DONALD E. CRAVEN, M.D.; ZUHEIR L. AWDEH, Ph.D.; LAUREEN M. KUNCHES, R.N., M.P.H.; EDMOND J. YUNIS, M.D.; JULES L. DIENSTAG, M.D.; BARBARA G. WERNER, Ph.D.; B. FRANK POLK, M.D.; DAVID R. SNYDMAN, M.D.; RICHARD PLATT, M.D.; CLYDE S. CRUMPACKER, M.D.; GEORGE F. GRADY, M.D.; CHESTER A. ALPER, M.D.
Twenty-eight health care workers who had a poor antibody response when initially vaccinated with hepatitis B vaccine were revaccinated with three additional 20-µg doses. Eight of the twenty nonresponders, who had levels of antibody to hepatitis B surface antigen (anti-HBs) of less than 8 estimated radioimmunoassay (RIA) units, and all 8 of the hyporesponders, who had anti-HBs levels of 8 or 16 RIA units, attained anti-HBs levels of 36 RIA units or more after revaccination. Tests for HLA-A, B, C, and DR; for complement proteins C2, C4A, C4B, and BF; and for the erythrocyte enzyme glyoxalase I were done in 17 nonresponders and 3 hyporesponders. Nine (45%) had HLA-DR7 and 8 (40%) had HLA-DR3, compared with an expected rate of 23% in the general population. At least one of two extended haplotypes (B44, DR7, FC31 or B8, DR3, SCOl) were detected in 6 of the 9 who did not respond to revaccination, compared with 2 of 11 who responded to a second course of vaccine. Poor responders to vaccine may benefit from revaccination, and genetic factors may modulate the immune response to vaccination.
CRAVEN DE, AWDEH ZL, KUNCHES LM, YUNIS EJ, DIENSTAG JL, WERNER BG, et al. Nonresponsiveness to Hepatitis B Vaccine in Health Care Workers: Results of Revaccination and Genetic Typings. Ann Intern Med. ;105:356–360. doi: 10.7326/0003-4819-105-3-356
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Published: Ann Intern Med. 1986;105(3):356-360.
Gastroenterology/Hepatology, Infectious Disease, Prevention/Screening, Vaccines/Immunization, Viral Hepatitis.
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