Hepatitis B seroepidemiology and booster vaccination in pre-clinical medical students in a Malaysian university

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Abstract

Introduction: Infant hepatitis B vaccination was introduced into the Expanded Programme on Immunisation (EPI) in Malaysia in 1989. This study aimed to investigate seroprevalence of hepatitis B among UKM pre-clinical medical students, born between 1991 and 1995, and had their infant vaccination more than 20 years ago. Materials and Methods: A prospective, cross-sectional study involving 352 students, comprising 109 (31.0%) males and 243 (69.0%) females. Blood specimens were tested for anti-HBs, where levels of ≥10 mIU/mL was considered reactive and protective. Students with non-reactive levels were given a 20 µg HBV vaccine booster. Anti-HBs levels were tested six weeks after the first booster dose. Those with anti-HBs <10 mIU/mL were then given another two booster doses, at least one month apart. Anti-HBs levels were tested six weeks after the third dose. Results: Ninety-seven students (27.6%) had anti-HBs ranging from 10 to >1000 mIU/ mL while 255 (72.4%) had anti-HBs <10 mIU/mL. After one booster dose, 208 (59.1%) mounted anti-HBs ≥10 mIU/mL. Among the remaining 47 (13.3%), all except two students (0.6%) responded following completion of three vaccination doses. They were negative for HBsAg and anti-HBcore antibody, thus regarded as non-responders. Conclusions: Anti-HBs levels waned after 20 years post-vaccination, where more than 70% were within non-reactive levels. For healthcare workers, a booster dose followed by documenting anti-HBs levels of ≥10 mIU/mL may be recommended, to guide the management of post-exposure prophylaxis. Pre-booster anti-HBs testing may not be indicated. Serological surveillance is important in long-term assessment of HBV vaccination programs. No HBV carrier was detected.

Original languageEnglish
Pages (from-to)295-302
Number of pages8
JournalMalaysian Journal of Pathology
Volume40
Issue number3
Publication statusPublished - 1 Dec 2018

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Hepatitis B
Medical Students
Vaccination
Students
Post-Exposure Prophylaxis
Immunization Programs
Malaysia
Seroepidemiologic Studies
Hepatitis B Surface Antigens
Anti-Idiotypic Antibodies
Vaccines
Cross-Sectional Studies
Delivery of Health Care

Keywords

  • Anti-HBs
  • Healthcare workers
  • Hepatitis B vaccination
  • Medical students
  • Serological surveillance
  • Seroprevalence

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology
  • Cell Biology

Cite this

@article{31e946233c4546299846b060f74f8ff5,
title = "Hepatitis B seroepidemiology and booster vaccination in pre-clinical medical students in a Malaysian university",
abstract = "Introduction: Infant hepatitis B vaccination was introduced into the Expanded Programme on Immunisation (EPI) in Malaysia in 1989. This study aimed to investigate seroprevalence of hepatitis B among UKM pre-clinical medical students, born between 1991 and 1995, and had their infant vaccination more than 20 years ago. Materials and Methods: A prospective, cross-sectional study involving 352 students, comprising 109 (31.0{\%}) males and 243 (69.0{\%}) females. Blood specimens were tested for anti-HBs, where levels of ≥10 mIU/mL was considered reactive and protective. Students with non-reactive levels were given a 20 µg HBV vaccine booster. Anti-HBs levels were tested six weeks after the first booster dose. Those with anti-HBs <10 mIU/mL were then given another two booster doses, at least one month apart. Anti-HBs levels were tested six weeks after the third dose. Results: Ninety-seven students (27.6{\%}) had anti-HBs ranging from 10 to >1000 mIU/ mL while 255 (72.4{\%}) had anti-HBs <10 mIU/mL. After one booster dose, 208 (59.1{\%}) mounted anti-HBs ≥10 mIU/mL. Among the remaining 47 (13.3{\%}), all except two students (0.6{\%}) responded following completion of three vaccination doses. They were negative for HBsAg and anti-HBcore antibody, thus regarded as non-responders. Conclusions: Anti-HBs levels waned after 20 years post-vaccination, where more than 70{\%} were within non-reactive levels. For healthcare workers, a booster dose followed by documenting anti-HBs levels of ≥10 mIU/mL may be recommended, to guide the management of post-exposure prophylaxis. Pre-booster anti-HBs testing may not be indicated. Serological surveillance is important in long-term assessment of HBV vaccination programs. No HBV carrier was detected.",
keywords = "Anti-HBs, Healthcare workers, Hepatitis B vaccination, Medical students, Serological surveillance, Seroprevalence",
author = "Othman, {Siti Norlia} and {Zainol Rashid}, Zetti and {Abdul Wahab}, Asrul and {Abdul Samat}, {Muttaqillah Najihan} and Ding, {Chuan Hun} and Ali, {Umi Kalsom @ Satariah}",
year = "2018",
month = "12",
day = "1",
language = "English",
volume = "40",
pages = "295--302",
journal = "Malaysian Journal of Pathology",
issn = "0126-8635",
publisher = "Malaysian Society of Pathologists",
number = "3",

