Durability of antibody response against hepatitis B virus in healthcare workers vaccinated as adults

Naveen Gara, Adil Abdalla, Elenita Rivera, Xiongce Zhao, Jens M. Werner, T. Jake Liang, Jay H. Hoofnagle, Barbara Rehermann, Marc G. Ghany

Research output: Contribution to journalArticlepeer-review

32 Scopus citations


Background.Follow-up studies of recipients of hepatitis B vaccine from endemic areas have reported loss of antibody to hepatitis B surface antigen (anti-HBs) in a high proportion of persons vaccinated at birth. In contrast, the long-term durability of antibody in persons vaccinated as adults in nonendemic areas is not well defined. We aimed to assess the durability of anti-HBs among healthcare workers (HCWs) vaccinated as adults and response to a booster among those without protective levels of antibody. Methods.Adult HCWs aged 18-60 at the time of initial vaccination were recruited. All were tested for hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen (anti-HBc), and anti-HBs level. HCWs with anti-HBs 20 years postvaccination, respectively, (P = ns). Four HCWs were anti-HBc positive; none had HBsAg. By logistic regression, older age at vaccination was the only predictor of inadequate anti-HBs level (P =. 0005). Thirty-four of 36 subjects with inadequate anti-HBs levels received a booster and 32 (94%) developed levels >12 mIU/mL within 3 weeks. Conclusions.Anti-HBs levels decrease after 10-31 years and fall below a level considered protective in approximately 25% of cases. The rapid and robust response to a booster vaccine suggests a long-lasting amnestic response. Hepatitis B vaccination provides long-term protection against hepatitis B and booster vaccination does not appear to be necessary in HCWs.

Original languageEnglish (US)
Pages (from-to)505-513
Number of pages9
JournalClinical Infectious Diseases
Issue number4
StatePublished - Feb 15 2015
Externally publishedYes


  • booster vaccination
  • chronic hepatitis B
  • healthcare workers
  • hepatitis B vaccine

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)


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