title: Anti-hepatitis B core antibody is not required for prevaccination screening in healthcare workers.
abstract: Vaccination against hepatitis B virus (HBV) is recommended for health care workers (HCWs), but it is not clear whether HBV vaccination is required for HCWs who have isolated antibody to hepatitis B core antigen (anti-HBc), or whether prevaccination screening for anti-HBc is needed in HCWs. Among 1812 HCWs, subjects with isolated anti-HBc and those with no HBV markers (control) were screened. The anamnestic response (antibody to hepatitis B surface antigen over 50 mIU/mL after the first vaccine injection) was compared prospectively between the two groups. The prevalence of isolated anti-HBc was 2.3%. Their anamnestic response was lower than that of controls (27.5% vs. 46.9%, P=0.020). The subjects who had isolated anti-HBc were older and predominantly male, compared with the controls. Multivariate analysis revealed that age (odds ratio [OR], 0.67; confidence interval [CI], 0.51-0.90) and prior vaccination (OR, 3.36; CI, 2.04-5.54) were independent predictors of the anamnestic response, regardless of the anti-HBc status. Serum HBV DNA was not detected in any subject. Anti-HBs seroconversion was achieved in most of the anti-HBc-positive subjects after full vaccination, and the rate was comparable with controls (89.5% vs. 96.6%, P=0.067). Isolated anti-HBc-positive HCWs are rare and most of them respond to vaccination. Anti-HBc testing is not a prerequisite for vaccination. This serology suggests a loss of acquired anti-HBs rather than occult HBV infection. Their reduced immunity to vaccination may be related to old age.
authors.affiliation: Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Jaejun
authors.initials: J
authors.lastname: Shim
authors.forename: Kyung Yup
authors.initials: KY
authors.lastname: Kim
authors.forename: Byung-Ho
authors.initials: BH
authors.lastname: Kim
authors.forename: Heekyung
authors.initials: H
authors.lastname: Chun
authors.forename: Mi Suk
authors.initials: MS
authors.lastname: Lee
authors.forename: Young
authors.initials: Y
authors.lastname: Hwangbo
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Jang
authors.forename: Seok Ho
authors.initials: SH
authors.lastname: Dong
authors.forename: Hyo Jong
authors.initials: HJ
authors.lastname: Kim
authors.forename: Young Woon
authors.initials: YW
authors.lastname: Chang
authors.forename: Rin
authors.initials: R
authors.lastname: Chang
mesh_terms: D000328:Adult; D000367:Age Factors; D000917:Antibody Formation; D016022:Case-Control Studies; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006282:Health Personnel; D006509:Hepatitis B / Q000276:immunology / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood*; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011446:Prospective Studies; D014611:Vaccination; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D017325:Hepatitis B Vaccines