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TY - JOUR

T1 - Hepatitis B seroepidemiology and booster vaccination in pre-clinical medical students in a Malaysian university

AU - Othman, Siti Norlia

AU - Zainol Rashid, Zetti

AU - Abdul Wahab, Asrul

AU - Abdul Samat, Muttaqillah Najihan

AU - Ding, Chuan Hun

AU - Ali, Umi Kalsom @ Satariah

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Introduction: Infant hepatitis B vaccination was introduced into the Expanded Programme on Immunisation (EPI) in Malaysia in 1989. This study aimed to investigate seroprevalence of hepatitis B among UKM pre-clinical medical students, born between 1991 and 1995, and had their infant vaccination more than 20 years ago. Materials and Methods: A prospective, cross-sectional study involving 352 students, comprising 109 (31.0%) males and 243 (69.0%) females. Blood specimens were tested for anti-HBs, where levels of ≥10 mIU/mL was considered reactive and protective. Students with non-reactive levels were given a 20 µg HBV vaccine booster. Anti-HBs levels were tested six weeks after the first booster dose. Those with anti-HBs <10 mIU/mL were then given another two booster doses, at least one month apart. Anti-HBs levels were tested six weeks after the third dose. Results: Ninety-seven students (27.6%) had anti-HBs ranging from 10 to >1000 mIU/ mL while 255 (72.4%) had anti-HBs <10 mIU/mL. After one booster dose, 208 (59.1%) mounted anti-HBs ≥10 mIU/mL. Among the remaining 47 (13.3%), all except two students (0.6%) responded following completion of three vaccination doses. They were negative for HBsAg and anti-HBcore antibody, thus regarded as non-responders. Conclusions: Anti-HBs levels waned after 20 years post-vaccination, where more than 70% were within non-reactive levels. For healthcare workers, a booster dose followed by documenting anti-HBs levels of ≥10 mIU/mL may be recommended, to guide the management of post-exposure prophylaxis. Pre-booster anti-HBs testing may not be indicated. Serological surveillance is important in long-term assessment of HBV vaccination programs. No HBV carrier was detected.

AB - Introduction: Infant hepatitis B vaccination was introduced into the Expanded Programme on Immunisation (EPI) in Malaysia in 1989. This study aimed to investigate seroprevalence of hepatitis B among UKM pre-clinical medical students, born between 1991 and 1995, and had their infant vaccination more than 20 years ago. Materials and Methods: A prospective, cross-sectional study involving 352 students, comprising 109 (31.0%) males and 243 (69.0%) females. Blood specimens were tested for anti-HBs, where levels of ≥10 mIU/mL was considered reactive and protective. Students with non-reactive levels were given a 20 µg HBV vaccine booster. Anti-HBs levels were tested six weeks after the first booster dose. Those with anti-HBs <10 mIU/mL were then given another two booster doses, at least one month apart. Anti-HBs levels were tested six weeks after the third dose. Results: Ninety-seven students (27.6%) had anti-HBs ranging from 10 to >1000 mIU/ mL while 255 (72.4%) had anti-HBs <10 mIU/mL. After one booster dose, 208 (59.1%) mounted anti-HBs ≥10 mIU/mL. Among the remaining 47 (13.3%), all except two students (0.6%) responded following completion of three vaccination doses. They were negative for HBsAg and anti-HBcore antibody, thus regarded as non-responders. Conclusions: Anti-HBs levels waned after 20 years post-vaccination, where more than 70% were within non-reactive levels. For healthcare workers, a booster dose followed by documenting anti-HBs levels of ≥10 mIU/mL may be recommended, to guide the management of post-exposure prophylaxis. Pre-booster anti-HBs testing may not be indicated. Serological surveillance is important in long-term assessment of HBV vaccination programs. No HBV carrier was detected.

KW - Anti-HBs

KW - Healthcare workers

KW - Hepatitis B vaccination

KW - Medical students

KW - Serological surveillance

KW - Seroprevalence

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SP - 295

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JO - Malaysian Journal of Pathology

JF - Malaysian Journal of Pathology

SN - 0126-8635

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