Author/Authors :
Bahari, Ali Endoscopic & Minimally Invasive Surgery Research Center - Faculty of Medicine - Mashhad University of Medical Sciences , Izadi, Shahrokh Department of Epidemiology and Biostatistics - School of Public Health - Zahedan University of Medical Sciences , Bari, Zohreh Fellow of Gastroenterology - Mazandaran University of Medical Sciences , Khosravi, Soheyla Blood Transfusion Organization , Baghaei, Bita Mostafa Khomeyni Hospital -Yazd University of Medical Sciences , Saneimoghadam, Esmaeil Blood Transfusion Organization , Firouzi, Farzad Research Institute of Gastroenterology and Liver Diseases (RIGLD) - Shahid Beheshti University , Espiari, Ali Research Institute of Gastroenterology and Liver Diseases (RIGLD) - Shahid Beheshti University , Esmaeilzadeh, Abbas Department of Internal Medicine - Faculty of Medicine - Mashhad University of Medical Sciences , Mokhtarifar, Ali Department of Internal Medicine - Faculty of Medicine - Mashhad University of Medical Sciences , Bakhshipour, Alireza Department of Internal Medicine - Faculty of Medicine - Zahedan University of Medical Sciences , Ganji, Azita Department of Internal Medicine - Faculty of Medicine - Mashhad University of Medical Sciences
Abstract :
BACKGROUND
It is important to differentiate whether isolated anti-HBc is due to false
positive results or the prior exposure to hepatitis B virus, because individuals
with false-positive anti-HBc can benefit from vaccination and their blood can
be safely transfused. To distinguish between these two conditions, we evaluated
the serologic response to hepatitis B vaccine.
METHODS
Ninety subjects with isolated anti-HBc (cases) and 100 subjects with totally
negative hepatitis B serologic markers (controls) were recruited to receive
three doses of hepatitis-B (HB) vaccine. Thirty days after the first dose of the
vaccine, anti-HBs titers were checked and individuals with anti-HBs titer >50
mIU/mL did not receive additional doses of the vaccine. However, others completed
the vaccination course, and another blood sample was collected 30 days
after the third dose to measure anti-HBs level.
RESULTS
Nineteen (21.1%) cases and three (3%) controls had no sero-conversion
(anti-HBs titers <10 mIU/mL) 30 days after the third dose (p<0.0001). Primary
response, defined as the development of anti-HBs antibody titers ≥10
mIU/mL 30 days after the third dose, was observed in 43 (47.8%) cases and 92
(92%) controls (p<0.0001). Also, 31.1% of cases developed anti-HBs titers ≥
50 mIU/mL 30 days after the first dose of vaccine, but the rate was significantly
lower (5%) in the control group (p<0.0001). Furthermore, half of the individuals
with positive isolated anti-HBc developed protective levels of anti-HBs
after three doses of HB vaccination. CONCLUSION
More than 75% of individuals with positive isolated anti-HBc can benefit
from vaccination and can be included in donor pool. Also, one fifth seemed to
have occult HBV infection. So HB vaccination may be used as a diagnostic
tool for clarifying the situation of the subjects with isolated anti-HBc.
