Document Type : Original Article
Authors
1 Bushehr University of Medical Sciences, Bushehr
2 Yazd University of Medical Sciences, Yazd, Iran
Abstract
Introduction: Hepatitis B infection is an important health problem all over the world, and
according to the studies, Iran is a country with intermediate prevalence, so vaccination is a
cost-benefit approach. In this study, evidence about the efficacy of hepatitis B vaccine was
collected by systematic review methods and its amount was estimated by a meta-analysis.
Materials and Methods: In this study, documents and literature search were performed
using valid key words in Information Sciences Institute, PubMed, Scientific Information
Data base, and Iranmedex databases from 1997 to 2010 in different regions of Iran. All
cross-sectional studies about the efficacy of hepatitis B vaccine in Iran which fulfilled
the inclusion criteria entered the study. Antibody titer (Anti-hemoglobins > 10 IU/L) was
considered as the desired efficacy. In order to present the results, prevalence and Forest
plot were used and for evaluation of the inconsistency meta-regression model and I2
index
were used. We used R.15.3.2 software for analysis. Results: Totally 64 studies (52 studies
in general population and 12 studies among specific populations) including 12,575 subjects
with age range from 8 months to 55 years entered the meta-analysis. The efficacy was
86.3% (confidence interval [CI]: 83.9-88.7%) in the general population and 59.62% (CI:
47.9-71.29%) in specific patient populations. Also the efficacy was significantly related to the
year of publication, age and gender (P < 0.05). Conclusion: Prevention is an important issue
in general health. Hepatitis B vaccination is one of the methods used to prevent hepatitis
B infection. According to this study, the efficacy of hepatitis B vaccination was more than
80% in general population, so injection of full course of hepatitis B vaccinationis enough
and booster dose is not required.
Keywords
1. Zuckerman JN, Zuckerman AJ. The epidemiology of hepatitis B.
Clin Liver Dis 1999;3:179‑87.
2. Daniels D, Grytdal S, Wasley A, Centers for Disease Control and
Prevention (CDC). Surveillance for acute viral hepatitis‑United
States, 2007. MMWR Surveill Summ 2009;58:1‑27.
3. Alter MJ. Epidemiology and prevention of hepatitis B. Semin Liver
Dis 2003;23:39‑46.
4. Kao JH, Chen PJ, Lai MY, Chen DS. Occult hepatitis B virus infection
and clinical outcomes of patients with chronic hepatitis C. J Clin
Microbiol 2002;40:4068‑71.
5. Andrade AF, Oliveira‑Silva M, Silva SG, Motta IJ, Bonvicino CR.
Seroprevalence of hepatitis B and C virus markers among blood
donors in Rio de Janeiro, Brazil, 1998‑2005. Mem Inst Oswaldo Cruz
2006;101:673‑6.
6. Mast EE, Margolis HS, Fiore AE, Brink EW, Goldstein ST, Wang SA,
et al. A comprehensive immunization strategy to eliminate
transmission of hepatitis B virus infection in the United States:
Recommendations of the advisory committee on immunization
practices (ACIP) part 1: Immunization of infants, children, and
adolescents. MMWR Recomm Rep 2005;54:1‑31.
7. World Health Organization. Introduction of hepatitis B vaccine into
childhood immunization services. Geneva, WHO, 2001 (unpublished
document WHO/V&B/01.31 available on request from Department of
Vaccines and Biologicals, World Health Organization, 1211 Geneva
27, Switzerland).
8. Poorolajal J, Majdzadeh R. Prevalence of chronic hepatitis B infection
in Iran: A review article. J Res Med Sci 2009;14:249‑58.
9. Goldstein ST, Alter MJ, Williams IT, Moyer LA, Judson FN,
Mottram K, et al. Incidence and risk factors for acute hepatitis B in
the United States, 1982‑1998: Implications for vaccination programs.
J Infect Dis 2002;185:713‑9.
10. Alizade M, Hooshang A, Alavian SM, JAfari Kh, Yazdi N. Prevalence
HIV‑Ab and HCV‑Ab and HbsAg in addicted prisoners of central jail
of Hamadan. J Res Med Sci 2002;7:311‑3.
11. Bonanni P, Pesavento G, Boccalini S, Bechini A. Perspectives of
public health: Present and foreseen impact of vaccination on the
epidemiology of hepatitis B. J Hepatol 2003;39 Suppl 1:S224‑9.
12. Vaccination and Immunity Guideline. 5th ed. The Office of Deputy
Ministry of Health. Ministry of Health and Medical Education. Tehran
(Iran): Seda Publishing; 1998.
13. Parmar Z, Khadivi R, Sadeghi B, Rahimi M. Immunization following
hepatitis B mass vaccination in the 18 years old student in
chaharmahalvabakhtyari province in Iran. J Shahrekord Univ Med
Sci 2009;13:35‑41.
14. Kazemi H, Yadegarinia D, Rasheki H. Evaluation of hepatitis B
antibody and factors related to hepatitis B vaccination in Tehran
Hospital staffs, 2010. J Dent Sch Shahid Beheshti Univ Med Sci
2010;35:114‑8.
15. Khodavisi M, Mohamadi N, Omidi A, Amini R. Determination of
Anti‑HBS titre hepatitis B in student of nursing and midwifery faculty
in Hamadan. J Hamadan Nurs Midwifery Fac 2010;18:45‑9.
