Post-vaccination Immunity Against Hepatitis B Virus and Predictors for Non-responders Among Medical Staff

BACKGROUND: Hepatitis B virus (HBV) is a major cause of chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma (HCC). HB vaccination is an essential step in the prevention of the disease and its consequent complications. OBJECTIVES: Immune status of medical personnel in teaching hospitals of Khuzestan is not well known. Since these personnel are usually at risk of needle stick and other high-risk events, some challenges exist in infection control committee with regard to managing these events. This study was conducted to assess post-vaccination immunity status and non-response to HBV vaccine as well as its predictors among medical staff in a teaching hospital affiliated to Ahvaz Jundishapur University of Medical Sciences (AJUMS) in Ahvaz, southwest Iran. PATIENTS AND METHODS: In this retrospective cross-sectional study, the medical staff of a teaching hospital was evaluated for their immune response against HBV and factors affecting it. The study conducted in Razi Hospital, Ahvaz City, southwest of Iran, in 2013. Demographical, clinical, and laboratory data registered in medical files of hospital staff were analyzed by SPSS software version 16 using chi-square and Fisher exact tests. Differences with P value < 0.05 were considered significant. To identify predictors for non-responders, we used odds ratio (OR) with 95% confidence interval (CI). RESULTS: Out of 239 participants, 43 (18 %) were men and 196 (82%) were women. Their mean age was 31.9 ± 18.1 years (range of 20 - 55 years). Fourteen (5.9%) participants were non-responders, 37 (15.5%) were poor responders, and 188 (78.6%) were good responders. The non-responders were older (> 50 years) than the responders (P = 0.0001), while the body mass index (BMI) was not significantly different (P = 0.37) between them. Diabetes mellitus (DM) (OR: 7.3, 95% CI, 1.3 - 41.7, P = 0.05), and using immunosuppressive drugs (ISD) (OR: 3.2, 95% CI, 1.1 - 11.5, P = 0.03) were two variables in association with non-response to HB vaccine. CONCLUSIONS: Non-response rate to HB vaccine in our study was approximately 6%. Age over 50 years, DM, and receiving immunosuppressive drugs may be considered as predictors for non-response to HB vaccine in medical staff.