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 ORIGINAL ARTICLE
Year : 2015  |  Volume : 33  |  Issue : 5  |  Page : 32-36

Prevalence of non-responsiveness to an indigenous recombinant hepatitis B vaccine: A study among South Indian health care workers in a tertiary hospital


1 Department of Clinical Virology, Christian Medical College Hospital, Vellore, Tamil Nadu, India
2 Department of Staff and Students Health Services, Christian Medical College Hospital, Vellore, Tamil Nadu, India
3 Department of Immunohematololgy and Transfusion Medicine, Christian Medical College Hospital, Vellore, Tamil Nadu, India
4 Department of Gastrointestinal Sciences, Christian Medical College Hospital, Vellore, Tamil Nadu, India

Correspondence Address:
P Abraham
Department of Clinical Virology, Christian Medical College Hospital, Vellore, Tamil Nadu
India
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Source of Support: This study was supported by an intramural research grant (No. 6625) from the Christian Medical College, Vellore, Conflict of Interest: None


DOI: 10.4103/0255-0857.150877

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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 significantly associated with the highest quartile of body mass index (BMI) (P < 0.001). We found no significant 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 findings 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 influence 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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