16. Azarkeivan A, Nasiritoosi M, Hajibeigi B, Afradi H, Eslami M,
Ghazizadeh Sh. Evaluation of immune response to hepatitis B
vaccination and effects of booster dose in chronic transfusion
patients. J Iran Univ Med Sci 2009;16:32‑9.
17. Alavian SM, Akbari H, Ahmadzadasl M, Kazem M, Davodi A.
Vaccination status of dentists participating in the forty‑second
international congress of dentists against hepatitis B and Infection
control practices. J Islam Dent Assoc Iran 2007;7:48‑56.
18. Moemenheravi M, Sharifa, Mousavi Gh. Evaluation of serum
anti‑HBs in health personnel vaccinated in Shahidbeheshti hospital
of Kashan. J Feiz 2006;10:11‑4.
19. Zangeneh M, Poopak B, Khavari M, Valikhani M, Parsania M.
Evaluation of immunogenicity of hepatitis B vaccination in
health workers. J Islam Azad Univ Med Sci‑Tehran Med Branch
2004;14:13‑22.
20. Rostami H, Farmani S, Mirzaee A, Ghorbanzade R. Evaluation of
immune response to hepatitis B in workers at risk. J Urmia Nurs
Midwifery Fac 2008;6:178‑82.
21. Ajami A, Abediyan F. Immunogenicity of hepatitis B vaccine in
medical sciences students‑2004. J Mazandaran Univ Med Sci
2006;16:72‑7.
22. Sarkari B, Zargar MA, Mohammadi R, Asgarian SH. Prevalence
of hepatitis B antibodies in health‑care workers in Yasuj
hospitals, Armaghane‑danesh bimonthly. J Yasuj Univ Med Sci
2006;11:97‑106.
23. Khaki M, Ghavamian M. The evaluation of recombinant HBS.
Ag vaccine immunity in vaccinated medical group and hospital
personnel in Borujerd‑2004. J Arak Univ Med Sci 2005;8:1‑6.
24. Izadpanah AM, Mashreghy Moghadam HR, Ziaee M, Foadaldini M,
Ebadian FS. Anti HBs level in nursing staff of Birjand university of
medical sciences. J Birjand Univ Med Sci 2008;15:80‑6.
25. Janbakhsh A, Hatami H, Sayyad B, Eini P, Hashemian A. The rate of
immune response to hepatitis B vaccination in health centers staff
in Kermanshah, 2002. J Kermanshah Univ Med Sci 2003;7:48‑53.
26. Davodzade M, Rajabipoor F, Shafizade F, Ghorbanivaghee A.
Evaluation anti‑HBs level in vaccinated Interns in Lorestan University
of medical sciences. J Lorestan Univ Med Sci 2004;23:57‑60.
27. Hajybagheri K, Kanani Sh, Moradi Gh, Yousefinejad V. Response to
hepatitis B vaccine in medical staff of hospitals in Kurdistan‑2006.
Iran J Infect Dis Trop Med 2008;13:53‑7.
28. Aminzade Z, Shabani Z, Gachkar L, Sayyadi A. Frequency of positive
HBs Ag in pregnant women of Zanjan. J Rafsenjan Univ Med Sci
2004;3:126‑32.
29. Mokhtarian K, Yazdanparast M, Tarshizi R, Moghani M. Evaluation
levels of antibodies against hepatitis B in staffs of Hajar Hospital,
2007‑2008. J Shahrekord Univ Med Sci 2009;11:35‑9.
30. Rajbar M, Keramat F, Keshavarz F. Immunogenicity of hepatitis B
vaccination in staff of HamedanSina Hospital (2001). Sci J Hamdan
Univ Med Sci 2002;7:55‑8.
31. Ayatollahi J, Sharifi MR, Sabzi F, Zare AR. Blood level Anti‑HBs
due to HB vaccine in health care personnel of ShahidSadoughi
Hospital – Yazd. Iran J Obstet Gynecol Infertility 2004;7:48‑51.
32. Saffar M, Nikkhah M, Anvari M. Measure antibody persistence
of hepatitis B virus in Thalassemia recipients of health personnel
6 years after vaccination in Sari. J Mazandaran Univ Med Sci
2001;11:60‑5.33. Baba Mahmoodi F. Evaluation of hepatitis B antibody (HBS) levels
in nursing staff of GaemshahrRazi hospital and it’s variation with
duration of immunity post HB vaccination. J Mazandaran Univ Med
Sci 2000;10:48‑53.
34. Mansour Ghanati F, Fallah MS, Jokar F, Jafarshad R, Aramy M,
Ale-Ismail A, et al. Safety of students vaccinated against hepatitis
B in Guilan University of Medical Sciences. Iran J Infect Dis Trop
Med 2008;13:47‑51.
35. Habibiyan R. Efficacy of complete hepatitis B‑vaccination in health
care workers. J Shahrekord Univ Med Sci 2003;5:42‑7.
36. Salari M, Alavian SM, Tadrisi D, Karimi A, Sadeghian H, Asadzandi M,
et al. Safety of hepatitis B immunization in health care workers.
Kowsar Med J 2006;11:343‑52.
37. Mohamadjafari R, Saadati N, Vaziri Sh, Sooranian A. Frequency of
positive HBs Ag in pregnant women referred to health centers in
Ahvaz City. J Iranian Inst Health Sci Res 2004;3:237‑43.
