Validity of the clinical recommendation of Hepatitis B virus vaccine to adults with negative HBsAg and AntiHBs

ABSTRACT

BACKGROUND: Administration of hepatitis B vaccine has played a major part in the management of public health in this country. There were many researches to assess the immunogenecity, safety, long term effectiveness, dose, and route of administration of hepatitis B vaccine. But there was lack of validation of the recommendation that hepatit.is B vaccine should be administered in adults with negative HBsAg and AntiHBs, in an endemic area with high prevalence of HBsAg. Authors tried to establish a proper candidate for hepatitis B vaccination evaluating viral markers of hepatitis B in adults vaccinated. METHODS: 172 hepatitis B vaccinated subjects(35.0%) were drawn from 491 adults who have visited at health care center, Asan Kangnung Hospital from April 1st to May 31th, 1997. They were asked designed questions about the beginning year, frequency of vaccination, and the presence of family members with HBsAg in a direct line. RESULTS: Of the subjects(172), 2.3% were HBsAg(+), 63.4% AntiHBs(+), 68.6% AntiHBc(+). Among the HBsAg(-) adults(149) who had been vaccinated more than three times, 70.4%(105) were AntiHBs(+), of whom 66.6%(70) were AntiHBc(+) and 29.6%(44) were AntiHBs(-), of whom 56.8%(25) were AntiHBc(+). In the subjects(20) with family history of HBsAg, 80% were AntiHBc(+), which is higher than 61.2% in the group(129) without family history. Among the HBsAg(-) and AntiHBc(-) adults(54) who had been vaccinated more than three times, AntiHBs(+) group was not significantly differnt from AntiHBs(-) group in comparison of age and years after initial vaccination. CONCLUSIONS: The two thirds(68.9%) of vaccinated subjects showed AntiHBc(+), which means reflection of previous exposure to Hepatitis B virus. Accordingly, vaccination is not thought to be required for these. Consequently, all individuals are thought to have to be pretested for the presence of AntiHBc as well as HBsAg and AntiHBs in Korea.