Durability of immunity by hepatitis B vaccine in Japanese health care workers depends on primary response titers and durations

Nori Yoshioka, Matsuo Deguchi, Hideharu Hagiya, Masanori Kagita, Hiroko Tsukamoto, Miyuki Takao, Hisao Yoshida, Norihisa Yamamoto, Yukihiro Akeda, Yoshiko Nabetani, Ikuhiro Maeda, Yoh Hidaka, Kazunori Tomono

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3 Citations (Scopus)

Abstract

Background: Health care workers (HCWs) are frequently exposed to hepatitis B virus (HBV) infection. The efficacy and safety of immunization with the hepatitis B (HB) vaccine are well recognized, but the durability of immunity and need for booster doses in those with secondary vaccine response failure remains controversial. Methods: This was a retrospective cohort study performed at Osaka University Hospital, Japan. We examined antibodies against HB surface antigen (anti-HBs) titers annually after immunization for previously non-immunized HCWs. Primary responders were categorized by their sero-positive durations as short responders (those whose anti-HBs titers declined to negative range within 3 years), and long responders (those who retained positive anti-HBs levels for 3 years and more). We re-immunized short responders with either single or 3-dose boosters, the long responders with a single booster when their titers dropped below protective levels, and examined their sero-protection rates over time thereafter. Results: From 2001 to 2012, data of 264 HCWs with a median age of 25.3 were collected. The rate of anti-HBs positivity after primary vaccination were 93.0% after three doses (n = 229), 54.5% after two doses (n = 11), and 4.2% after a single dose (n = 24). Of 213 primary responders, the anti-HBs levels of 95 participants (44.6%) fell below the protective levels, including 46 short responders and 49 long responders. HCWs with higher initial anti-HBs titers after primary vaccination had significantly longer durations of sero-positivity. For short responders, 3-dose booster vaccination induced a longer duration of anti-HBs positivity compared to a single-dose booster, whereas for long responders, a single-dose booster alone could induce prolonged anti-HBs positivity. Conclusion: Our preliminary data suggested that it may be useful to differentiate HB vaccine responders based on their primary response durations to maintain protective levels of anti-HBs efficiently. A randomized, prospective, large-scale study is warranted to support our findings.

Original languageEnglish
Article numbere0187661
JournalPloS one
Volume12
Issue number11
DOIs
Publication statusPublished - Nov 2017
Externally publishedYes

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ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Yoshioka, N., Deguchi, M., Hagiya, H., Kagita, M., Tsukamoto, H., Takao, M., Yoshida, H., Yamamoto, N., Akeda, Y., Nabetani, Y., Maeda, I., Hidaka, Y., & Tomono, K. (2017). Durability of immunity by hepatitis B vaccine in Japanese health care workers depends on primary response titers and durations. PloS one, 12(11), [e0187661]. https://doi.org/10.1371/journal.pone.0187661