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KMID : 0384320040250050392
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Korean Journal of Family Medicine
2004 Volume.25 No. 5 p.392 ~ p.396
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Immune response to Hepatitis B vaccination for adults with Isolated Antibody to Hepatitis B Core Antigen in the Hepatitis B Endemic Area
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Koh Hee-Jeong
Choi Ji-Ho
Kim Sung-Ryul
Lee Hong-Soo
Kang Hyun-Eun
Yoo Tai-Woo
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Abstract
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Background: Korea is a highly prevalent area of isolated anti-HBc with a rate of 15%, but there is neither vaccination nor management guideline agreed. To know the management for Hepatitis B Vaccination for adults with isolated anti-HBc, we investigated immune response to hepatitis B vaccination in adults with isolated anti-HBc.
Methods: The 23 adults with persistent isolated anti-HBc, who visited a health promotion center from Dec. 1998 to Aug. 1999, were vaccinated with HepavaxⰒ-B by the standard schedule (0, 1, 6 month) and anti-HBs titers were measured 1 month after 1st and 3rd vaccinations (1, 7 month).
Results: After the 1st vaccination, 18 (78.26%) developed anti-HBs seroconversion. Among them, 4 (17.39%) had titers of 10∼49 mIU/ml, 8 (34.78%) 50∼99 mIU/ml, and 6 (26.09%) more than 100 mIU/ml. All non-responders after the 1st vaccination remained as such even with 3 doses of complete vaccination. The majority of seroconverted group did not show more anti-HBs response with further vaccination.
Conclusions: Since none of adults with isolated anti-HBc had a primary response, which indicated few false positive results. Therefore they should be excluded on vaccination programs in Korea. To differentiate between immunity and occult infections, a single dose of vaccine with a follow-up anti-HBs test is preferable for adults with isolated anti-HBc. If the test shows a seroconversion it would indicate protective immunity, if not, then occult infection may be suspected. (J Korean Acad Fam Med 2004;25:392-396)
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KEYWORD
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isolated anti-HBc, HBV, vaccination, immune response
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