Indian Journal of Medical Research

CORRESPONDENCE
Year
: 2015  |  Volume : 141  |  Issue : 1  |  Page : 125--126

Antibody response to hepatitis B vaccination in isolated anti-HBc positive subjects


Hasan Tahsin Gozdas 
 Department of Infectious Diseases & Clinical Microbiology, Dr. Münif Islamoglu Kastamonu State Hospital, Kastamonu, Turkey

Correspondence Address:
Hasan Tahsin Gozdas
Department of Infectious Diseases & Clinical Microbiology, Dr. Münif Islamoglu Kastamonu State Hospital, Kastamonu
Turkey




How to cite this article:
Gozdas HT. Antibody response to hepatitis B vaccination in isolated anti-HBc positive subjects.Indian J Med Res 2015;141:125-126


How to cite this URL:
Gozdas HT. Antibody response to hepatitis B vaccination in isolated anti-HBc positive subjects. Indian J Med Res [serial online] 2015 [cited 2019 Sep 16 ];141:125-126
Available from: http://www.ijmr.org.in/text.asp?2015/141/1/125/154516


Full Text

Sir,

I read with interest the article by Sugunan et al[1] on impact of hepatitis B immunization among the Nicobarese tribe. The authors investigated protective antibody response after hepatitis B vaccination in their study. I feel that several points in this study need to be clarified.

Hepatitis B infection has been reported to be hyperendemic in Nicobarese where this study was conducted. As per the inclusion criteria, subjects negative for both HBsAg and Anti-HBs were included in the study. However, hepatitis B core antibody (anti-HBc) status of the study population was not mentioned. This condition could be a confounding factor. Because hepatitis B vaccine is not recommended for isolated anti-HBc positive subjects (HBsAg and anti-HBs negative) living in highy endemic areas due to the high probability of previous exposure to hepatitis B infection [2] . Isolated anti-HBc positivity might be present in these subjects who were at high risk for prior exposure to hepatitis B infection. Antibody response after hepatitis B vaccination may be different in isolated anti-Hbc positive subjects from that of naive subjects [3] . In addition, primary anti-HBs response develops when anti-HBc was positive at a low titre; whereas secondary or anamnestic antibody response develops when anti-HBc was positive at a high titre [3],[4] . Subjects enrolled in this study might be heterogeneous in terms of anti-Hbc status due to sampling error. Further in this study [1] , protective antibody level was tested one month after each vaccine dose and after the completion of vaccine series at second, third and fifth year. As understood from the Figure, protective antibody level after the third vaccine dose was tested at sixth month rather than the seventh month. However, as mentioned in the article, protective levels should have been checked one month after each vaccine dose (after the third dose of vaccine at seventh month not at sixth month). I think there is a typographical error in the figure.

References

1Sugunan AP, Bhattacharya H, Bhattacharya D, Mandal A, Ghosal SR, Rao RC, et al. Impact of hepatitis B immunization among the Nicobarese tribe antibody titres & seroprotection five years after vaccination. Indian J Med Res 2014; 139 : 427-30.
2Lok AS, McMahon BJ. Chronic hepatitis B: update 2009. Hepatology 2009; 50 : 661-2.
3McMahon BJ, Parkinson AJ, Helminiak C, Wainwright RB, Bulkow L, Kellerman-Douglas A, et al. Response to hepatitis B vaccine of persons positive for antibody to hepatitis B core antigen. Gastroenterology 1992; 103 : 590-4.
4Lok AS, Lai CL, Wu PC. Prevalence of isolated antibody to hepatitis B core antigen in an area endemic for hepatitis B virus infection: implications in hepatitis B vaccination programs. Hepatology 1988; 8 : 766-70.