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Predictive factors for anti-HBs status after 1 booster dose of hepatitis B vaccine
I-Cheng Lu1, Mei-Chu Yen Jean, Chi-Wei Lin
1aDepartment of Family Medicine, E-Da Hospital bI-Shou University cDepartment of Occupational Medicine, E-Da Hospital dKaohsiung Medical University eDepartment of Anesthesia, E-Da Hospital fDepartment of Hepatology and Gastroenterology Medicine, E-Da Hospital gDepartment of Environmental and Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan ROC.
Insights
Young adults who lost hepatitis B immunity after childhood vaccination can regain protection with one booster dose. Prebooster antibody levels strongly predict a positive response, potentially saving vaccine doses and costs.
Area of Science:
- Immunology
- Vaccinology
- Public Health
Background:
- Infants in Taiwan receive 3 doses of hepatitis B virus (HBV) vaccine.
- Some young adults lose anti-hepatitis B surface antibody (HBs) positivity despite childhood vaccination.
- Booster doses are often needed to restore protective antibody levels.
Purpose of the Study:
- To identify a predictive factor for screening individuals needing a single HBV vaccine booster dose.
- To determine factors influencing the regain of positive anti-HBs status (≥10 mIU/mL) or protective status (≥100 mIU/mL) after a booster.
Main Methods:
- 103 university freshmen with prior complete HBV vaccination but negative anti-HBs were recruited.
- Participants received one HBV booster dose, with anti-HBs titers rechecked after 4 weeks.
- Multivariate logistic regression analyzed prebooster anti-HBs level, BMI, SGPT, and sex as predictors.
Main Results:
- 50 students achieved protective postbooster anti-HBs status (≥100 mIU/mL).
- Prebooster anti-HBs level was the strongest predictor for both positive (≥10 mIU/mL) and protective (≥100 mIU/mL) postbooster status.
- The odds ratio for prebooster anti-HBs level predicting positive status was 218.645 (P=0.001).
Conclusions:
- Prebooster anti-HBs level is a powerful predictor for achieving positive and protective anti-HBs status after a single HBV booster.
- Individuals with prebooster anti-HBs >1 mIU/mL are likely to regain immunity with one booster.
- This approach can conserve HBV vaccines, saving costs and time.
Abstract:
In Taiwan, infants need to receive 3 doses of hepatitis B virus (HBV) vaccine under the public health policy from the government. However, there are many young adults who even though received complete HBV vaccination in their childhood would lose the positive response of anti-hepatitis B surface antibody (HBs) and need the booster dose of HBV vaccine. The aim of our study is to determine the powerful predictive factor for screening the candidates who need only 1 booster dose of HB vaccine then they can regain positive postbooster anti-HBs status (≧10 mIU/mL) or protective postbooster anti-HBs status (≧100 mIU/mL).We recruited 103 university freshmen who were born after July 1986 with complete HBV vaccination in childhood, but displayed negative results for hepatitis B surface antigen and anti-HBs levels at their health examinations upon university entry. They received 1 booster dose of HB vaccine, and their anti-HBs titers were rechecked 4 weeks after the booster administration. Multivariate analysis logistic regression for positive postbooster anti-HBs status (≧10 mIU/mL, model 1) and protective postbooster anti-HBs status (≧100 mIU/mL, model 2) was done with predictive factors of prebooster anti-HBs level, body mass index, serum glutamate pyruvate transaminase level, and sex.Twenty-four students got positive postbooster anti-HBs status (10-100 mIU/mL) and 50 students got protective postbooster anti-HBs status (≧100 mIU/mL). In the model of multivariate analysis logistic regression for positive postbooster anti-HBs status (≧10 mIU/mL), prebooster anti-HBs level was the strongest predictive factor. The odds ratio was 218.645 and the P value was 0.001. Even in the model of multivariate analysis logistic regression for protective postbooster anti-HBs status (≧100 mIU/mL), prebooster anti-HBs level was still the strongest predictive factor, but the odds ratio of a protective booster effect was 2.143, with 95% confidence interval between 1.552 and 2.959, and the P value was less than 0.001.Prebooster anti-HBs level can be the powerful predictive factor for positive postbooster anti-HBs status (≧10 mIU/mL) and protective postbooster anti-HBs status (≧100 mIU/mL). According to the result of this study, if someone received complete HBV vaccination in childhood, but displayed negative results for hepatitis B surface antigen and anti-HBs levels around 2 decades later, 1 booster dose of HBV vaccine could help him or her to regain positive postbooster anti-HBs status (≧10 mIU/mL) under the strong predictive factor of prebooster anti-HBs level higher than 1 mIU/mL. The other 2 HBV vaccines could be saved and the case could also save money and time.
