Predictors of poor response to the hepatitis B vaccine among healthcare workers at the National Liver Institute Hospital

Objectives This study aimed to estimate the nonresponder rates to the hepatitis B vaccine and identify possible risk factors of nonresponse among a group of healthcare workers (HCWs) at the National Liver Institute Hospital. Background Hepatitis B is the most important infectious occupational disease among HCWs. The most effective preventive measure is hepatitis B vaccination. Response to the hepatitis B vaccine [significant hepatitis B surface antibodies (HBsAbs) titer] ranges from 85 to 90% globally. HCWs are at a high risk of acquiring hepatitis B virus (HBV), and nonresponder rates after HBV vaccination have not been reported previously among HCWs at the National Liver Institute. Participants and methods A retrospective and follow-up study was carried out at the National Liver Institute. The studied group included 200 HCWs who were evaluated for immune response by measuring serum HBsAbs levels within 6 months after completing three doses of the HBV vaccine. A questionnaire was administered to them to assess the risk factors of nonresponse. Results The nonresponder rate to the hepatitis B vaccine (nonsignificant HBsAbs titer) was 9%. The results showed that there was a significant relationship between nonresponse and older age, high BMI, and the presence of chronic diseases; 55.6% of the nonresponders were older than 30 years of age, 66.7% of the nonresponders had BMI above 30, and 100% of hepatitis C-infected HCWs showed no response to the vaccine (P < 0.05). Conclusion and recommendations Nonresponder HCWs to the HBV vaccine who work in a high-risk environment are at a high risk of acquiring HBV infection. Therefore, it is crucial to check postvaccination HBsAbs in all HCWs. This strategy will ensure safety at work by reducing nosocomial transmission, and will have a cost-effective impact at an individual as well as at a national level.