Research Paper
Persistence of specific antibodies after hepatitis B vaccination

https://doi.org/10.1016/S0168-8278(88)80032-1Get rights and content

Summary

Antibody levels to hepatitis B surface antigen (anti-HBs) in healthy adults vaccinated with three doses of plasma-derived hepatitis B vaccine, containing 20, 10 or 5 μg of antigen, were followed for 4–6 years. After vaccination, 1034 of 1076 individuals had developed anti-HBs and 1016 had antibody concentrations above 10 IU/l. 681 of all initial responders could be tested after 1 year, 520 after 2, 380 after 3 and 213 after 4 years. 72 and 39 individuals, respectively, of the 185 earliest vaccinated volunteers were available for retesting after 5 and 6 years. Four years after the first vaccination, anti-HBs levels in 34% had dropped below 10 IU/l. The persistence of anti-HBs above this value depended on the peak antibody response after the third vaccination. Whereas all vaccinees tested with peak anti-HBs levels above 10 000 IU/l still had levels above 10 IU/l after 6 years, no-one with initial values between 10 and 100 IU/l maintained antibody concentrations above 10 IU/l for longer than 4 years. The rate of decrease in anti-HBs was independent of the peak anti-HBs value, the vaccine dose, and the age and sex of the vaccinees.

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    Hypo-responders tend to have a shorter duration of detectable anti-HBsAg and therefore may not have long-term immunity to HBV infection [5]. It has also been shown that achieving and maintaining anti-HBsAg ≥ 100 mIU/mL is associated with long-term persistence of seroprotection [6,7]. Persons older than 40 years have a 25–50% non-responder rate [8], and patients receiving hemodialysis or those with diabetes have been reported to have a 30–40% non-responder rate [9].

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