38. Asefzade M, Sharifi M, Aliaee A. Prevalence of HBsAg carriers and
antiHBsAg in health care workers of Boali‑Sina teaching hospital in
Qazvin. J Qazvin Univ Med Sci 2004;32:41‑6.
39. Baharvand M, Iramloo Z. Survey of anti‑HBs titers in vaccinated
dental students of ShahidBeheshti University of Medical Sciences
in 2002. J Dent Sch Shahid Beheshti Univ Med Sci 2003;21:653‑60.
40. Tohidast Z, Farahani Z, Salmani Gh. Titer of HBs Ab in the faculty
members, residents and student of dental college after three rounds
of vaccination in Tehran university of medical sciences (2002‑2004).
J Islam Dent Assoc Iran 2005;17:98‑103.
41. Keshavarz M, Ahoee M, Babakhani A, Haratipoor H. Efficacy of
hepatitis B vaccine in medical students in Shahrood‑2004. Med J
Mashad Univ Med Sci 2007;3:53‑9.
42. Talebi Taher M, Akbari M, Rezaee M, Ashaerii N, Omrani Z,
Ghaderian H, et al. Determination of anti‑HBS titre mean induced by
hepatitis B vaccine among health care workers in Firoozgar hospital
in Tehran. Razi j Med Sci 2004;11:789‑95.
43. Sohrabi MB, Sarafha J, Zolfaghari P, Eskandari Z. HBs Ab level in
clinical personnel of Immam Hossein Hospital of Shahrood. J Blood
2009;6:65‑4.
44. Savadkoohi R, Hoseinian MA. Level of blood anti‑HBs in the hospital
staff of Amirkola. J Babol Univ Med Sci 2003;5:38‑42.
45. Hagybagheri K, Rahimi A, Mansoorifar Sh. Evaluation of serum
anti‑HBs and related factors in staff vaccinated of Tohid Hospital in
Sanandaj. J Kordestan Univ Med Sci 2001;5:27‑9.
46. Kashifar M, Hasanjaniroshan MR. Response to hepatitis B
vaccination in hospital personnel Yahyanejad‑2002. J Babol Univ
Med Sci 2004;6:39‑42.
47. Taghavi N, Eilami O, Nabavi M, Azargashb E, Yadegarynia D,
Alizadeh AM. Immunogenicity of recombinant hepatitis B vaccine
in health care worker of Boo‑Ali Hospital in Tehran, Iran, 2002‑2004.
Iran J Clin Infect Dis 2006;1:67‑70.
48. Abdolsamadi HR, BakianianVaziri P, Abdollahzadeh Sh, Mani
Kashani KH, Vahedi M. Immune response to hepatitis B vaccine
among dental students. Iran J Public Health 2009;38:113‑8.
49. Torkzaban P, Abdolsamadi H, Vaziri P. Efficacy rate of hepatitis
B vaccination in vaccinated dentists in Hamadan city. J Dent Res
2009;6:62‑6.
50. Behjati M, Mirhoseini NA, Ayatollahi J. Titer of HBs Ab in 8 year old
children vaccinated in Yazd city schools (2001). J Shaheed Sadoughi
Univ Med Sci 2002;10:3‑7.
51. Zahedpashay Y, Ahmadpourkacho M, Pour Nasrollah M, Bijani A,
Saadat H, MazloumiA. Immune response in preterm infants to
hepatitis B vaccine. J Babol Univ Med Sci 2010;13:34‑9.
52. Mahyar A. Survey of antibody titers against recombinant hepatitis
B vaccination in 6 years old children. J Guilan Univ Med Sci
2007;16:39‑43.
53. Kazemi SA, Azizi N. Evaluation of the effects of hepatitis B
vaccination in children after 3 dose vaccine in Zanjan. J Zanjan Univ
Med Sci 1993;22:5‑10.
54. Fathollahporr A, Hemmatpoor S, Ghaderi E. Protective effect of
hepatitis B vaccine in vaccinated children 12‑24 months in the city
of Sanandaj. Iran J Infect Dis Trop Med 2008;13:65‑70.
55. Esmaeeldooki M, Seyedkala F. Evaluation of serum anti‑HBs children
have been vaccinated against hepatitis B in children admitted to
Mirkala Hospital in Babol. Feyz J 2002;24:45‑8.
56. Azarkar Z. Efficacy of hepatitis B vaccine in children from
12‑16 months in Mashad Health Centers. J Qazvin Univ Med Sci
2004;29:38‑41.
57. Moradi A, Khodabakhshi B, Ghaemi E, Mansoorian A, Sarikhani A,
Saeedi M. The rate of response to hepatitis B vaccination in children
less than one year of Gorgan. J Gorgan Univ Med Sci 2008;10:50‑3.
58. Mostafavizade K, Salehi H, Imani R, Haghayegh MR. Antibody levels
following vaccination against hepatitis B virus surface antigen after
a period of 5‑6 years old children new to school in Sharekord. Res
Med Sci 2000;6:194‑6.
59. Salehi M, Saneimoghadam E, Khosravi S. Evaluation of immune
response of hepatitis B vaccination in Zahedaninfants. Zahedan J
Res Med Sci 2002;4:155‑8.
60. Esmail Duki MR, Zahed Pasha Y, Mahdavi A, Haji Ahmadi M.
Comparison of the effect of hepatitis B vaccination in normal and
low birth weight neonates. J Babol Univ Med Sci 2003;5:13‑8.
