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HBV seroprevalence after 25 years of universal mass vaccination and management of non‐responders to the anti‐Hepatitis B vaccine: An Italian study among medical students
Author(s) -
Bianchi Francesco P.,
Gallone Maria S.,
Gallone Maria F.,
Larocca Angela M. V.,
Vimercati Luigi,
Quarto Michele,
Tafuri Silvio
Publication year - 2019
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.13001
Subject(s) - medicine , immunogenicity , vaccination , titer , booster dose , hepatitis b , seroprevalence , booster (rocketry) , hepatitis b vaccine , hepatitis b virus , antibody , immunology , pediatrics , hbsag , virus , serology , physics , astronomy
Summary According to international guidelines, healthcare workers and medical students immunized against HBV are periodically tested for anti‐ HB s IgG. Subjects who show an anti‐ HB s titre <10 mUI /mL must receive additional vaccine doses to induce a measurable antibody response. This study aimed to evaluate the long‐time immunogenicity of anti‐hepatitis B vaccination in a sample of medical students and residents of the University of Bari who attended the Hygiene Department for biological risk assessment (April 2014‐June 2017). The strategy for the management of nonresponder subjects was evaluated. A total of 3676 students and residents were invited for testing according to a standardized protocol. Anti‐ HB s IgG was tested for in 3140 (85.4%) subjects: 1174/3140 (37.7%) subjects were negative. 14.6% (128/808) of subjects who received the vaccine during their 12th year of life and 45.8% (1056/2305) of subjects immunized during the first year of life ( P < 0.0001) were negative. 1005/1174 (85.6%) seronegative subjects received a booster dose, and 903/1005 (89.9%) were tested for anti‐ HB s 1 month after the booster dose: 82/903 (9.1%) subjects were still negative. Of these, 56/82 (68.3%) received 2 additional doses of vaccine and 52/56 (92.9%) were tested 1 month after the third dose: 50/52 subjects (96.2%) developed a positive titre. In conclusion, several medical students, immunized at birth or at young age against HBV , did not develop protective titres against the virus. Our management strategy (booster retest; for negative subjects, 2 doses and retest) seems consistent with the purpose of evidencing immunological memory.