Reversal of nonresponders and postexposure prophylaxis by intradermal hepatitis B vaccination in Japanese medical personnel.
Thirty-one Japanese nonresponders to subcutaneous hepatitis B vaccination and 15 medical personnel who were accidentally exposed to specimens positive for hepatitis B e antigen and were given hepatitis B immunoglobulin were intradermally immunized with 5 micrograms of plasma-derived hepatitis B vaccine every 2 weeks until delayed type hypersensitivity skin reaction to hepatitis B surface antigen became positive. Thirty (97%) of the 31 nonresponders developed delayed type hypersensitivity skin reactions to hepatitis B surface antigen after 2.3 +/- 1.2 (mean +/- SD) revaccinations. Twenty-nine (94%) of the 31 nonresponders had anti-hepatitis B surface antigen antibody levels greater than 10 IU/L. The immunoglobulin subclass of the antibody to hepatitis B surface antigen was mainly IgG1. After 1 year, 23 (74%) of the 31 nonresponders continued to have anti-hepatitis B surface antigen antibody levels greater than 10 IU/L. Persons accidentally exposed to specimens positive for hepatitis B e antigen developed delayed type hypersensitivity skin reactions to hepatitis B surface antigen following 3.1 +/- 1.1 revaccinations. None developed clinical hepatitis. There was no production of anti-hepatitis B core antigen antibody 1 year after exposure, indicating that protection was 100%. Intradermal hepatitis B vaccination is useful in reversing nonresponsiveness to hepatitis B surface antigen and for prophylaxis after exposure.
Nagafuchi
S
S
First Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Kashiwagi
S
S
Okada
K
K
Anzai
K
K
Nakamura
M
M
Nishimura
Y
Y
Sasazuki
T
T
Niho
Y
Y
D000328:Adult; D005260:Female; D006680:HLA Antigens / Q000032:analysis; D006280:Health Workforce; D006508:Hepatitis Antibodies / Q000032:analysis; D006509:Hepatitis B / Q000276:immunology* / Q000517:prevention & control; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D017325:Hepatitis B Vaccines; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000276:immunology; D007115:Immunization Schedule; D007271:Injections, Intradermal; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000276:immunology* / Q000517:prevention & control; D012867:Skin / Q000276:immunology; D014614:Vaccines, Synthetic / Q000008:administration & dosage*; D014761:Viral Hepatitis Vaccines / Q000008:administration & dosage*
D006680:HLA Antigens; D006508:Hepatitis Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D014614:Vaccines, Synthetic; D014761:Viral Hepatitis Vaccines