61. Rafiee M, Majidi J, Hashemi F, Hoseinpoor S, Nejati N, Mostafa
gharabaghi M, et al. Comparison of hepatitis B surface antigen
antibody response in premature and received infants after
vaccination with hepatitis B vaccine in hospital’s children center
Alzahra. Med J Tabriz Univ Med Sci Health Serv 2006;28:55‑8.
62. Safari M, Yazdanpanah B. Decline of hepatitis B antibody level in
vaccinated 5‑7 year‑old children. J Zahedan Med Res 2010;12:24‑8.
63. Saffar MJ, Rezaee MS. Persistence of hepatitis B vaccine safety ten
years after public vaccination in infancy. J Semnan Univ Med Sci
2003;5:63‑71.
64. Rafizade B, Kazemi A, Amirmoghadami HR, Moosavinasab N.
Evaluation of serum anti‑HBs in 5‑6 years old children vaccinated
in Zanjan‑2003. J Zanjan Univ Med Sci Health Serv 2004;47:49‑55.
65. Ramazani A, Aghakhani A, Eslamifar A, Banifazl M, Gachkar L,
Taeb J, et al. Long‑term safety of hepatitis B vaccine in hemodialytic
patient. Iran J Clin Infect Dis 2009;13:21‑4.
66. Raeissi N, Habibian R, Zandian K. Determination of HBs Ab stability
after HBV vaccination in multitransfused patients, Hajar Hospital,
Shahrekord, 2003. J Blood 2006;3:259‑63.
67. Varesvazirian M, Vahidi A, Shamsadini S, Shamsadini A. Evaluation
blood level Anti‑HBs due to HB vaccine in thalassemia children in
Kerman, 2007. J Kerman Univ Med Sci 2007;6:309‑15.
68. Esmaeilpoor N, Mirzaei N, Chaman R, Rasoulinegad M, Haji
abdolbaghi M, Raham M, et al. Investigating HIV/AIDS patient’s
immune response to hepatitis B vaccination. J Shahrood Univ Med
Sci 2010;5:1‑4.
69. Afrasiabian SH, Hajibageri K, Yousefinejad V, Esmaeeli Nasab NE,
Sayfi SH. Response to hepatitis B vaccine in HIV‑Infected patients,
Armaghane‑danesh bimonthly. J Yasuj Univ Med Sci 2008;12:11‑8.
70. Ahmadi F, Maziar S, Ramazani A, Pezeshki M, Khatami M,
Mahdavi M, et al. Evaluation immune hepatitis B and factors in
response to vaccination in hemodialysis patients (2004). Iran J Clin
Infect Dis 2004;9:38‑41.
71. Alaee K, Mansouri D, Alaee A. The rate of response to hepatitis B
vaccination in in HIV positive patient referred to HIV/AIDS advice and
care centers in Kermanshah. J Babol Univ Med Sci 2004;6:46‑51.
72. Shahbazian H, Dinparast R. Evaluation of the immune response
and efficacy of intradermal injection of hepatitis B vaccine in
hemodialysis patient. Sci Med J Ahwaz Jundishapur Univ Med Sci
2006;5:499‑504.
73. Sharifi M, Talebitaher M, Sadeghi M. Antibody response to hepatitis
B vaccination in hemodialytic patient. J Qazvin Univ Med Sci
2003;25:47‑52.
74. Azarkar Z, Sharifizade Gh. The effectiveness of vaccination against
hepatitis B in children with thalassemia major‑Khorasan (2007).
Ofogh-e-Danesh 2008;14:44‑7.
75. Janbakhsh A, Vaziri S, Sayad B, Afsharian M, Rezaei M, et al. Immune
response to standard dose of hepatitis B vaccine in HIV positive
clients of Kermanshah behavioral diseases counseling center. Hepat
Mon 2006;6:71‑4.76. Koike Y, Yoo YC, Mitobe M, Oka T, Okuma K, Tono‑oka S, et al.
Enhancing activity of mycobacterial cell‑derived adjuvants on
immunogenicity of recombinant human hepatitis B virus vaccine.
Vaccine 1998;16:1982‑9.
77. Jafarzadeh A, Khoshnoodi J, Ghorbani SH, Hazrati S, Mazaheri B,
Shokri F. Differential immunogenicity of recombinant hepatitis B
vaccine n Iranian neonates: Influence of ethnicity and environmental
factors. Iran J Immunol 2004;2:98‑103.
78. Koff RS. Hepatitis vaccine. In: Schiff ER, Sorrell MF, Maddery WC,
editors. Disease of the Liver. 8th ed. New York: Lippincott Williams
and Wilkins; 1999.
79. Alimonos K, Nafziger AN, Murray J, Bertino JS Jr. Prediction of
response to hepatitis B vaccine in health care workers: Whose titers
of antibody to hepatitis B surface antigen should be determined
after a three‑dose series, and what are the implications in terms of
cost‑effectiveness? Clin Infect Dis 1998;26:566‑71.
80. STROBE Statement — Checklist of items that should be included
in reports of cross‑sectional studies. Available from: http://www.
strobe‑statement.org/. [Last accessed date Dec 2010].
81. Fisman DN, Agrawal D, Leder K. The effect of age on immunologic
response to recombinant hepatitis B vaccine: A meta‑analysis. Clin
Infect Dis 2002;35:1368‑75.
