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Hepatitis B vaccination alone is not adequate for the categorizing of adult subjects with isolated anti‐HBc
Author(s) -
CHAN CHOYU,
LEE SHOUDONG,
TSAI YANGTE,
LO KWANGJUEI
Publication year - 1995
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.1995.tb01077.x
Subject(s) - medicine , vaccination , hepatitis b , antibody , hepatitis b virus , titer , antigen , virology , vaccination schedule , immunology , hepatitis b vaccine , hepatitis , hbsag , virus , immunization
To evaluate the meaning of isolated antibody to hepatitis B core antigen (anti‐HBc), 88 Chinese subjects with isolated anti‐HBc received rescreening of hepatitis B virus (HBV) markers. Eighty (90.9%) of them were still positive for this antibody and 29 were also found to be positive for antibody to hepatitis B surface antigen (anti‐HBs). The remaining 51 subjects (58.0%) were positive for anti‐HBc alone; 50 of them received a four‐dose schedule of hepatitis B (HB) vaccine. After the initial dose, only one vaccinee disclosed an amnestic anti‐HBs response, that is, anti‐HBs titre > 1000 miu/mL. Forty‐five vaccinees completed the vaccination schedule and 44 (97.8%) had anti‐HBs response. The anti‐HBs responses in 25 of these vaccinees were compared with 25 age‐ and sex‐matched normal susceptible vaccinees. The anti‐HBs response rates in both groups were the same (96 vs 96%). However, the geometric mean titre was significantly lower in the vaccinees with isolated anti‐HBc (512 mIU/mL vs 4688 mIU/mL, P < 0.001). Prevaccinated sera were available in 49 vaccinees with isolated anti‐HBc for detection of antibody to hepatitis B e antigen (anti‐HBe) and HBV DNA; 37 (75.5%) of them had one or two of these markers. As we regarded the rescreening of HBV markers, response to hepatitis B vaccination and presence or absence of anti‐HBe and/or HBV DNA together for categorizing the 88 subjects with isolated anti‐HBc, at least three‐quarters of them had past infection of HBV. The subjects with false positive anti‐HBc test were a minor group. We concluded that the presence or absence of amnestic anti‐HBs response to HB vaccination is not a reliable indicator for categorizing subjects with isolated anti‐HBc. Rescreening of HBV markers, with addition of anti‐HBe and HBV DNA, may be helpful in determining the necessity of HB vaccination.