Prevalence of anti-HBc antibodies among medical workers, depending on age, gender, and occupational categories

Despite a wide availability of specific prophylaxis against viral hepatitis B (HBV), the issues of HBV morbidity among healthcare workers remain quite sufficient. A latent form of hepatitis (LHB) may play a role in maintaining the epidemic spread of HBV. The aim of the study was to identify the dependence of the incidence of anti-HBc antibodies among employees of medical institutions by their age, gender and professional categories. Materials and methods: Blood serum samples were tested for anti-HBc in 1,643 medical staff members (doctors, nurses, paramedics, other personnel). Blood sera were examined for the presence of anti-HBc by ELISA using the HepaBest anti-HBc-IgG enzyme-linked immunosorbent assay system manufactured by Vector-Best-Europe JSC. The results were statistically analyzed using Microsoft Office Excel 2010 and Prism9 (GraphPad, USA). For comparison groups of medical workers according to the frequency of occurrence of Anti-HBc, the chi-square criterion was used. Results. Anti-HBs were detected in 601 persons, thus reaching 36.6% of the total study sample. In 1042 subjects (63.4%), anti-HBs were not revealed. Almost half of paramedical personnel from the study sample were IgG seropositive for the HBV nuclear antigen (50.6%). There were no significant differences in the anti-HBc detection rates for men (31.5%) and women (37.0%). In the structure of seropositive anti-HBc, a smaller percentage was detected in the category “young age” (24.0%), the largest prevalence is noted in the category of “middle age” (45 to 59 years), with 38.8%, which may be associated with service duration and longer exposure to potential HBV sources. The detection frequencies of anti-HBc to HBV nuclear antigen, along with anti-virus surface protein antibodies (anti-HBs) represent an index of HBV prevalence. We would like to recommend anti-HB testing for the medical staff members before repeated immunization and with additional examinations (search for viral DNA with a positive result) in order to exclude medical workers as a source of infection followed by further monitoring of these persons for timely medical aid, as well as adjusting the vaccination volume against HBV in this professional cohort.

1. Bazhenov A.I., Elgort D.A., Feldsherova A.A., Budnitskaya P.Z., Nikitina G.I., Hats Yu.S., Konopleva M.V., Godkov M.A., Borisova V.N., Semenenko T.A., Suslov A.P. The comparative estimation of Anti-HBs activity against native and recombinant type HBsAg. Epidemiologiya i vatsinoprofilaktika = Epidemiology and Vaccinal Prevention, 2012, no. 2, pp. 76-81. (In Russ.)

2. Batskikh S.N. Resolved Hepatitis B: Achieved or Imaginary Wellbeing? Rossiyskiy zhurnal gastroenterologii, gepatologii, koloproktologii = Russian Journal of Gastroenterology, Hepatology and Coloproctology, 2021, Vol. 31, no. 1, pp. 7-19. (In Russ.)

3. Beliaieva T.V. Viral hepatitis as a sexually transmitted infection. Zhurnal akusherstva i zhenskikh bolezney = Journal of Obstetrics and Women Diseases, 2004, Vol. 53, pp. 112-113. (In Russ.)

4. Batskikh S.N. Hepatitis B: Familiar and Unknown]. Moscow: GEOTAR-Media, 2024. 160 p.

5. Grjibovski A.M. Choosing a statistical test for hypothesis testing. Ekologiya cheloveka = Human Ecology, 2008, no. 11, pp. 48-57. (In Russ.)

6. Danilova E.S. Nosocomial infections among medical professionals of therapeautic-and-prophylactic organizations. Rossiyskiy mediko-biologicheskiy vestnik imeni akademika I.P. Pavlova = I.P. Pavlov Russian Medical Biological Herald, 2013, Vol. 1, pp. 137-144. (In Russ.)

7. Methodological guidelines MU 3.1.2792-10 “3.1. Prevention of infectious diseases. Epidemiological surveillance of hepatitis B”]. Moscow: Federal Center for Hygiene and Epidemiology of Rospotrebnadzor, 2011. [Electronic resource]. Available at: https://36.rospotrebnadzor.ru/documents/rekdoc1/5683/print_page/ (date of access: September 15, 2025).

8. Nikitina G.Yu., Semenenko T.A., Gotvyanskaya T.P., Hahaeva I.B., Konopleva M.V., Nikolaeva O.G., Yarosh L.V., Kozhevnikova L.K., Suslov A.P. THE Prevalence of parenteral hepatitis markers among the medical personnel in the russian federation regions with different intensity of epidemic process. Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya = Clinical Microbiology and Antimicrobial Chemotherapy, 2017, Vol. 19, no. 2, pp. 161-167. (In Russ.)

