INVESTIGATION OF POST-VACCINATION IMMUNITY AGAINST HEPATITIS B IN MEDICAL PERSONNEL OF TUBERCULOSIS HOSPITAL

The strength and duration of an immune response to hepatitis B virus (HBV) after vaccination among the medical personnel of a tubercular center and a need for their vaccination were studied. Serum samples from 96 medical workers of the clinic were studied; Engerix vaccine was used in accordance with the standard scheme (0-1-6 months) in the period from 1998 to 2008. The markers of hepatitis B (HBsAg, anti-HBs, anti-HBc) and hepatitis C (anti-HCV) viruses were tested by enzyme immunoassay. All anti-HBsAg positive samples were examined for HCV RNA using PCR. For the analysis of post-infection immunity (protective criterion), the antibody detection rates were as follows: anti-HBs, 10 mIU/ml or more (low titers, 10-199 mIU/ml; medium titers, 200-5000 mIU/ml; high titers, over 5000 mIU/ml). The medical workers were proven to remain a risk group for parenteral hepatic infections: the presence of isolated anti-HBc in 5.2% of cases; the discovery of anti-HCV in 3.1% of the persons with HCV RNA, in the absence of clinical and biochemical parameters, is suggestive of latent HBV and HCV infections. Almost every three (28.1%) medical workers with anti-HBs were found to have anti-HBc, which might suggest prior HBV infection. It was ascertained that 21.9% of the medical workers had no post-vaccination antibodies to HBV in the protective titer in the analyzed period. Among 78.1% of the medical personnel having protective levels of antibodies to HBV (anti-HBs), 54, 20, and 26% had low, medium, and high antibody titers, respectively. A dynamic investigation for postvaccination immunity to HBV showed that the proportion of individuals with the concentration of protective antibody titers among the medical staff was 84.2% one year after completion of vaccination. However, the number of persons with protective titers of antibodies to HBV decreased with years. According to the time of vaccination, there was a reduction in the number of persons with high titers of antibodies to HBV and simultaneously an increase in the number of subjects with low and medium titers of antibodies to HBV. The strength of post-vaccination immunity to HBV among different groups of medical personnel in the tuberculosis center depends on the kind of professional activity.

medical personnel, hepatitis B, post-vaccination immunity, antibody titers, strength, duration