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Long-term persistence of seroprotection by hepatitis B vaccination in healthcare workers of southern Italy.

Grosso G, Mistretta A, Marventano S, Ferranti R, Mauro L, Cunsolo R, Proietti L, Malaguarnera M - Hepat Mon (2012)

Bottom Line: A good level of seroprotection persisted in 57.9% of the subjects after 30 years.Factors related to this immunization status confirmed the importance of vaccinating HCWs early in their careers and ensuring an adequate vaccination schedule.However, with particular reference to the low rate of hepatitis B vaccine coverage among HCWs in Southern Italy, the implementation of a new educational intervention as part of an active vaccination program is needed.

View Article: PubMed Central - PubMed

Affiliation: G.F. Ingrassia Department, Section of Hygiene and Public Health, University of Catania, Catania, Italy.

ABSTRACT

Background: The impact of hepatitis B virus (HBV) vaccination campaigns on HBV epidemiology needs to be evaluated, in order to assess the long-term immunity offered by vaccines against HBV.

Objectives: To evaluate the current status of anti-HBV vaccine coverage among healthcare workers (HCWs) in Southern Italy, and to determine the long-term persistence of antibodies to hepatitis B surface antigens (anti-HBs) in such a cohort of subjects.

Patients and methods: A longitudinal, retrospective seroepidemiological survey was conducted among 451 HCWs, who were working at or visiting, the Occupational Health Department of a city hospital, in Catania, Italy, between January 1976 and December 2010.

Results: At the 30-year follow-up (mean follow-up 10.15 ± 5.96 years, range 0.74-30), 261 HCWs had detectable anti-HBs titers indicating a persistence of seroprotection of 89.4% (out of 292 anti-HBs positive results, three months after vaccination). An inadequate vaccination schedule was the strongest predictor of antibody loss during follow-up (OR = 8.37 95% CI: 5.41-12.95, P < 0.001). A Kaplan-Maier survival curve revealed that the persistence of anti-HBs 30 years after vaccination, was 92.2% for high responders, while it was only 27.3% for low responders (P = 0.001).

Conclusions: A good level of seroprotection persisted in 57.9% of the subjects after 30 years. Factors related to this immunization status confirmed the importance of vaccinating HCWs early in their careers and ensuring an adequate vaccination schedule. However, with particular reference to the low rate of hepatitis B vaccine coverage among HCWs in Southern Italy, the implementation of a new educational intervention as part of an active vaccination program is needed.

No MeSH data available.


Related in: MedlinePlus

Anti-HBsAg Persistence According to Post-Vaccination Anti-HBsAg Titers
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fig355: Anti-HBsAg Persistence According to Post-Vaccination Anti-HBsAg Titers

Mentions: Sociodemographic and medical characteristics of the 451 HCWs included in the study are listed in Table 1. Fully compliant subjects with a completed vaccination schedule consisted of 157 (34.8%) HCWs. Three months following vaccination, the overall anti-HBs prevalence in vaccinated HCWs was 64.7% (292 subjects). Vaccination at a young age, either at birth or before the age of 12, as well as having received an inadequate schedule of vaccination, were significantly associated with being seronegative when tested (P < 0.0001). Among the 181 subjects vaccinated at job commencement or during their working life, the response after primary immunization was 52.1% (158 subjects). At the 30-year follow-up (mean follow-up 10.15 ± 5.96 years, range 0.74-30), 261 HCWs (57.9% out of the overall 451 vaccinated HCWs) had detectable anti-HBs titers, indicating a persistence of seroprotection of 89.4% (out of the 292 anti-HBs positive HCWs three-months after vaccination). Characteristics significantly associated with becoming seronegative are listed in Table 2. Younger and overweight HCWs with 10-20 years in their occupation were less likely to lose seroprotection against HBV (OR = 0.47, 95% CI: 0.3-0.72, P = 0.01; OR = 0.7, 95% CI: 0.51-0.95, P = 0.022 and OR = 0.65, 95% CI: 0.43-0.98, P = 0.41, respectively), compared with older, normal weight HCWs employed for less than 10 years. By contrast, an inadequate vaccination schedule was found to be most strongly associated with antibody loss during follow-up, even after adjusting for other significant covariates (OR = 8.37, 95% CI: 5.41-12.95, P < 0.001). Results of anti-HBs titer levels detected in subjects vaccinated at job commencement or during their working life were similar to those for all vaccinated HCWs (Table 2). At the 30-year follow-up, the odds for antibody loss were higher in subjects that had received an inadequate schedule (OR = 16.97, 95% CI: 7.12-40.41, P < 0.001). Kaplan-Maier survival curve of time from primary vaccination to an anti-HBs antibody measurement outcome less than 10 mIU/ml, revealed that low post-immunization titers (10–99 mIU/ml) was a predictor of antibody loss during the follow-up period. The persistence of anti-HBs 30 years after vaccination was 92.2% for high responders, while it was only 27.3% for low responders (P < 0.001) (Figure 1). When analyzing risk factors associated with becoming seronegative against hepatitis B, being a low-responder after primary immunization was a predictor of antibody loss after the follow-up period (OR = 6.18, 95% CI: 2.48-17.01, P < 0.001), but after adjusting for the vaccination schedule, only the last factor remained significant (OR = 11.76, 95% CI: 2.99-46.2, P < 0.001).


