From the Guidelines
Post-vaccination serology for hepatitis B should be performed 1-2 months after completing the three-dose vaccination series to confirm immunity, with a focus on healthcare workers, immunocompromised individuals, sexual partners of hepatitis B carriers, and others at high risk of exposure, as recommended by the most recent guidelines 1. The test measures hepatitis B surface antibody (anti-HBs) levels, with results ≥10 mIU/mL indicating successful immunization and protection against infection.
- Key groups that require post-vaccination serology include: + Healthcare workers + Immunocompromised individuals + Sexual partners of hepatitis B carriers + Hemodialysis patients + HIV-infected persons
- If antibody levels are inadequate (<10 mIU/mL), revaccination with another complete three-dose series is recommended, followed by repeat serology testing, as supported by studies 2, 3, 4.
- The immune response to hepatitis B vaccination varies based on age, weight, smoking status, and immune function, with approximately 5-10% of healthy adults failing to develop adequate antibody levels after standard vaccination, as noted in previous research 5.
- For those who develop adequate antibody levels, immunity is generally long-lasting, and routine booster doses are not recommended for immunocompetent individuals, according to the latest guidelines 1.
From the Research
Post-Vaccination Serology for Hepatitis B
- The persistence of immunity provided by hepatitis B (Hep B) vaccine 18-26 years after primary vaccination was evaluated in a cross-sectional study of 628 participants 6.
- The study found that 55.4% of participants had anti-HBs levels of ≥10 mIU/mL, with a geometric mean concentration (GMC) of 82.59 mIU/mL.
- Among participants with anti-HBs levels of <10 mIU/mL, 93.1% reached anti-HBs levels of ≥10 mIU/mL after a booster dose, with a GMC of 493.47 mIU/mL 6.
- The Centers for Disease Control and Prevention (CDC) recommends postvaccination serologic testing (antibody to hepatitis B surface antigen [anti-HBs]) 1-2 months after the final dose of vaccine is administered 7.
- A longitudinal study demonstrated long-lasting hepatitis B virus (HBV) cellular immunity despite loss of antibody against HBV surface antigen, with all 44 participants testing positive for tumor necrosis factor α, interleukin 10, or interleukin 6 production by HBV surface antigen-specific T cells 8.
- Seroconversion rates after hepatitis B vaccination were evaluated in patients with end-stage renal disease, with 83% of patients seroconverting after three doses of Heplisav-B, a recombinant adjuvanted vaccine 9.
- The American College of Physicians and the Centers for Disease Control and Prevention recommend vaccinating against hepatitis B virus (HBV) in all unvaccinated adults at risk for infection, and screening for HBV in high-risk persons 10.
Key Findings
- Booster doses can increase anti-HBs levels in participants with initial levels of <10 mIU/mL 6.
- Long-lasting cellular immunity against HBV can persist despite loss of antibody against HBV surface antigen 8.
- Hepatitis B vaccination is recommended for all unvaccinated adults at risk for infection, and screening for HBV is recommended for high-risk persons 10.
- Seroconversion rates after hepatitis B vaccination can be high in patients with end-stage renal disease, with 83% of patients seroconverting after three doses of Heplisav-B 9.