Rate of Hepatitis B seroconversion in health science students enrolled at a single academic institution

Objectives: Requirements for proof of protective Hepatitis B virus (HBV) titers in students enrolled in health science schools affords a unique opportunity to assess HBV seroconversion rates.  The purpose of this study is to determine the HBV seroconversion rate in healthcare students at an academic institution in the Southeastern United States.

Methods: This study has been approved by the Institutional Review Board.  A retrospective, non-interventional pilot study was conducted at the University of South Carolina in Columbia, South Carolina in all pharmacy, nursing, and medical students enrolled between 2007 and 2011. Demographic data, dates of HBV vaccinations, and HBV titer results, were collected by immunization chart review.  The primary endpoint is the percentage of students with positive Hepatitis B titers (≥10 IU/mL) after receiving the initial Hepatitis B vaccination series.  Factors associated with Hepatitis B seroconversion results will be secondary endpoints.  A detailed assessment will be performed on data from students with an initial negative titer at enrollment that required HBV "booster" series. 

Results: Preliminary results from the pharmacy student cohort show 83% (259/312) of students had positive titers and averaged 10 years between completion of HBV vaccination series and follow-up titer.  Students with initial negative titers 17% (53/312), had 10.9 years on average between last vaccination and titer.  Students with initial negative titers and one documented vaccination (4/53) averaged 7.5 years between vaccination and initial titer, whereas students with initial negative titers and two documented (3/53) vaccinations averaged 13.5 years between vaccination and titer.  Students were predominantly female (67.5%).

Conclusions: Increased rate of seroconversion was seen among students who completed the primary HBV series, with less time between last HBV vaccination and titer.  The rate of negative titers stresses the need for established guidelines and prudent record-keeping and follow-up for healthcare students.