reducing noso­comial transmission and will have a cost­effective impact

at an individual as well as a national level, which is very much desired in a

resource-limited country. [5]

In this manuscript, the immune response to HBV vaccine in HCWs at the Firuzgar

Hos­pital, who had been immunized by HBV vac­cine, is studied.

[Guest guest]

FULL TEXT:

http://www.sjkdt.org/article.asp?issn=1319-2442;year=2011;volume=22;issue=1;spag\

e=179;epage=184;aulast=Zamani

RENAL DATA FROM ASIA-AFRICA

Year : 2011 | Volume : 22 | Issue : 1 | Page : 179-184

Immune response to hepatitis B vaccine in health-care workers

Farhad Zamani1, Farahnaz Fallahian1, Forough Hashemi1, Zeinab Shamsaei1,

Seyed-Moayed Alavian2

1 Gastroenterintestinal and Liver Disease Research Center, Iran University of

Medical Sciences, Tehran, Iran

2 Baqiyatallah Research Center for Gastroenterology and Liver Disease, Firuzgar

Hospital, Tehran, Iran

Abstract

This study was performed to study the immune response to hepatitis B virus (HBV)

vaccine in health-care workers. Through a cross-sectional study, relevant

information and blood samples from 151 healthcare workers at the Firuzgar

hospital were studied. The age range of the study individuals was 20-59 years,

with the mean and standard deviation being 35.11 and 10.06, respectively. There

were 24 males (15.9%) and 127 females (84.1%). The mean and median of months

after HBV vaccination was 63.42 and 49.00, respectively. The mean and median of

anti­HBs titer in those who received HBV vaccination was 164.81 and 200 milli

international units per milliliter (mIU/mL), respectively. Of the 129

HBV-vaccinated subjects, 103 (68.2%) had anti­HBs titer >10 and 26 (17.2%) had

anti-HBs titer <10. There was no association between gender and anti-HBs titer,

but vaccination and adequate completion of its courses were associated with

higher anti-HBs titer (P < 0.05). Also, the logistic regression method showed

that the association between duration after vaccination and age with anti-HBs

titer was not statistically significant. Our study suggests that the HBV vaccine

immunization program had obtained excellent efficacy. There is need for further

investigation among subjects who are not vaccinated against HBV but are positive

for anti-HBs as well as in HBV-vaccinated subjects with low anti-HBs titers,

about possible low-level viremia and other causes of lower vaccine efficacy,

particularly in health-care workers.

How to cite this article:

Zamani F, Fallahian F, Hashemi F, Shamsaei Z, Alavian S. Immune response to

hepatitis B vaccine in health-care workers. Saudi J Kidney Dis Transpl

2011;22:179-84

How to cite this URL:

Zamani F, Fallahian F, Hashemi F, Shamsaei Z, Alavian S. Immune response to

hepatitis B vaccine in health-care workers. Saudi J Kidney Dis Transpl [serial

online] 2011 [cited 2011 Jan 17];22:179-84. Available from:

http://www.sjkdt.org/text.asp?2011/22/1/179/74350

Introduction

In a study, a model was developed to calculate the age-specific risk of

acquiring hepatitis B virus (HBV) infection, acute hepatitis B (ill­ness and

death) and progression to chronic HBV infection. The effect of hepatitis B

vacci­nation was calculated from vaccine efficacy and vaccination series

coverage, with and with­out the administration of the first dose of vac­cine

within 24 hours of birth (i.e., birth dose) to prevent perinatal HBV infection.

For the year 2000, the model estimated that 620,000 per­sons died worldwide from

HBV-related causes: 580,000 (94%) from chronic infection-related cirrhosis and

hapatocellular carcinoma and 40,000 (6%) from acute hepatitis B. In the

surviving birth cohort for the year 2000, the model estimated that, without

vaccination, 64.8 million would become HBV infected and 1.4 million would die

from HBV-related disease. Routine infant HBV vaccination, with 90% co­verage and

the first dose administered at birth, would prevent 84% of the global

HBV-related deaths. [1]

