title: Study of hepatitis B (HB) vaccine non-responsiveness among health care workers from an endemic area (Taiwan).
abstract: OBJECTIVE
  To evaluate the etiology of non-responsiveness to hepatitis B (HB) vaccination in adults from an endemic area.
  
  
  METHODS
  A total of 250 subjects who were HBsAg negative and anti-HBs<10 mIU/ml received three-dose HB-vaccine series. Anti-HBs 'negative' was defined as a level<1.5 mIU/ml. 'Weakly' positive was defined as 1.5-10 mIU/ml at pre-vaccination testing. Anti-HBs response was defined as a level >10 mIU/ml at post-vaccination testing. Among non-responders who were anti-HBc positive, serum anti-HBe and hepatitis B virus (HBV) DNA were tested.
  
  
  RESULTS
  Three variables were associated with non-responsiveness by univariate analysis: anti-HBc positive, male gender, and age >40 years. Multivariate analysis additionally showed that anti-HBs negative was associated with non-responsiveness. Among 23 non-responders in anti-HBc positive subjects, post-vaccination serum was available in 16 subjects. HBV-DNA in all subjects was under detectable level by PCR assay. Anti-HBe positive were found in 13 of 16 subjects and were assumed to be occult HBV infection.
  
  
  CONCLUSIONS
  Male gender, age >40 years and anti-HBc positive are associated with non-responsiveness to HB vaccination. Most of non-responders among anti-HBc positive subjects were assumed to be occult HBV infection. Subjects with weakly positive anti-HBs were associated with responsiveness which may be the effect of immune memory.
authors.affiliation: Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Yi-Hao
authors.initials: YH
authors.lastname: Yen
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Chen
authors.forename: Jing-Houng
authors.initials: JH
authors.lastname: Wang
authors.forename: Chuan-Mo
authors.initials: CM
authors.lastname: Lee
authors.forename: Chi-Sin
authors.initials: CS
authors.lastname: Changchien
authors.forename: Sheng-Nan
authors.initials: SN
authors.lastname: Lu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006282:Health Personnel; D006509:Hepatitis B / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control; D006510:Hepatitis B Antibodies / Q000097:blood*; D006512:Hepatitis B Core Antigens / Q000032:analysis / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000097:blood / Q000276:immunology; D017325:Hepatitis B Vaccines / Q000276:immunology*; D006513:Hepatitis B e Antigens / Q000097:blood / Q000276:immunology; D006801:Humans; D007117:Immunization, Secondary; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D013624:Taiwan / Q000453:epidemiology; D014614:Vaccines, Synthetic / Q000276:immunology*
chemical_list: C075654:Engerix-B; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D006513:Hepatitis B e Antigens; D014614:Vaccines, Synthetic