- D Palmović: University Hospital of Infections Diseases Dr Fran Mihaljević, Zagreb, Croatia.
The results of the analysis of vaccination against hepatitis B performed in 2,000 persons of high-risk groups in Croatia are described. All susceptible non-immunocompromised persons (HBsAg, anti-HBs, and anti-HBc negative) received either plasma-derived vaccine (HB-Vax MSD, 20 micrograms per dose) or recombinant HB vaccine (ENGERIX-B, SKB, 20 micrograms per dose) according to a 0.1 and 6-month schedule. Hemodialysis patients received four doses of HB vaccine (40 micrograms per dose). Seroconversion occurred in 98% of health care workers, 98.5% of family members of HBsAg chronic carriers, 98% of infants born to HBsAg carrier-mothers and 92% of hemodialysis patients. The percentage of poor-responders (titer of anti-BHs = 1-10 mIU/ml) for the groups was 2, 2, 8 and 20%, respectively, while low-responders (titer of anti-BHs = 10.1-100 mIU/ml) were 5, 4.5, 12 and 26%, respectively. A significant prevalence of non-responders, poor-responders and low-responders among male health care workers was noticed (p = 0.01, 0.026 and 0.002, respectively). Females significantly prevailed among excellent-responders (p = 0.0039). In hemodialysis patients, there were 8% non-responders, 19.5% poor-responders, and 26% low-responders. A significant difference between the percentage of good-responders (titer of anti-HBs = 101-1,000 mIU/ml) and excellent-responders (titer of anti-HBs over 1,000 mIU/ml) among health care workers and hemodialysis patients was documented (91% versus 46.5%, p < 0.0001). The combined passive-active immunization (hyperimmune hepatitis B globulin + hepatitis B vaccine) was effective in 98% of infants born to HBsAg carrier-mothers, and only one boy developed subclinical HBV infection (HBsAg and anti-HBc positive findings with normal ALT-values).(ABSTRACT TRUNCATED AT 250 WORDS)