9. Popova O.V., Semenenko T.A., Mikhailov M.I. The duration of post-vaccination immunity against hepatitis B. Mir virusnykh gepatitov = World of Viral Hepatitis, 2003, Vol. 12, pp. 10-13. (In Russ.)

10. Tupoleva T.A. Occult form of infection caused by the hepatitis b virus. Gematologiya i transfuziologiya = Russian Journal of Hematology and Transfusiology, 2018, Vol. 63, no. 2, pp. 166-173. (In Russ.)

11. Center for Hygienic Education of the population of Rospotrebnadzor. From the history of preventive vaccination in the USSR and Russia [Electronic resource]. Available at: https://cgon.rospotrebnadzor.ru/naseleniyu/vaktsinatsiya/natsionalnyykalendar-profilakticheskikh-privivok/iz-istorii-kalendarya-profilakticheskikh-privivok-v-sssr-rossii/ (date of access: September 15, 2025).

12. Filatov N.N., Khrapunova I.A., Filippov V.A., The main factors of occupational infection of medical workers with hemocontact infections. Epidemiologiya i vaktsinoprofilaktika = Epidemiology and Vaccinal Prevention, 2005, no. 2, pp. 41-45. (In Russ.)

13. Shironina N.L., Dodonov N.P., Shironina N.L., Polskaya L.R. Hepatitis B in medical workers. Epidemiological features and methods of prevention. Mir virusnykh gepatitov = World of Viral Hepatitis, 2002, no. 10. pp. 2-6. (In Russ.)

14. Adugna A., Sinamou D., Bailey T. Getinet M., Haimanot A.B., Amare G.A., Belew H., Hibstu Z., Abebaw D., Fenta A., Getinet M., Abiy D., Ashagre A., Jemal M. Seropositivity of antibodies to hepatitis B nuclear antigen in vaccinated individuals with a negative hepatitis B surface antigen test result aged 5-12 years in northwestern Ethiopia. Heliyon, 2024, Vol. 10, no. 21, e40107. doi: 10.1016/j.heliyon.2024.e40107.

15. Alavian S.M., Carman W.F., Jazayeri S.M. HBsAg variants: diagnostic-escape and diagnostic dilemma. J. Clin. Virol., 2013, Vol. 57, no. 3, pp. 201-208.

16. Busch M.P. Should HBV DNA NAT replace HBsAg and/or anti-HBc screening of blood donors? Transfus. Clin. Biol., 2004, Vol. 11, no 1, pp. 26-32.

17. Dyussenbayev A. Age periods of human life. Adv. Soc. Sci. Res. J., 2017, Vol. 4, no. 6, pp. 258-263.

18. Jaroszewicz J., Serrano B., Wursthorn K., Deterding K., Schlue J., Raupach R., Flisiak R., Bock C.-T., Manns M., Wedemeyer H., Cornberg M. Hepatitis B surface antigen (HBsAg) levels in the natural history of hepatitis B virus (HBV)-infection: A European perspective. J. Hepatol., 2010, Vol. 52, no. 4, pp. 514-522.

19. Jiang X, Chang L., Yan Y., Wang L. Paradoxical HBsAg and anti-HBs coexistence among Chronic HBV Infections: Causes and Consequences. Int. J. Biol. Sci., 2021, Vol. 17, no. 4, pp. 1125-1137.

20. Lok A.S., Everhart J.E., Di Bisceglie A.M, Kim H.Y., Hussain M., Morgan T.R. Occult and previous hepatitis B virus infection are not associated with hepatocellular carcinoma in United States patients with chronic hepatitis C. Hepatology, 2011, Vol. 54, no. 2, pp. 434-442.

21. Terrault N.A., Lok A.S.F., McMahon B.J., Chang K.M., Hwang J.P., Jonas M.M., Brown R.S. Jr, Bzowej N.H., Wong J.B. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology, 2018, Vol. 67, no. 4. pp. 1560-1599.

22. Yuen M.-F., Chen D.-Sh., Dusheiko G.M., Janssen H.L.A., Lau D.T.Y., Locarnini S.A., Peters M.G., Lai C.-L. Hepatitis B virus infection. Nat. Rev. Dis. Primers, 2018, Vol. 4, 18035. doi: 10.1038/NRDP.2018.35.