A mass campaign of immunization against hepatitis B was undertaken for those

born from 1989 to March 2007 in Iran. During this cam­paign, 1,320,000 people

were vaccinated and about 90% coverage was reached. Hepatitis B vaccination

takes years if not decades to show effectiveness in the community. In 2002,

con­sidering the country's health needs and prio­rities, the program also

recommended vacci­nating people with high-risk occupations like firefighters,

workers of city hall, etc. It was con­cluded that 12% of the first target group

was already vaccinated against HBV. The health infrastructure to expand the

coverage for more vaccination is accessible in Iran, and this ap­proach will

decrease the incidence rate in the Iranian population, especially if followed by

these considerations: educating the people, es­pecially the at-risk group;

implementing stra­tegies to prevent transmission to others and screening and

finding the patients in early stages and asymptomatic phase. [2]

Although protective anti-HBs response rates after HBV vaccination typically

exceed 90%, a number of factors can impede an adequate an­tibody response.

Smoking, obesity, injection into the buttock, chronic liver disease, presence of

human leukocyte antigens (HLA)-DR3, DR7 and DQ2 alleles, absence of the HLA-A2

allele and extremes of age may be associated with reduced immunogenicity. The

response rates are also lower in immunocompromised patients, such as transplant

recipients, patients receiving chemotherapy and those with end-stage liver

disease. Patients with chronic kidney disease should be vaccinated early in the

course of their disease, before the renal disease progresses, to ensure optimal

response to vaccination. [3]

In Iran, Cuban hepatitis B vaccine became available approximately in 1994 and

mass vac­cination of neonates and children was incor­porated in the national

vaccination scheme. [4] Healthcare workers (HCWs) are at a high risk of

acquiring HBV. The seroconversion rate after HBV vaccination in Pakistani HCWs

was similar to that reported in the western and neighboring populations. HCWs

with a reduced immune response to HBV vaccine in a high­disease-prevalent

population are at greater risk. Therefore, it is crucial to check

post-vacci­nation HBsAb in all the HCWs. This strategy will ensure safety at

work by reducing noso­comial transmission and will have a cost­effective impact

at an individual as well as a national level, which is very much desired in a

resource-limited country. [5]

In this manuscript, the immune response to HBV vaccine in HCWs at the Firuzgar

Hos­pital, who had been immunized by HBV vac­cine, is studied.

[Guest guest]

FULL TEXT:

http://www.sjkdt.org/article.asp?issn=1319-2442;year=2011;volume=22;issue=1;spag\

e=179;epage=184;aulast=Zamani

RENAL DATA FROM ASIA-AFRICA

Year : 2011 | Volume : 22 | Issue : 1 | Page : 179-184

Immune response to hepatitis B vaccine in health-care workers

Farhad Zamani1, Farahnaz Fallahian1, Forough Hashemi1, Zeinab Shamsaei1,

Seyed-Moayed Alavian2

1 Gastroenterintestinal and Liver Disease Research Center, Iran University of

Medical Sciences, Tehran, Iran

2 Baqiyatallah Research Center for Gastroenterology and Liver Disease, Firuzgar

Hospital, Tehran, Iran

Abstract

This study was performed to study the immune response to hepatitis B virus (HBV)

vaccine in health-care workers. Through a cross-sectional study, relevant

information and blood samples from 151 healthcare workers at the Firuzgar

hospital were studied. The age range of the study individuals was 20-59 years,

with the mean and standard deviation being 35.11 and 10.06, respectively. There

were 24 males (15.9%) and 127 females (84.1%). The mean and median of months

after HBV vaccination was 63.42 and 49.00, respectively. The mean and median of

anti­HBs titer in those who received HBV vaccination was 164.81 and 200 milli

international units per milliliter (mIU/mL), respectively. Of the 129

HBV-vaccinated subjects, 103 (68.2%) had anti­HBs titer >10 and 26 (17.2%) had

anti-HBs titer <10. There was no association between gender and anti-HBs titer,

but vaccination and adequate completion of its courses were associated with

higher anti-HBs titer (P < 0.05). Also, the logistic regression method showed

that the association between duration after vaccination and age with anti-HBs

titer was not statistically significant. Our study suggests that the HBV vaccine

immunization program had obtained excellent efficacy. There is need for further

investigation among subjects who are not vaccinated against HBV but are positive

for anti-HBs as well as in HBV-vaccinated subjects with low anti-HBs titers,

about possible low-level viremia and other causes of lower vaccine efficacy,

particularly in health-care workers.

