The hepatitis B vaccine protects re-exposed health care workers, but does not provide sterilizing immunity.

MedStar author(s):
Citation: Gastroenterology. 145(5):1026-34, 2013 Nov.PMID: 23916846Institution: MedStar Washington Hospital CenterDepartment: Medicine/GastroenterologyForm of publication: Journal ArticleMedline article type(s): Comparative Study | Journal Article | Research Support, N.I.H., Intramural | Research Support, Non-U.S. Gov'tSubject headings: *Health Personnel | *Hepatitis B Vaccines/tu [Therapeutic Use] | *Hepatitis B/pc [Prevention & Control] | *Immunity/im [Immunology] | *Infectious Disease Transmission, Professional-to-Patient/pc [Prevention & Control] | *Occupational Exposure | Adult | Aged | Antibodies, Viral/bl [Blood] | Antibodies, Viral/im [Immunology] | CD8-Positive T-Lymphocytes/im [Immunology] | CD8-Positive T-Lymphocytes/pa [Pathology] | Female | Hepatitis B Surface Antigens/bl [Blood] | Hepatitis B Surface Antigens/im [Immunology] | Hepatitis B Vaccines/im [Immunology] | Hepatitis B virus/im [Immunology] | Hepatitis B/im [Immunology] | Humans | Longitudinal Studies | Male | Middle Aged | Time FactorsLocal holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1996 - presentISSN:
  • 0016-5085
Name of journal: GastroenterologyAbstract: BACKGROUND & AIMS: Infection with hepatitis B virus (HBV) can be prevented by vaccination with HB surface (HBs) antigen, which induces HBs-specific antibodies and T cells. However, the duration of vaccine-induced protective immunity is poorly defined for health care workers who were vaccinated as adults.CONCLUSIONS: HBs antigen vaccine-induced immunity protects against future infection but does not provide sterilizing immunity, as evidenced by HBcore- and polymerase-specific CD8(+) T cells in vaccinated health care workers with occupational exposure to HBV. The presence of HBcore- and HBV polymerase-specific T-cell responses is a more sensitive indicator of HBV exposure than detection of HBcore-specific antibodies. Copyright 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.METHODS: We investigated the immune mechanisms (antibody and T-cell responses) of long-term protection by the HBV vaccine in 90 health care workers with or without occupational exposure to HBV, 10-28 years after vaccination.RESULTS: Fifty-nine of 90 health care workers (65%) had levels of antibodies to HBs antigen above the cut-off (>12 mIU/mL) and 30 of 90 (33%) had HBs-specific T cells that produced interferon-gamma. Titers of antibodies to HBs antigen correlated with numbers of HBs-specific interferon-gamma-producing T cells, but not with time after vaccination. Although occupational exposure to HBV after vaccination did not induce antibodies to the HBV core protein (HBcore), the standard biomarker for HBV infection, CD4(+) and CD8(+) T cells against HBcore and polymerase antigens were detected. Similar numbers of HBcore- and polymerase-specific CD4(+) and CD8(+) T cells were detected in health care workers with occupational exposure to HBV and in patients who acquired immunity via HBV infection. Most of the HBcore- and polymerase-specific T cells were CD45RO(+)CCR7(-)CD127(-) effector memory cells in exposed health care workers and in patients with acquired immunity. In contrast, most of the vaccine-induced HBs-specific T cells were CD45RO(-)CCR7(-)CD127(-) terminally differentiated cells.All authors: Abdalla A, Gara N, Ghany MG, Rehermann B, Werner JMDigital Object Identifier: Date added to catalog: 2014-04-04
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Journal Article MedStar Authors Catalog Article Available 23916846

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1996 - present

BACKGROUND & AIMS: Infection with hepatitis B virus (HBV) can be prevented by vaccination with HB surface (HBs) antigen, which induces HBs-specific antibodies and T cells. However, the duration of vaccine-induced protective immunity is poorly defined for health care workers who were vaccinated as adults.

CONCLUSIONS: HBs antigen vaccine-induced immunity protects against future infection but does not provide sterilizing immunity, as evidenced by HBcore- and polymerase-specific CD8(+) T cells in vaccinated health care workers with occupational exposure to HBV. The presence of HBcore- and HBV polymerase-specific T-cell responses is a more sensitive indicator of HBV exposure than detection of HBcore-specific antibodies. Copyright 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.

METHODS: We investigated the immune mechanisms (antibody and T-cell responses) of long-term protection by the HBV vaccine in 90 health care workers with or without occupational exposure to HBV, 10-28 years after vaccination.

RESULTS: Fifty-nine of 90 health care workers (65%) had levels of antibodies to HBs antigen above the cut-off (>12 mIU/mL) and 30 of 90 (33%) had HBs-specific T cells that produced interferon-gamma. Titers of antibodies to HBs antigen correlated with numbers of HBs-specific interferon-gamma-producing T cells, but not with time after vaccination. Although occupational exposure to HBV after vaccination did not induce antibodies to the HBV core protein (HBcore), the standard biomarker for HBV infection, CD4(+) and CD8(+) T cells against HBcore and polymerase antigens were detected. Similar numbers of HBcore- and polymerase-specific CD4(+) and CD8(+) T cells were detected in health care workers with occupational exposure to HBV and in patients who acquired immunity via HBV infection. Most of the HBcore- and polymerase-specific T cells were CD45RO(+)CCR7(-)CD127(-) effector memory cells in exposed health care workers and in patients with acquired immunity. In contrast, most of the vaccine-induced HBs-specific T cells were CD45RO(-)CCR7(-)CD127(-) terminally differentiated cells.

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