82. Fabrizi F, Martin P, Dixit V, Bunnapradist S, Dulai G. Meta‑analysis:
The effect of age on immunological response to hepatitis B
vaccine in end‑stage renal disease. Aliment Pharmacol Ther
2004;20:1053‑62.
83. Afzali H, Vali Gh, Khalifehsoltani A. Comparative effect of intradermal
and intramuscular injections of hepatitis B vaccine. Arch Iran Med
2003;6:9‑12.
84. Ferraz ML, Silva AE, Kemp VL, Cruz CN, Guimarães Rx. Evaluation
of the immunological response to hepatitis B vaccine in health care
professionals. Rev Assoc Med Bras 1992;38:5‑8.
85. Mansori D. Survey of incidence and affect of hepatitis B vaccine in
students. J Babol Med Univ Sci 1993;2:39‑42.
86. Park K. Text Book of Preventive and Social Medicine. Translated by
ShojaiTehrani H. 3rd ed. Tehran: Samat; 2002. p. 113‑21.
Clin Liver Dis 1999;3:179‑87.
2. Daniels D, Grytdal S, Wasley A, Centers for Disease Control and
Prevention (CDC). Surveillance for acute viral hepatitis‑United
States, 2007. MMWR Surveill Summ 2009;58:1‑27.
3. Alter MJ. Epidemiology and prevention of hepatitis B. Semin Liver
Dis 2003;23:39‑46.
4. Kao JH, Chen PJ, Lai MY, Chen DS. Occult hepatitis B virus infection
and clinical outcomes of patients with chronic hepatitis C. J Clin
Microbiol 2002;40:4068‑71.
5. Andrade AF, Oliveira‑Silva M, Silva SG, Motta IJ, Bonvicino CR.
Seroprevalence of hepatitis B and C virus markers among blood
donors in Rio de Janeiro, Brazil, 1998‑2005. Mem Inst Oswaldo Cruz
2006;101:673‑6.
6. Mast EE, Margolis HS, Fiore AE, Brink EW, Goldstein ST, Wang SA,
et al. A comprehensive immunization strategy to eliminate
transmission of hepatitis B virus infection in the United States:
Recommendations of the advisory committee on immunization
practices (ACIP) part 1: Immunization of infants, children, and
adolescents. MMWR Recomm Rep 2005;54:1‑31.
7. World Health Organization. Introduction of hepatitis B vaccine into
childhood immunization services. Geneva, WHO, 2001 (unpublished
document WHO/V&B/01.31 available on request from Department of
Vaccines and Biologicals, World Health Organization, 1211 Geneva
27, Switzerland).
8. Poorolajal J, Majdzadeh R. Prevalence of chronic hepatitis B infection
in Iran: A review article. J Res Med Sci 2009;14:249‑58.
9. Goldstein ST, Alter MJ, Williams IT, Moyer LA, Judson FN,
Mottram K, et al. Incidence and risk factors for acute hepatitis B in
the United States, 1982‑1998: Implications for vaccination programs.
J Infect Dis 2002;185:713‑9.
10. Alizade M, Hooshang A, Alavian SM, JAfari Kh, Yazdi N. Prevalence
HIV‑Ab and HCV‑Ab and HbsAg in addicted prisoners of central jail
of Hamadan. J Res Med Sci 2002;7:311‑3.
11. Bonanni P, Pesavento G, Boccalini S, Bechini A. Perspectives of
public health: Present and foreseen impact of vaccination on the
epidemiology of hepatitis B. J Hepatol 2003;39 Suppl 1:S224‑9.
12. Vaccination and Immunity Guideline. 5th ed. The Office of Deputy
Ministry of Health. Ministry of Health and Medical Education. Tehran
(Iran): Seda Publishing; 1998.
13. Parmar Z, Khadivi R, Sadeghi B, Rahimi M. Immunization following
hepatitis B mass vaccination in the 18 years old student in
chaharmahalvabakhtyari province in Iran. J Shahrekord Univ Med
Sci 2009;13:35‑41.
14. Kazemi H, Yadegarinia D, Rasheki H. Evaluation of hepatitis B
antibody and factors related to hepatitis B vaccination in Tehran
Hospital staffs, 2010. J Dent Sch Shahid Beheshti Univ Med Sci
2010;35:114‑8.
15. Khodavisi M, Mohamadi N, Omidi A, Amini R. Determination of
Anti‑HBS titre hepatitis B in student of nursing and midwifery faculty
in Hamadan. J Hamadan Nurs Midwifery Fac 2010;18:45‑9.
16. Azarkeivan A, Nasiritoosi M, Hajibeigi B, Afradi H, Eslami M,
Ghazizadeh Sh. Evaluation of immune response to hepatitis B
vaccination and effects of booster dose in chronic transfusion
patients. J Iran Univ Med Sci 2009;16:32‑9.
17. Alavian SM, Akbari H, Ahmadzadasl M, Kazem M, Davodi A.
Vaccination status of dentists participating in the forty‑second
international congress of dentists against hepatitis B and Infection
control practices. J Islam Dent Assoc Iran 2007;7:48‑56.
18. Moemenheravi M, Sharifa, Mousavi Gh. Evaluation of serum
anti‑HBs in health personnel vaccinated in Shahidbeheshti hospital
of Kashan. J Feiz 2006;10:11‑4.
19. Zangeneh M, Poopak B, Khavari M, Valikhani M, Parsania M.
Evaluation of immunogenicity of hepatitis B vaccination in
health workers. J Islam Azad Univ Med Sci‑Tehran Med Branch
2004;14:13‑22.
