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Abstract

For evaluating the boosting (anamnestic) effects of the most recent commercially produced plasma derived heat-inactivated hepatitis B vaccine (A. Co.), 117 adults with naturally acquired antibody to hepatitis B surface antigen (anti-HBs) were selected at random. In addition, out of case immunized at zero and 1 month, and boosted at 6 months (primary boosting) by conventional vaccine (B. Co), inactivated by pepsin digestion and formalin treatment, 11 cases who showed elevated titer after primary boosting were also submitted to the study. The results were as follows: 1) Out of the 117 subjects with naturally acquired anti-HBs, 6(5.1%) showed isolated anti-HBs and the titers were below 10 ratio units (RU). Negative seroconversion was seen in 4(3.4%) of the 117 cases at 12 months after the screening and, of these cases, 3 showed isolated anti-HBs and the titers were below 10 RU. 2) Eighty-three percent of the cases with naturally acquired isolated anti-HBs below 10 RU did not respond to a booster injection with 3 us dose of A. Co. vaccine at all, but 90% of the other subjects responded. 3) The anti-HBs titers of all the 11 cases who showed a rise of more than 10 RU (increased GMT, 28.04) at one month after primary booster injection by $20{\mu}g$ dose of B. Co. vaccine decreased at 19 months after the primary booster. And 3 subjects (27.3%) of the 11 reached negative seroconversion. All of the 11 cases, who had secondary booster injection with $3{\mu}g$ dose of A. Co. vaccine at 19 months after primary boosting, showed increased anti-HBs titer at least 20 RU or more (increased GMT, 57. 72) at one month after the boosting. According to the above results in the anti-HBs screening survey for the purpose of immunization with hepatitis B vaccine, subjects with isolated anti-HBs below 10 RU should be regarded as being in an unimmunized state. In cases who are in risk circumstances, immunized primarily with a $20{\mu}g$ dose of B. Co. vaccine, a secondary booster injection should be given within 2 years after initiation of primary immunization and a $3{\mu}g$ booster dose of A. Co. vaccine can be reliably used.

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