title: Anti-pre-S(2) analysis after hepatitis B vaccination in haemodialysis patients.
abstract: We investigated the development of anti-pre-S(2) antibodies by enzyme immunoassay and by Western blot analysis in a vaccination study in haemodialysis patients; both the Pasteur plasma vaccine retaining the pre-S(2) epitopes and the Merck, Sharp and Dohme (MSD) plasma vaccine containing only HBsAg were used. By enzyme immunoassay (EIA), one anti-pre-S(2) response at month 7 was registered in 23 patients after 5 injections with the 5 micrograms dose of Pasteur vaccine (PS group), whereas 6 responses were seen in 20 patients after 4 injections with the 10 micrograms dose (PD group). None of the 22 vaccines injected with MSD vaccine (40 micrograms) (4 injections, MD group) showed an anti-pre-S(2) response at month 7. In the Western blot an anti-pre-S(2) response was seen in 12 PS patients, in 8 PD patients and in none of the MD patients. Anti-pre-S(2) responses were predominantly observed in patients with a high anti-HBs response but exceptions occurred. Prevaccination anti-pre-S(2) positivity, in the absence of anti-HBc and anti-HBs, was detected in dialysis patients with EIA as well as Western blot, in 10.8 and 21.6%, respectively; similar findings were made in health care personnel. The possible nature of this phenomenon is discussed. In this study the Western blot technique has been shown to be a suitable test system for qualitative and semi-quantitative analysis of anti-pre-S(2) antibodies after hepatitis B vaccination with a higher sensitivity, but probably also a different specificity than the EIA.
authors.affiliation: Department of Virology, Erasmus University, Rotterdam, The Netherlands.
authors.forename: R A
authors.initials: RA
authors.lastname: Heijtink
authors.forename: G A
authors.initials: GA
authors.lastname: de Wilde
authors.forename: J
authors.initials: J
authors.lastname: Kruining
authors.forename: M B
authors.initials: MB
authors.lastname: Smit-Leijs
authors.forename: S W
authors.initials: SW
authors.lastname: Schalm
mesh_terms: D000328:Adult; D000368:Aged; D000918:Antibody Specificity; D015153:Blotting, Western; D005260:Female; D006509:Hepatitis B / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000032:analysis*; D006514:Hepatitis B Surface Antigens / Q000276:immunology*; D017325:Hepatitis B Vaccines; D006801:Humans; D007124:Immunoenzyme Techniques; D008137:Longitudinal Studies; D008875:Middle Aged; D011498:Protein Precursors / Q000276:immunology*; D006435:Renal Dialysis; D014611:Vaccination; D014759:Viral Envelope Proteins / Q000276:immunology*; D014761:Viral Hepatitis Vaccines / Q000276:immunology*
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D011498:Protein Precursors; D014759:Viral Envelope Proteins; D014761:Viral Hepatitis Vaccines; C050807:presurface protein 2, hepatitis B surface antigen