Evaluation of immunological response to hepatitis B vaccine among healthcare workers at Rwanda Military Hospital

Abstract

INTRODUCTION: Healthcare workers (HCWs) are at high risk of acquiring hepatitis B viral (HBV) infection through occupational exposure to blood or body fluids. However, the rates of non- responders after HBV vaccination among HCWs are not well documented. Therefore, we aimed to determine the proportion of immunological non-responders among HCWs who received Hepatitis B vaccine at Rwanda Military Hospital (RMH) and characterize the memory T cell responses to the Hepatitis B vaccine.

METHODS: A cross sectional study was conducted at the RMH. HBV vaccinated HCWs were evaluated for immune response by measuring serum Hepatitis B surface antibody (anti-HBs) titers and levels of HB core antibodies (HBcAb) on COBAS e411 machine, 6 years post vaccination.RESULTS: Initially 87 employees were included in the study. Four participants were excluded due to incomplete records. 52 (62.7%) participants were female and 31 (37.3%) were male. HWCs’ age ranged between 23 and 66 years with a mean (±SD) age of 38.2 ± 7.3. Of 83 HCWs, 70 (84.3%)showed response to HBV vaccine, non-responders were 11 (13.3%) and 2 (2.4%) showed immunity due to natural infection. There was no significant difference in Th cell frequencies and function between responders and non-responders after stimulation with rHBsAg vaccine.

CONCLUSION: Immunological response six years post HBsAg vaccination was 84.3% in HCWs at RMH and similar to the global prevalence. Anti-HBs levels should be tested in all HCWs following HBsAg vaccination. Personal protective equipment, and a dose of Hepatitis B prophylaxis when exposed should be emphasized.