20. Rostami H, Farmani S, Mirzaee A, Ghorbanzade R. Evaluation of
immune response to hepatitis B in workers at risk. J Urmia Nurs
Midwifery Fac 2008;6:178‑82.
21. Ajami A, Abediyan F. Immunogenicity of hepatitis B vaccine in
medical sciences students‑2004. J Mazandaran Univ Med Sci
2006;16:72‑7.
22. Sarkari B, Zargar MA, Mohammadi R, Asgarian SH. Prevalence
of hepatitis B antibodies in health‑care workers in Yasuj
hospitals, Armaghane‑danesh bimonthly. J Yasuj Univ Med Sci
2006;11:97‑106.
23. Khaki M, Ghavamian M. The evaluation of recombinant HBS.
Ag vaccine immunity in vaccinated medical group and hospital
personnel in Borujerd‑2004. J Arak Univ Med Sci 2005;8:1‑6.
24. Izadpanah AM, Mashreghy Moghadam HR, Ziaee M, Foadaldini M,
Ebadian FS. Anti HBs level in nursing staff of Birjand university of
medical sciences. J Birjand Univ Med Sci 2008;15:80‑6.
25. Janbakhsh A, Hatami H, Sayyad B, Eini P, Hashemian A. The rate of
immune response to hepatitis B vaccination in health centers staff
in Kermanshah, 2002. J Kermanshah Univ Med Sci 2003;7:48‑53.
26. Davodzade M, Rajabipoor F, Shafizade F, Ghorbanivaghee A.
Evaluation anti‑HBs level in vaccinated Interns in Lorestan University
of medical sciences. J Lorestan Univ Med Sci 2004;23:57‑60.
27. Hajybagheri K, Kanani Sh, Moradi Gh, Yousefinejad V. Response to
hepatitis B vaccine in medical staff of hospitals in Kurdistan‑2006.
Iran J Infect Dis Trop Med 2008;13:53‑7.
28. Aminzade Z, Shabani Z, Gachkar L, Sayyadi A. Frequency of positive
HBs Ag in pregnant women of Zanjan. J Rafsenjan Univ Med Sci
2004;3:126‑32.
29. Mokhtarian K, Yazdanparast M, Tarshizi R, Moghani M. Evaluation
levels of antibodies against hepatitis B in staffs of Hajar Hospital,
2007‑2008. J Shahrekord Univ Med Sci 2009;11:35‑9.
30. Rajbar M, Keramat F, Keshavarz F. Immunogenicity of hepatitis B
vaccination in staff of HamedanSina Hospital (2001). Sci J Hamdan
Univ Med Sci 2002;7:55‑8.
31. Ayatollahi J, Sharifi MR, Sabzi F, Zare AR. Blood level Anti‑HBs
due to HB vaccine in health care personnel of ShahidSadoughi
Hospital – Yazd. Iran J Obstet Gynecol Infertility 2004;7:48‑51.
32. Saffar M, Nikkhah M, Anvari M. Measure antibody persistence
of hepatitis B virus in Thalassemia recipients of health personnel
6 years after vaccination in Sari. J Mazandaran Univ Med Sci
2001;11:60‑5.33. Baba Mahmoodi F. Evaluation of hepatitis B antibody (HBS) levels
in nursing staff of GaemshahrRazi hospital and it’s variation with
duration of immunity post HB vaccination. J Mazandaran Univ Med
Sci 2000;10:48‑53.
34. Mansour Ghanati F, Fallah MS, Jokar F, Jafarshad R, Aramy M,
Ale-Ismail A, et al. Safety of students vaccinated against hepatitis
B in Guilan University of Medical Sciences. Iran J Infect Dis Trop
Med 2008;13:47‑51.
35. Habibiyan R. Efficacy of complete hepatitis B‑vaccination in health
care workers. J Shahrekord Univ Med Sci 2003;5:42‑7.
36. Salari M, Alavian SM, Tadrisi D, Karimi A, Sadeghian H, Asadzandi M,
et al. Safety of hepatitis B immunization in health care workers.
Kowsar Med J 2006;11:343‑52.
37. Mohamadjafari R, Saadati N, Vaziri Sh, Sooranian A. Frequency of
positive HBs Ag in pregnant women referred to health centers in
Ahvaz City. J Iranian Inst Health Sci Res 2004;3:237‑43.
38. Asefzade M, Sharifi M, Aliaee A. Prevalence of HBsAg carriers and
antiHBsAg in health care workers of Boali‑Sina teaching hospital in
Qazvin. J Qazvin Univ Med Sci 2004;32:41‑6.
39. Baharvand M, Iramloo Z. Survey of anti‑HBs titers in vaccinated
dental students of ShahidBeheshti University of Medical Sciences
in 2002. J Dent Sch Shahid Beheshti Univ Med Sci 2003;21:653‑60.
40. Tohidast Z, Farahani Z, Salmani Gh. Titer of HBs Ab in the faculty
members, residents and student of dental college after three rounds
of vaccination in Tehran university of medical sciences (2002‑2004).
J Islam Dent Assoc Iran 2005;17:98‑103.
41. Keshavarz M, Ahoee M, Babakhani A, Haratipoor H. Efficacy of
hepatitis B vaccine in medical students in Shahrood‑2004. Med J
Mashad Univ Med Sci 2007;3:53‑9.
