Anti-hepatitis B core antibody is not required for prevaccination screening in healthcare workers

▶ Vaccination against hepatitis B virus (HBV) is recommended in health care workers (HCWs). ▶ The isolated anti-HB core antibody (anti-HBc) positivity represents one of the following conditions: past HBV exposure, occult HBV infection, or false positive. ▶ The prevalence of isolated anti-HBc in HCWs was not so high (2.3%). ▶ Most isolated anti-HBc positivity represents past HBV exposure and attenuated immunity. Because most of them acquired anti-HBs seroconversion after vaccination and their early vigorous immune reaction was decreased as compared with the controls. ▶ Their attenuated vaccine response was correlated with old age. ▶ In light of the finding that older persons may have decreased titers of anti-HBs, and have reduced immunity despite prior exposure to HBV, interval screening for anti-HBs and a booster vaccination may be required in older HCWs.