Evaluation of Anti-HBs Antibody Titres and assessing the Immune Response among healthcare workers vaccinated against Hepatitis B in AIIMS Rajkot

Globally, Hepatitis B virus (HBV) infection is a pressing health concern, affecting an estimated 257 million individuals. In the WHO South-East Asia Region, approximately 2% of the general population is infected with hepatitis B. India, situated in the intermediate endemic zone, has the world’s second-largest number of hepatitis B cases. It is estimated that between 2%-8% of individuals in India carry the hepatitis B surface antigen (HBsAg), resulting in over 50 million cases. Additionally, nursing officers are at high risk for occupational exposure to hepatitis B due to its prevalence and ability to be transmitted through blood during patient care. Although implementing infection control measures can help mitigate risks, HBV remains highly infectious and can even be transmitted without visible blood. Furthermore, it can survive on surfaces for up to seven days. Despite efforts to address this issue through protocols, occupational exposure to HBV remains a significant concern.

By ensuring HBV protection for nursing staff, this project addresses an essential aspect of occupational health within healthcare settings. This intramural project could lead to significant improvements in staff safety and contribute to broader public health goals if it analyzes anti-HBs antibody titers, assesses immune responses, and identifies non-responders among vaccinated nursing staff.

Study design: Cross-sectional study

Study duration: -All samples collected from regular full-time working employees for 24 months

Study Setting: -The study will be conducted in the Serology section of the Department of Microbiology, AIIMS Rajkot

Study Population: - The target population will be regular full-time healthcare workers working in AIIMS Rajkot who have completed a course of Hepatitis B vaccination (n=313)

Inclusion criteria

1   All healthcare workers who are regular employees and who have received a complete course of the Hepatitis B vaccine

 2.  All healthcare workers who gave valid consent for participation

 Exclusion criteria:

1. All healthcare workers who are regular employees and who are non-vaccinated against Hepatitis B

2. All those employees who have a positive history of HBV infection in the past

3. Regular full-time working employees are not willing to participate and give consent.

Methodology A cross-sectional survey will be conducted to gather information from regular working  employees who have received at least one complete course of the Hepatitis B vaccine and are volunteering to participate. Once written consent is obtained, an investigator will explain the study’s objectives. Participants’ personal histories will be obtained using a standardized questionnaire. This will include demographic information such as age, gender, occupation, and details about their hepatitis B vaccination and any previous needle stick injuries. Blood samples (5ml) will be collected using aseptic techniques and labeled accordingly for serum separation. The level of anti-HBs antibodies in the serum will be determined using ELISA following the manufacturer’s instructions. According to the Centers for Disease Control and Prevention guidelines, a quantitative anti-HBS level below 10.0 mIU/ml will indicate an inadequate immune response to HBV vaccination.