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      Evaluación de la respuesta inmunológica a tres dosis de la vacuna contra la Hepatitis B en trabajadores de un hospital universitario portugués Translated title: Evaluation of the immunological response to three doses of the Hepatitis B vaccine in workers of a Portuguese university Hospital

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          Abstract

          RESUMEN. Objetivos: Evaluar la respuesta a tres dosis de la vacuna contra la Hepatitis B en profesionales de la salud. Analizar su asociación con la edad, género, tabaquismo, índice de masa corporal (IMC), presencia de enfermedades crónicas y tiempo transcurrido entre la vacunación y la medición del AcHBs. Material y Métodos: estudio observacional, transversal. Muestra de trabajadores de un Hospital Universitario Portugués que realizaron medición del AcHBs en 2018 y que tenían esquema de vacunación completo. El proceso clínico individual fue consultado. Fue aplicado el Test Mann-Whitney y Chi-cuadrado y se aceptó un nivel de significancia del 5%. Resultados y Conclusiones: Analizamos resultados de 181 trabajadores, edad media 32,99 años (min. 20 - max. 64), la mayoría mujeres (76,80%). El AcHBs fue positivo en 140 (77.35%) y negativo en 41 (22.65%). La presencia de enfermedades crónicas mostró asociación estadísticamente significativa con AcHBs negativo tras un esquema de vacunación completo.

          Translated abstract

          ABSTRACT Objectives: evaluate the response to three doses of the Hepatitis B vaccine in healthcare workers. Analyze its association with age, gender, smoking, body mass index (BMI), presence of chronic diseases and time elapsed between vaccination and the measurement of AcHBs. Material and Methods: observational, cross-sectional study. Sample of workers from a Portuguese University Hospital who measured AcHBs in 2018 and who had a complete vaccination scheme. The individual clinical process was consulted. The Mann-Whitney and Chi-square test were applied and a significance level of 5% was accepted. Results and Conclusions: We analyzed the results of 181 workers, mean age 32.99 years (min. 20 - max. 64), the majority women (76.80%). The AcHBs was positive in 140 (77.35%) and negative in 41 (22.65%). The presence of chronic diseases showed a statistically significant association with negative AcHBs after a complete vaccination scheme.

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          Hepatitis B and the need for a booster dose.

          After several decades of vaccination against hepatitis B virus in newborns, infants, adolescents, and adults, the question remains whether a booster dose is ever needed. Long-term protection is most commonly measured through 4 methods: the anamnestic response after administration of a booster dose, infection rate in vaccinated populations, in vitro B and T cell activity testing, and seroepidemiological studies. Long-term protection is present despite a decrease in anti-hepatitis B surface antibodies over time. The exact mechanism of long-term protection, however, is not yet fully understood. There is no need for boosters in immunologically potent persons as long as a full course was adequately administered that respected the recommended timelines, as evidenced by studies conducted up to 20 years after the original immunization course. However, a booster dose should be planned for immunocompromised patients, based on serological monitoring. © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.
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            Hepatitis B vaccination: The key towards elimination and eradication of hepatitis B.

            Hepatitis B virus infection is a global health problem. Worldwide, about 360 million people are chronically infected with the virus. They continue to spread the virus to others and are themselves at risk of chronic liver diseases and hepatocellular carcinoma. The infection can now be treated by antivirals or interferons and the transmission route can be interrupted. Nevertheless, the most effective means is to immunize all susceptible individuals, especially young children, with safe and efficacious vaccines. The combined efforts of vaccination, effective treatment and interruption of transmission make elimination of the infection plausible and may eventually lead to eradication of the virus. Because hepatitis B vaccination has a key role in the control of hepatitis B, properties of this vaccine, its effectiveness in pre-exposure and post-exposure settings, duration of protection after vaccination and the need of booster doses are discussed. Mass hepatitis B vaccination in children decreases the carriage of the virus, and the diseases associated with acute and chronic infection, including hepatocellular carcinoma. Challenges that need to be solved to expand mass vaccination, and the strategies towards elimination and eventual eradication of hepatitis B in the world are also discussed.
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              Factors influencing immunologic response to hepatitis B vaccine in adults

              Hepatitis B was still a worldwide health problem. This study aimed to conducted a systematic review and meta-analysis to assess a more precise estimation of factors that influence the response to hepatitis B vaccine in adults. Our included studies examined seroprotection rates close to the end of vaccination schedules in healthy adult populations. This meta-analysis including 21053 adults in 37 articles showed that a significantly decreased response to hepatitis B vaccine appeared in adults (age ≥ 40) (RR:1.86, 95% CI:1.55–2.23), male adults (RR:1.40, 95% CI:1.22–1.61), BMI ≥ 25 adults (RR:1.56, 95% CI:1.12–2.17), smoker (RR:1.53, 95% CI:1.21–1.93), and adults with concomitant disease (RR:1.39, 95% CI:1.04–1.86). Meanwhile, we further found a decreased response to hepatitis B vaccine appeared in adults (age ≥ 30) (RR:1.77, 95% CI:1.48–2.10), and adults (age ≥ 60) (RR:1.30, 95% CI:1.01–1.68). However, there were no difference in response to hepatitis B vaccine both in alcoholic (RR:0.90, 95% CI:0.64–1.26) and 0-1-12 vs. 0-1-6 vaccination schedule (RR:1.39, 95% CI:0.41–4.67). Pooling of these studies recommended the sooner the better for adult hepatitis B vaccine strategy. More vaccine doses, supplemental/additional strengthening immunity should be emphasized on the susceptible population of increasing aged, male, BMI ≥ 25, smoking and concomitant disease. The conventional 0-1-6 vaccination schedule could be still worth to be recommended.
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                Author and article information

                Journal
                medtra
                Revista de la Asociación Española de Especialistas en Medicina del Trabajo
                Rev Asoc Esp Espec Med Trab
                Asociación Española de Especialistas en Medicina del Trabajo (Madrid, Madrid, Spain )
                1132-6255
                3020-1160
                2021
                : 30
                : 1
                : 57-62
                Affiliations
                [6] Lisboa orgnameCentro Hospitalar Universitário Lisboa Norte, EPE orgdiv1Serviço de Saúde Ocupacional Portugal
                [8] Lisboa orgnameUniversidade de Lisboa orgdiv1Faculdade de Medicina Portugal
                [1] Lisboa orgnameCentro Hospitalar Universitário Lisboa Norte, EPE orgdiv1Serviço de Saúde Ocupacional Portugal
                [2] Lisboa orgnameCentro Hospitalar Universitário Lisboa Norte, EPE orgdiv1Serviço de Saúde Ocupacional Portugal
                [7] Lisboa orgnameUniversidade Nova de Lisboa orgdiv1CISP-ENSP Portugal
                [4] Almada orgnameHospital Garcia de Orta Portugal
                [5] Lisboa orgnameCentro Hospitalar Universitário Lisboa Norte, EPE orgdiv1Serviço de Saúde Ocupacional Portugal
                [3] Lisboa orgnameCentro Hospitalar Universitário Lisboa Norte, EPE orgdiv1Serviço de Saúde Ocupacional Portugal
                Article
                S3020-11602021000100057 S3020-1160(21)03000100057
                247e172e-555c-4147-8dec-6a40686e7f51

                This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

                History
                : 03 April 2021
                : 31 July 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 23, Pages: 6
                Product

                SciELO Spain

                Categories
                Textos Originales

                Healthcare Workers,Hepatitis B,trabajadores sanitarios,vacuna contra la hepatitis B,Hepatitis B Antibodies,Hepatitis B Vaccine,anticuerpos contra la hepatitis B

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