Transcript HEPATITIS B MARKERS AND VACCINE

HEPATITIS B
MARKERS AND
VACCINE
PBL 21
TUTOR : PROF MOHAMED A. EL-FARRASH
1. DEFINITION ?
2. MARKERS OF HEPATITIS B ?
A. HBV SURFACE ANTIGEN (HBsAg)
B. HBV e ANTIGEN (HBeAg)
C. SURFACE ANTIBODY (Anti-HBs)
D. e ANTIBODY (Anti-HBe)
E. CORE ANTIBODY (Anti HBc IgM)
F. CORE ANTIBODY (Anti HBc IgG)
3. VACCINE FOR HEPATITIS B ?
I. WHAT IT IS MADE OF?
II. GIVEN TO WHOM?
III.WHAT TO DO BEFORE & AFTER VACCINATION?
IV.FATE OF VACCINATION?
OBJECTIVES
DEFINITION ?
• Hepatitis : inflammation of liver; presence of inflammatory
cells in organ tissue.
• Type : Hepadnaviridae (DNA Virus).
• Hepatitis B serological markers : A generic term referring to
hepatitis B antigens and antibodies to these antigens.
• Vaccine : administration of antigenic material to stimulate an
individual's immune system to develop adaptive immunity to
a pathogen.
MARKERS OF
HEPATITIS B ?
HBV surface antigen (HBsAg)
• Is the first antigen to show up on a test when someone
becomes initially infected with HBV.
• HBsAg may be present before symptoms appear.
• If someone has the surface antigen they are able to infect
others.
• When the antigen is in the body longer than 6 months then
a person has chronic HBV infection.
HBV e antigen (HBeAg)
• The second antigen that appears as a result of the virus
replicating in the body.
• If someone has the “e” antigen it means that HBV is
actively infecting and replicating in liver cells.
• The presence of the “e” antigen also means that the
person’s blood and bodily fluids are very infectious.
• This test determines how contagious the patient is and
may differentiate chronic replicative from chronic nonreplicative states.
Surface antibody (anti-HBs)
• Is produced to fight HBV.
• If the body produces large enough quantities, it can
clear HBV from the body called a resolved
infection.
• It remains detectable for life and is not found in
chronic carriers.
• It is the antibody present after successful HBV
vaccine.
E antibody (Anti-HBe)
• Is produced when the body responds to infection by
producing antibodies to the “e” antigen.
• Generally, when the “e” antibody is found it means
that the body is fighting HBV.
• Its presence cannot be used to predict the outcome of
a chronic infection.
Core antibody
(Anti HBc IgM)
Core antibody
( Anti HBc IgG)
• Appear shortly after the onset
of symptoms of hepatitis B
infection and soon after the
appearance of hepatitis B
surface antigen (HBsAg).
• Rises soon after IgM, and
remains present for life in both
chronic carriers as well as
those who clear infection.
• Marker of acute infection,
which rises early (within 2-4
weeks) of HBV infection and
slowly disappears.
• It rises 4-6 months after
infection and persists for life.
• ↓ levels of Anti HBc IgM
indicate resolving infection.
• Partially protective anti-HBc
antibody levels can be induced
by recombinant vaccination,
but are short-lived.
Markers in Acute HBV infection
Markers in Chronic infection
VACCINE FOR
HEPATITIS B ?
VACCINATION FOR HEPATITIS B
• The first hepatitis B vaccine to become available commercially in 1982
consisted of HBsAg purified from the plasma of persons with chronic
HBV infection.
• Now been replaced by recombinant vaccines that are free of any
concerns associated with human blood products.
• HBsAg gene has been inserted into yeast and mammalian cells by
means of appropriate expression vectors.
• Antigen expressed in several species of yeast, namely Saccharomyces
cerevisiae, Pichia pastoris and Hansenula polymorpha, and
Chinese hamster ovary (CHO) cells
Administration of 3 doses induces protective level
of antibodies in 95% of vaccine recipients.
GIVEN TO WHOM ?
• Sexually active homosexual and bisexual males,
including those with HIV infection.
• Persons who may be exposed to the virus by means of
blood such as healthcare workers
• Sexual contacts of HBV carriers.
• Persons in areas with high risk of HBV infection.
• Persons who shared the use of illegal injection drugs.
• Infants of HBV carrier mothers.
• All newborn infants are now vaccinated.
vaccines: Recombinant
HBsAg
WHAT TO DO BEFORE VACCINATION?
1. Pre-vaccination serologic screening for previous
infection is not indicated for healthcare providers.
2. Screening may exclude persons with high titers of
HBsAb as they are already immune.
3. Neworn babies are not screened before vaccination
WHAT TO DO AFTER VACCINATION?
1. After 3-4 weeks from the last dose of the vaccine,
vaccinated person should be tested for HBsAb.
2. In health care workers the protective titer should be above
100 mIU/ml of HBs Ab while in usual persons it is 10
mIU/ml.
3. Booster doses (after the 3 doses course) are not necessary,
and periodic serologic testing to monitor antibody titer after
completion of the vaccine series is not recommended.
FATE OF UNSUCCESSFUL VACCINATION?
• A "vaccine non-responder" is a person who does not
develop protective surface antibodies after completing two
full series of the hepatitis B vaccine and for whom an
acute or chronic hepatitis B infection has been ruled out.
• Although the majority of persons vaccinated against
hepatitis B successfully respond to vaccination, an
estimated 5-15% of persons may not respond.
• It is possible that a person who does not respond to the
vaccine may already be infected with hepatitis B.
• Therefore, testing for the presence of the virus
(HBsAg) is recommended before diagnosing a person
as a "vaccine non-responder".
• You would be wise to seek a check on your hepatitis B
status. It is possible that you have been exposed to past
infection, and this would be confirmed if your serum is
Anti-HB core positive.
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AFIQA KHIR
NUR AQMAR
MARYAM
DAnial SHah
ANNAS SUBERI
ALI HANI
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SERI AMIRAH
ERMIN SYAHMIN
YOMNA
SUFIAN
NOURHAN
AMIRA MANAN
THANK YOU 