Long-term persistence of seroprotection by hepatitis B vaccination in healthcare workers of southern Italy.

Grosso G, Mistretta A, Marventano S, Ferranti R, Mauro L, Cunsolo R, Proietti L, Malaguarnera M - Hepat Mon (2012)

Anti-HBsAg Persistence According to Post-Vaccination Anti-HBsAg Titers
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3475028&req=5

fig355: Anti-HBsAg Persistence According to Post-Vaccination Anti-HBsAg Titers
Mentions: Sociodemographic and medical characteristics of the 451 HCWs included in the study are listed in Table 1. Fully compliant subjects with a completed vaccination schedule consisted of 157 (34.8%) HCWs. Three months following vaccination, the overall anti-HBs prevalence in vaccinated HCWs was 64.7% (292 subjects). Vaccination at a young age, either at birth or before the age of 12, as well as having received an inadequate schedule of vaccination, were significantly associated with being seronegative when tested (P < 0.0001). Among the 181 subjects vaccinated at job commencement or during their working life, the response after primary immunization was 52.1% (158 subjects). At the 30-year follow-up (mean follow-up 10.15 ± 5.96 years, range 0.74-30), 261 HCWs (57.9% out of the overall 451 vaccinated HCWs) had detectable anti-HBs titers, indicating a persistence of seroprotection of 89.4% (out of the 292 anti-HBs positive HCWs three-months after vaccination). Characteristics significantly associated with becoming seronegative are listed in Table 2. Younger and overweight HCWs with 10-20 years in their occupation were less likely to lose seroprotection against HBV (OR = 0.47, 95% CI: 0.3-0.72, P = 0.01; OR = 0.7, 95% CI: 0.51-0.95, P = 0.022 and OR = 0.65, 95% CI: 0.43-0.98, P = 0.41, respectively), compared with older, normal weight HCWs employed for less than 10 years. By contrast, an inadequate vaccination schedule was found to be most strongly associated with antibody loss during follow-up, even after adjusting for other significant covariates (OR = 8.37, 95% CI: 5.41-12.95, P < 0.001). Results of anti-HBs titer levels detected in subjects vaccinated at job commencement or during their working life were similar to those for all vaccinated HCWs (Table 2). At the 30-year follow-up, the odds for antibody loss were higher in subjects that had received an inadequate schedule (OR = 16.97, 95% CI: 7.12-40.41, P < 0.001). Kaplan-Maier survival curve of time from primary vaccination to an anti-HBs antibody measurement outcome less than 10 mIU/ml, revealed that low post-immunization titers (10–99 mIU/ml) was a predictor of antibody loss during the follow-up period. The persistence of anti-HBs 30 years after vaccination was 92.2% for high responders, while it was only 27.3% for low responders (P < 0.001) (Figure 1). When analyzing risk factors associated with becoming seronegative against hepatitis B, being a low-responder after primary immunization was a predictor of antibody loss after the follow-up period (OR = 6.18, 95% CI: 2.48-17.01, P < 0.001), but after adjusting for the vaccination schedule, only the last factor remained significant (OR = 11.76, 95% CI: 2.99-46.2, P < 0.001).

Bottom Line: A good level of seroprotection persisted in 57.9% of the subjects after 30 years.Factors related to this immunization status confirmed the importance of vaccinating HCWs early in their careers and ensuring an adequate vaccination schedule.However, with particular reference to the low rate of hepatitis B vaccine coverage among HCWs in Southern Italy, the implementation of a new educational intervention as part of an active vaccination program is needed.

View Article: PubMed Central - PubMed

Affiliation: G.F. Ingrassia Department, Section of Hygiene and Public Health, University of Catania, Catania, Italy.

ABSTRACT

Background: The impact of hepatitis B virus (HBV) vaccination campaigns on HBV epidemiology needs to be evaluated, in order to assess the long-term immunity offered by vaccines against HBV.

Objectives: To evaluate the current status of anti-HBV vaccine coverage among healthcare workers (HCWs) in Southern Italy, and to determine the long-term persistence of antibodies to hepatitis B surface antigens (anti-HBs) in such a cohort of subjects.

Patients and methods: A longitudinal, retrospective seroepidemiological survey was conducted among 451 HCWs, who were working at or visiting, the Occupational Health Department of a city hospital, in Catania, Italy, between January 1976 and December 2010.

Results: At the 30-year follow-up (mean follow-up 10.15 ± 5.96 years, range 0.74-30), 261 HCWs had detectable anti-HBs titers indicating a persistence of seroprotection of 89.4% (out of 292 anti-HBs positive results, three months after vaccination). An inadequate vaccination schedule was the strongest predictor of antibody loss during follow-up (OR = 8.37 95% CI: 5.41-12.95, P < 0.001). A Kaplan-Maier survival curve revealed that the persistence of anti-HBs 30 years after vaccination, was 92.2% for high responders, while it was only 27.3% for low responders (P = 0.001).

Conclusions: A good level of seroprotection persisted in 57.9% of the subjects after 30 years. Factors related to this immunization status confirmed the importance of vaccinating HCWs early in their careers and ensuring an adequate vaccination schedule. However, with particular reference to the low rate of hepatitis B vaccine coverage among HCWs in Southern Italy, the implementation of a new educational intervention as part of an active vaccination program is needed.

No MeSH data available.


Related in: MedlinePlus