Longitudinal Study of Hepatitis B immunization in Healthcare Workers in One Egyptian Center

Objective: We have performed this study to: 1- Evaluate the prevalence of hepatitis B virus surface antigen (HBsAg) and antibody to hepatitis C virus (anti- HCV) in health care workers at start of the study and after 5 years to evaluate the risks of seroconversions 2- Evaluate the rates of antibodies titer in HCWs both after HBV immunization and after 5 years from vaccination. Methods: The study included 302 health care workers in Mansoura University Children hospital, Egypt from December 2009 till February 2015. HCWs receive vaccination for HBsAg and the states of antibodies titer for HBsAg were evaluated after complete vaccination and after 5 years. Also the anti-HCV and HBsAg were determined by immunoassay at start of the study and after 5 years. Results: Ninety percent of HCWs developed anti-HBsAg above 10mIU/ml. The non-responsive of HCWs was 10%, and HCWs with levels between 10-100 mIU/ml were 21.7%. The results of HCV IgG and HBsAg among HCWs at the start of the study were 4.3% and 0.7% respectively. After 5 years, the rates of HCV IgG and HBsAg were 18.2% and 4.4%% respectively. The seroconversion rates showed around four folds increase in HCVIgG and six folds increase in HBsAg the increase was highly significant (P=0.0001, P=0.006 respectively). The presence of protective antibodies titer after five years for anti-HBs was 59.8%. HCWs that have less 10mIU/ml anti-HBs were 40.3%, HCWs who had levels between 10-100 mIU/ml were 14.5% and HCWs with levels more than 100mIU/ml were 45.3%. Conclusions: The present study highlights an important finding among some Egyptian health care workers. There is good response for hepatitis B vaccination after primary vaccination however, there are some non-responders and hypo responders so the evaluation of antibodies levels after vaccination is important for application of revaccination or/and booster dose application for achieving of utmost protection level. The decline of antibodies level after 5 years is remarkable necessity for the evaluation of health care workers for antibodies levels for booster dose administration. The seroconversion for hepatitis C and B viruses were significant among our health care workers. Strict adherence to infection control guidelines should be implanted.