Nonresponsiveness to hepatitis B vaccine in health care workers. Results of revaccination and genetic typings.
Twenty-eight health care workers who had a poor antibody response when initially vaccinated with hepatitis B vaccine were revaccinated with three additional 20-microgram doses. Eight of the twenty nonresponders, who had levels of antibody to hepatitis B surface antigen (anti-HBs) of less than 8 estimated radioimmunoassay (RIA) units, and all 8 of the hyporesponders, who had anti-HBs levels of 8 or 16 RIA units, attained anti-HBs levels of 36 RIA units or more after revaccination. Tests for HLA-A, B, C, and DR; for complement proteins C2, C4A, C4B, and BF; and for the erythrocyte enzyme glyoxalase I were done in 17 nonresponders and 3 hyporesponders. Nine (45%) had HLA-DR7 and 8 (40%) had HLA-DR3, compared with an expected rate of 23% in the general population. At least one of two extended haplotypes (B44, DR7, FC31 or B8, DR3, SCO1) were detected in 6 of the 9 who did not respond to revaccination, compared with 2 of 11 who responded to a second course of vaccine. Poor responders to vaccine may benefit from revaccination, and genetic factors may modulate the immune response to vaccination.
D000328:Adult; D003165:Complement System Proteins / Q000235:genetics; D005260:Female; D006680:HLA Antigens / Q000235:genetics; D006684:HLA-DR Antigens; D006238:Haploidy; D006280:Health Workforce; D006509:Hepatitis B / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000032:analysis; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D017325:Hepatitis B Vaccines; D000949:Histocompatibility Antigens Class II / Q000235:genetics; D006801:Humans; D007115:Immunization Schedule; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000517:prevention & control*; D014761:Viral Hepatitis Vaccines / Q000276:immunology*
D006680:HLA Antigens; D006684:HLA-DR Antigens; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D000949:Histocompatibility Antigens Class II; D014761:Viral Hepatitis Vaccines; D003165:Complement System Proteins