42. Talebi Taher M, Akbari M, Rezaee M, Ashaerii N, Omrani Z,
Ghaderian H, et al. Determination of anti‑HBS titre mean induced by
hepatitis B vaccine among health care workers in Firoozgar hospital
in Tehran. Razi j Med Sci 2004;11:789‑95.
43. Sohrabi MB, Sarafha J, Zolfaghari P, Eskandari Z. HBs Ab level in
clinical personnel of Immam Hossein Hospital of Shahrood. J Blood
2009;6:65‑4.
44. Savadkoohi R, Hoseinian MA. Level of blood anti‑HBs in the hospital
staff of Amirkola. J Babol Univ Med Sci 2003;5:38‑42.
45. Hagybagheri K, Rahimi A, Mansoorifar Sh. Evaluation of serum
anti‑HBs and related factors in staff vaccinated of Tohid Hospital in
Sanandaj. J Kordestan Univ Med Sci 2001;5:27‑9.
46. Kashifar M, Hasanjaniroshan MR. Response to hepatitis B
vaccination in hospital personnel Yahyanejad‑2002. J Babol Univ
Med Sci 2004;6:39‑42.
47. Taghavi N, Eilami O, Nabavi M, Azargashb E, Yadegarynia D,
Alizadeh AM. Immunogenicity of recombinant hepatitis B vaccine
in health care worker of Boo‑Ali Hospital in Tehran, Iran, 2002‑2004.
Iran J Clin Infect Dis 2006;1:67‑70.
48. Abdolsamadi HR, BakianianVaziri P, Abdollahzadeh Sh, Mani
Kashani KH, Vahedi M. Immune response to hepatitis B vaccine
among dental students. Iran J Public Health 2009;38:113‑8.
49. Torkzaban P, Abdolsamadi H, Vaziri P. Efficacy rate of hepatitis
B vaccination in vaccinated dentists in Hamadan city. J Dent Res
2009;6:62‑6.
50. Behjati M, Mirhoseini NA, Ayatollahi J. Titer of HBs Ab in 8 year old
children vaccinated in Yazd city schools (2001). J Shaheed Sadoughi
Univ Med Sci 2002;10:3‑7.
51. Zahedpashay Y, Ahmadpourkacho M, Pour Nasrollah M, Bijani A,
Saadat H, MazloumiA. Immune response in preterm infants to
hepatitis B vaccine. J Babol Univ Med Sci 2010;13:34‑9.
52. Mahyar A. Survey of antibody titers against recombinant hepatitis
B vaccination in 6 years old children. J Guilan Univ Med Sci
2007;16:39‑43.
53. Kazemi SA, Azizi N. Evaluation of the effects of hepatitis B
vaccination in children after 3 dose vaccine in Zanjan. J Zanjan Univ
Med Sci 1993;22:5‑10.
54. Fathollahporr A, Hemmatpoor S, Ghaderi E. Protective effect of
hepatitis B vaccine in vaccinated children 12‑24 months in the city
of Sanandaj. Iran J Infect Dis Trop Med 2008;13:65‑70.
55. Esmaeeldooki M, Seyedkala F. Evaluation of serum anti‑HBs children
have been vaccinated against hepatitis B in children admitted to
Mirkala Hospital in Babol. Feyz J 2002;24:45‑8.
56. Azarkar Z. Efficacy of hepatitis B vaccine in children from
12‑16 months in Mashad Health Centers. J Qazvin Univ Med Sci
2004;29:38‑41.
57. Moradi A, Khodabakhshi B, Ghaemi E, Mansoorian A, Sarikhani A,
Saeedi M. The rate of response to hepatitis B vaccination in children
less than one year of Gorgan. J Gorgan Univ Med Sci 2008;10:50‑3.
58. Mostafavizade K, Salehi H, Imani R, Haghayegh MR. Antibody levels
following vaccination against hepatitis B virus surface antigen after
a period of 5‑6 years old children new to school in Sharekord. Res
Med Sci 2000;6:194‑6.
59. Salehi M, Saneimoghadam E, Khosravi S. Evaluation of immune
response of hepatitis B vaccination in Zahedaninfants. Zahedan J
Res Med Sci 2002;4:155‑8.
60. Esmail Duki MR, Zahed Pasha Y, Mahdavi A, Haji Ahmadi M.
Comparison of the effect of hepatitis B vaccination in normal and
low birth weight neonates. J Babol Univ Med Sci 2003;5:13‑8.
61. Rafiee M, Majidi J, Hashemi F, Hoseinpoor S, Nejati N, Mostafa
gharabaghi M, et al. Comparison of hepatitis B surface antigen
antibody response in premature and received infants after
vaccination with hepatitis B vaccine in hospital’s children center
Alzahra. Med J Tabriz Univ Med Sci Health Serv 2006;28:55‑8.
62. Safari M, Yazdanpanah B. Decline of hepatitis B antibody level in
vaccinated 5‑7 year‑old children. J Zahedan Med Res 2010;12:24‑8.
63. Saffar MJ, Rezaee MS. Persistence of hepatitis B vaccine safety ten
years after public vaccination in infancy. J Semnan Univ Med Sci
2003;5:63‑71.
64. Rafizade B, Kazemi A, Amirmoghadami HR, Moosavinasab N.
Evaluation of serum anti‑HBs in 5‑6 years old children vaccinated
in Zanjan‑2003. J Zanjan Univ Med Sci Health Serv 2004;47:49‑55.