How to cite this article:

Zamani F, Fallahian F, Hashemi F, Shamsaei Z, Alavian S. Immune response to

hepatitis B vaccine in health-care workers. Saudi J Kidney Dis Transpl

2011;22:179-84

How to cite this URL:

Zamani F, Fallahian F, Hashemi F, Shamsaei Z, Alavian S. Immune response to

hepatitis B vaccine in health-care workers. Saudi J Kidney Dis Transpl [serial

online] 2011 [cited 2011 Jan 17];22:179-84. Available from:

http://www.sjkdt.org/text.asp?2011/22/1/179/74350

Introduction

In a study, a model was developed to calculate the age-specific risk of

acquiring hepatitis B virus (HBV) infection, acute hepatitis B (ill­ness and

death) and progression to chronic HBV infection. The effect of hepatitis B

vacci­nation was calculated from vaccine efficacy and vaccination series

coverage, with and with­out the administration of the first dose of vac­cine

within 24 hours of birth (i.e., birth dose) to prevent perinatal HBV infection.

For the year 2000, the model estimated that 620,000 per­sons died worldwide from

HBV-related causes: 580,000 (94%) from chronic infection-related cirrhosis and

hapatocellular carcinoma and 40,000 (6%) from acute hepatitis B. In the

surviving birth cohort for the year 2000, the model estimated that, without

vaccination, 64.8 million would become HBV infected and 1.4 million would die

from HBV-related disease. Routine infant HBV vaccination, with 90% co­verage and

the first dose administered at birth, would prevent 84% of the global

HBV-related deaths. [1]

A mass campaign of immunization against hepatitis B was undertaken for those

born from 1989 to March 2007 in Iran. During this cam­paign, 1,320,000 people

were vaccinated and about 90% coverage was reached. Hepatitis B vaccination

takes years if not decades to show effectiveness in the community. In 2002,

con­sidering the country's health needs and prio­rities, the program also

recommended vacci­nating people with high-risk occupations like firefighters,

workers of city hall, etc. It was con­cluded that 12% of the first target group

was already vaccinated against HBV. The health infrastructure to expand the

coverage for more vaccination is accessible in Iran, and this ap­proach will

decrease the incidence rate in the Iranian population, especially if followed by

these considerations: educating the people, es­pecially the at-risk group;

implementing stra­tegies to prevent transmission to others and screening and

finding the patients in early stages and asymptomatic phase. [2]

Although protective anti-HBs response rates after HBV vaccination typically

exceed 90%, a number of factors can impede an adequate an­tibody response.

Smoking, obesity, injection into the buttock, chronic liver disease, presence of

human leukocyte antigens (HLA)-DR3, DR7 and DQ2 alleles, absence of the HLA-A2

allele and extremes of age may be associated with reduced immunogenicity. The

response rates are also lower in immunocompromised patients, such as transplant

recipients, patients receiving chemotherapy and those with end-stage liver

disease. Patients with chronic kidney disease should be vaccinated early in the

course of their disease, before the renal disease progresses, to ensure optimal

response to vaccination. [3]

In Iran, Cuban hepatitis B vaccine became available approximately in 1994 and

mass vac­cination of neonates and children was incor­porated in the national

vaccination scheme. [4] Healthcare workers (HCWs) are at a high risk of

acquiring HBV. The seroconversion rate after HBV vaccination in Pakistani HCWs

was similar to that reported in the western and neighboring populations. HCWs

with a reduced immune response to HBV vaccine in a high­disease-prevalent

population are at greater risk. Therefore, it is crucial to check

post-vacci­nation HBsAb in all the HCWs. This strategy will ensure safety at

work by reducing noso­comial transmission and will have a cost­effective impact

at an individual as well as a national level, which is very much desired in a

resource-limited country. [5]

In this manuscript, the immune response to HBV vaccine in HCWs at the Firuzgar

Hos­pital, who had been immunized by HBV vac­cine, is studied.