Estimation of Antibody Titre of Hepatitis B Surface Antigen among Medical Students of a Tertiary Care Centre in North Kerala


Sujatha Sankaran*


Hepatitis B Virus (HBV) infections at younger age lead to chronic liver damage and hepatocellular carcinoma. Medical students have high risk of exposure to HBV. Vaccination certificate is mandatory for medical course admission as it is vaccine preventable. The immune response wanes gradually over time and antibody level was needed to be maintained by booster dose. Objective of the study was to find out anti-HBs titer and to evaluate the seroprotection in students of Govt. Medical college, Manjeri in North Kerala.


A cross sectional study was conducted among 375 students of Govt. medical college, Manjeri in north Kerala during 2018-2019. Anti-HBs titre was estimated in serum samples by quantitative ELISA method using direct antibody sandwich enzyme immunoassay kits (Monolisa Anti - HBs PLUS 72566).


Among the 375 participants, 149 (39.7%) were completely vaccinated, 90 (24%) had partial immunization and 136 (36.27%) had no vaccination records. Protective titre of >10 mIU/mL was maintained by 304 (81.06%) students. Good seroprotection >100 mIU/mL was seen in 234 (62.4%) and 70 (18.7%) individuals were with 10-100 mIU/mL. No significant association was seen with age, gender or Body Mass Index (BMI) to seroprotection. Time since last dose of vaccination and number of doses were associated with good immune response (p <0.005).


Anti-HBs wanes over period of time. Partially immunized individual were sensitized to complete the doses. Fully immunized individuals with <100 mIU /mL titre were advised to take single booster dose. Subjects who had <10 mIU/mL after the booster dose were asked to repeat three primary doses. Instead of submitting a vaccination certificate, an electronic register is preferred in Medical institutions to record of HBV seroprotection. Immune status against HBV is to be rechecked at the end of course before starting the internship.