Hepatitis B titer low?

[dreamchase]

I asked my Dr to run a test for hepatitis b and c.

Hep C came back negative.

The test he ran was called Hepatitis B surface ab quan.

Beside the test was listed 8.3...which I'm guessing is low.

Here's the stressful part. I've worked in a nursing home for two years tons of hepatitis . And my job didn't give me the vaccines at the time because they asked me was I ever vaccinated and I told them a few years ago and they wouldn't do it. So young and dumb I just went with the flow. Does a low titer and being a healthcare worker not protected means I'm at huge risk? I asked for a hep b test but he didn't do it only the titer. I'm asking because I'm wrecking my nerves and I don't hear from my Dr until Monday ...thanks

[VANurse2010]

I think my titre was >1000

[TriciaJ, RN]

My understanding is that the titre level can drop years after the vaccination, even if it showed previously showed immunity. Check the CDC website. I think if you need the titre to show immunity, you can try one booster then retest after (?) 4 weeks.

[edmia, BSN, RN]

Yes, immunity can wane and for some, several doses still don't provide immunity. Where I work, if your titer is less than 10, you get a booster shot and retest titers in 6 weeks. The number I've heard from the ID people at work is 10 years (as an appropriate time to recheck your titer after your original series).

Sent from my iPhone -- blame all errors on spellcheck

[dienw]

If you do get infected with hepatitis B, it can kill you. Most people survive the acute phase. It is debilitating and recovery takes months. These facts make it appropriate to go beyond just being careful when working with patients.

You may be what is known as a nonresponder as defined by the CDC in this document found on the WHO website: http://www.who.int/occupational_health/activities/3hepatiti.pdf

Should you be revaccinated? Perhaps not, or at least maybe not by repeating the same process that didn't work the first time. See this: Repeated vaccinations do not improve specific immune defenses against Hepatitis B in non-responder health care workers

Possibly you should be revaccinated with a different adjuvant, if you can even find this formulation described in Human Vaccines & Immunotherapeutics "Immunogenicity of an investigational hepatitis B vaccine (hepatitis B surface antigen co-administered with an immunostimulatory phosphorothioate oligodeoxyribonucleotide) in nonresponders to licensed hepatitis B vaccine"

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Here is one possible explanation of why some people are nonresponders Increased Serum MicroRNA-155 Level Associated with Nonresponsiveness to Hepatitis B Vaccine

Some nonresponders seem to benefit from intradermal administration of the second series instead of repeating the IM administration that didn't work well the first time. Scandanavian Journal of Gastroenterology, "A low-dose intradermal hepatitis B vaccine programme in health-care workers and students is highly effective and cost saving: A retrospective follow-up survey in the clinical setting"

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informahealthcareDOTcom/doi/abs/10.1080/00365520701733806?journalCode=gas

More information on the intradermal route. Hepatitis B vaccine by intradermal route in non responder patients: An update

The links I provided contain links to even more research and guidance. Please don't make decisions based on what I say. Instead, take some time and educate yourself. Best of luck and health to you.

[klone, MSN, RN]

That its a big chance you contracted hep b.

I'm confused by what you're saying. Are you saying that because your Hep B titer was low, you've been exposed or infected with HBV? Why would you think that?

In order to know if you've been infected or exposed is by getting a HBSag (antigen testing). If it's negative, you don't have to worry. You should probably still get a repeat of the series, and then retest your titer/antibody in a few months.