65. Ramazani A, Aghakhani A, Eslamifar A, Banifazl M, Gachkar L,
Taeb J, et al. Long‑term safety of hepatitis B vaccine in hemodialytic
patient. Iran J Clin Infect Dis 2009;13:21‑4.
66. Raeissi N, Habibian R, Zandian K. Determination of HBs Ab stability
after HBV vaccination in multitransfused patients, Hajar Hospital,
Shahrekord, 2003. J Blood 2006;3:259‑63.
67. Varesvazirian M, Vahidi A, Shamsadini S, Shamsadini A. Evaluation
blood level Anti‑HBs due to HB vaccine in thalassemia children in
Kerman, 2007. J Kerman Univ Med Sci 2007;6:309‑15.
68. Esmaeilpoor N, Mirzaei N, Chaman R, Rasoulinegad M, Haji
abdolbaghi M, Raham M, et al. Investigating HIV/AIDS patient’s
immune response to hepatitis B vaccination. J Shahrood Univ Med
Sci 2010;5:1‑4.
69. Afrasiabian SH, Hajibageri K, Yousefinejad V, Esmaeeli Nasab NE,
Sayfi SH. Response to hepatitis B vaccine in HIV‑Infected patients,
Armaghane‑danesh bimonthly. J Yasuj Univ Med Sci 2008;12:11‑8.
70. Ahmadi F, Maziar S, Ramazani A, Pezeshki M, Khatami M,
Mahdavi M, et al. Evaluation immune hepatitis B and factors in
response to vaccination in hemodialysis patients (2004). Iran J Clin
Infect Dis 2004;9:38‑41.
71. Alaee K, Mansouri D, Alaee A. The rate of response to hepatitis B
vaccination in in HIV positive patient referred to HIV/AIDS advice and
care centers in Kermanshah. J Babol Univ Med Sci 2004;6:46‑51.
72. Shahbazian H, Dinparast R. Evaluation of the immune response
and efficacy of intradermal injection of hepatitis B vaccine in
hemodialysis patient. Sci Med J Ahwaz Jundishapur Univ Med Sci
2006;5:499‑504.
73. Sharifi M, Talebitaher M, Sadeghi M. Antibody response to hepatitis
B vaccination in hemodialytic patient. J Qazvin Univ Med Sci
2003;25:47‑52.
74. Azarkar Z, Sharifizade Gh. The effectiveness of vaccination against
hepatitis B in children with thalassemia major‑Khorasan (2007).
Ofogh-e-Danesh 2008;14:44‑7.
75. Janbakhsh A, Vaziri S, Sayad B, Afsharian M, Rezaei M, et al. Immune
response to standard dose of hepatitis B vaccine in HIV positive
clients of Kermanshah behavioral diseases counseling center. Hepat
Mon 2006;6:71‑4.76. Koike Y, Yoo YC, Mitobe M, Oka T, Okuma K, Tono‑oka S, et al.
Enhancing activity of mycobacterial cell‑derived adjuvants on
immunogenicity of recombinant human hepatitis B virus vaccine.
Vaccine 1998;16:1982‑9.
77. Jafarzadeh A, Khoshnoodi J, Ghorbani SH, Hazrati S, Mazaheri B,
Shokri F. Differential immunogenicity of recombinant hepatitis B
vaccine n Iranian neonates: Influence of ethnicity and environmental
factors. Iran J Immunol 2004;2:98‑103.
78. Koff RS. Hepatitis vaccine. In: Schiff ER, Sorrell MF, Maddery WC,
editors. Disease of the Liver. 8th ed. New York: Lippincott Williams
and Wilkins; 1999.
79. Alimonos K, Nafziger AN, Murray J, Bertino JS Jr. Prediction of
response to hepatitis B vaccine in health care workers: Whose titers
of antibody to hepatitis B surface antigen should be determined
after a three‑dose series, and what are the implications in terms of
cost‑effectiveness? Clin Infect Dis 1998;26:566‑71.
80. STROBE Statement — Checklist of items that should be included
in reports of cross‑sectional studies. Available from: http://www.
strobe‑statement.org/. [Last accessed date Dec 2010].
81. Fisman DN, Agrawal D, Leder K. The effect of age on immunologic
response to recombinant hepatitis B vaccine: A meta‑analysis. Clin
Infect Dis 2002;35:1368‑75.
82. Fabrizi F, Martin P, Dixit V, Bunnapradist S, Dulai G. Meta‑analysis:
The effect of age on immunological response to hepatitis B
vaccine in end‑stage renal disease. Aliment Pharmacol Ther
2004;20:1053‑62.
83. Afzali H, Vali Gh, Khalifehsoltani A. Comparative effect of intradermal
and intramuscular injections of hepatitis B vaccine. Arch Iran Med
2003;6:9‑12.
84. Ferraz ML, Silva AE, Kemp VL, Cruz CN, Guimarães Rx. Evaluation
of the immunological response to hepatitis B vaccine in health care
professionals. Rev Assoc Med Bras 1992;38:5‑8.
85. Mansori D. Survey of incidence and affect of hepatitis B vaccine in
students. J Babol Med Univ Sci 1993;2:39‑42.
86. Park K. Text Book of Preventive and Social Medicine. Translated by
ShojaiTehrani H. 3rd ed. Tehran: Samat; 2002. p. 113‑21.
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