Reversal of Nonresponders and Postexposure Prophylaxis by Intradermal Hepatitis B Vaccination in Japanese Medical Personnel

Seiho Nagafuchi, Seizaburo Kashiwagi, Kenji Okada, Keizo Anzai, Minoru Nakamura, Yasuharu Nishimura, Takehiko Sasazuki, Yoshiyuki Niho

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Abstract

Thirty-one Japanese nonresponders to subcutaneous hepatitis B vaccination and 15 medical personnel who were accidentally exposed to specimens positive for hepatitis B e antigen and were given hepatitis B immunoglobulin were intradermally immunized with 5 μg of plasma-derived hepatitis B vaccine every 2 weeks until delayed type hypersensitivity skin reaction to hepatitis B surface antigen became positive. Thirty (97%) of the 31 nonresponders developed delayed type hypersensitivity skin reactions to hepatitis B surface antigen after 2.3 ±1.2 (mean±SD) revaccinations. Twenty-nine (94%) of the 31 nonresponders had anti—hepatitis B surface antigen antibody levels greater than 10 IU/L. The immunoglobulin subclass of the antibody to hepatitis B surface antigen was mainly IgG1. After 1 year, 23 (74%) of the 31 nonresponders continued to have anti—hepatitis B surface antigen antibody levels greater than 10 IU/L. Persons accidentally exposed to specimens positive for hepatitis B e antigen developed delayed type hypersensitivity skin reactions to hepatitis B surface antigen following 3.1 ±1.1 revaccinations. None developed clinical hepatitis. There was no production of anti—hepatitis B core antigen antibody 1 year after exposure, indicating that protection was 100%. Intradermal hepatitis B vaccination is useful in reversing nonresponsiveness to hepatitis B surface antigen and for prophylaxis after exposure.

Original languageEnglish
Pages (from-to)2679-2683
Number of pages5
JournalJAMA: The Journal of the American Medical Association
Volume265
Issue number20
DOIs
Publication statusPublished - May 22 1991

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All Science Journal Classification (ASJC) codes

  • Medicine(all)

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