A study of HBV vaccination among anti-HBs negative hospital health care workers

Abstract number: 1134_03_296

Shin B.-M., Yoo H.M., Yoo S.M., Park S.K.

Objective:  

Needle stick injury is not a rare accident among hospital health care workers. Hepatitis B virus (HBV) infection is one of the main infectious agent through needle stick injury. Therefore, HBV vaccination is strongly recommended for HBV exposure risk group. Through the surveillance we studied how many HCWs could get anti-HBs after vaccination and analysed the effects of HBV vaccination in Korean HCWs.

Methods:  

We surveyed 571 hospital HCWs (doctors, nurses, aid-nurses and technicians) about previous HBV vaccination history and tested HBsAg, anti-HBs with titer and HBcAb,IgG using enzyme immunoassay. After that, we recommended HBV vaccinations according to 3 cycle schedules (0.1 and 2 months) in 118 cases of anti-HBs negative HCWs.

Results:  

Of 571 persons, 118 showed anti-HBs negative results. Among them, 58 persons had completely finished 3 cycle HBV vaccination programme. The ratio of male to female was 11:47(19%:81%). The positive rate of anti-HBs were 65.5%(38), 81.0%(47) and 93.1%(54) after 1st, 2nd and 3rd cycle respectively. However, the anti-HBs titers were not associated with vaccination cycles. The 4 cases of anti-HBs negative persons had no previous vaccination histories and HBcAb were also negative. The HBcAb negative group showed remarkably higher anti-HBs titers compared with HBcAb positive group (622 IU/mL vs. 52 IU/mL) though their anti-HBs formation rates were lower than HBcAb positive group (92% vs. 100%)

Conclusions:  

The lower rate of programme performance (49.2%) needed further regular education about risk of HBV infection among HCWs. The result of HBV vaccination was excellent after 3 cycles and could reduce the risk of HBV infection among HCWs. According to anti-HBs titers, no further vaccination was needed if anti-HBs was acquired during the any vaccination cycles. The different results about anti-HBs formation and the titers of anti-HBs between HBcAb positive and negative group suggested pre-existing under-detectable anti-HBsAb and different memory B cell functions.