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Response to Challenge Dose Among Young Adults Vaccinated for Hepatitis B as Infants: Importance of Detectable Residual Antibody to Hepatitis B Surface Antigen

Published online by Cambridge University Press:  03 February 2015

Philip R. Spradling ,
Saleem Kamili ,
Jian Xing ,
Jan Drobeniuc ,
Dale J. Hu  and
Amy B. Middleman
Philip R. Spradling*
Affiliation:
Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
Saleem Kamili
Affiliation:
Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
Jian Xing
Affiliation:
Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
Jan Drobeniuc
Affiliation:
Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
Dale J. Hu
Affiliation:
Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
Amy B. Middleman
Affiliation:
Baylor College of Medicine, Houston, Texas
*
Address correspondence to Philip R. Spradling, MD, Division of Viral Hepatitis, Centers for Disease Control and Prevention, Mailstop G37, 1600 Clifton Rd., NE, Atlanta, GA 30333 ([email protected]).
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Abstract

OBJECTIVE

To determine whether a difference in antibody to hepatitis B surface antigen (anti-HBs) response to a hepatitis B vaccine challenge dose existed among persons with a baseline anti-HBs level of 0 mIU/mL (group 1) and those with “non-zero” levels of 0.1–4.9 (group 2) and 5.0–9.9 (group 3) mIU/mL, according to the VITROS ECi anti-HBs assay.

DESIGN

Subanalysis of randomized clinical trial. Response was defined as a postchallenge anti-HBs level of at least 10 mIU/mL and 4-fold rise in anti-HBs level 2 weeks after a single challenge dose of 10 vs 20 µg Engerix-B. Baseline was defined as the anti-HBs level immediately before administration of the challenge dose.

SETTING

Pediatric integrated healthcare system near Houston, Texas.

PARTICIPANTS

Three hundred nineteen US-born 16–19-year-olds who completed the hepatitis B vaccine series during the first year of life.

RESULTS

One hundred seventy-eight persons had zero (group 1) and 141 (114 group 2 and 27 group 3) had non-zero anti-HBs levels at baseline. Response to the challenge dose was significantly higher among those with non-zero vs zero anti-HBs levels, irrespective of challenge dosage; only 1 person with a non-zero anti-HBs level failed to respond to the challenge dose (group 3, 27/27 [100%] vs group 2, 113/114 [99%] vs group 1, 145/178 [82%]; P<.0001).

CONCLUSIONS

Among participants with residual anti-HBs levels less than 10 mIU/mL 16–19 years after primary hepatitis B vaccination during infancy, non-zero anti-HBs levels, with rare exception, indicated persistence of immune memory to HBsAg.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT01341275

Infect Control Hosp Epidemiol 2015;00(0):1–5

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 5 , May 2015 , pp. 529 - 533
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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References

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