Observational studyMedical science monitor : international medical journal of experimental and clinical research2026
Systemic Inflammation and the Persistence of Vaccine-Induced Hepatitis B Immunity in Healthcare Workers.
Observational study in Medical science monitor : international medical journal of experimental and clinical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND The long-term persistence of hepatitis B surface antigen (anti-HBs) levels varies among individuals, and the role of systemic inflammation remains unclear. This study evaluated the relationship between anti-HBs antibody levels and systemic inflammatory markers in healthcare workers. MATERIAL AND METHODS This longitudinal observational study with a retrospective component included 583 healthcare workers who underwent routine occupational health screening between 2023 and 2025. Anti-HBs levels at 2 time points were analyzed together with C-reactive protein (CRP) level, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, and systemic inflammation response index. Nonparametric and correlation analyses were performed. RESULTS Anti-HBs levels decreased significantly between baseline and follow-up (Hodges-Lehmann estimate: -23.00 mIU/mL, 95% CI: -27.60 to -18.93; P<0.001). No significant associations were observed between antibody levels and sex, smoking status, or the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, and systemic inflammation response index. In contrast, CRP positivity was associated with lower anti-HBs levels at the second measurement; however, no association was observed between CRP and longitudinal change in anti-HBs levels. Higher anti-HBs levels were observed among physicians and healthcare workers in the very high occupational biological-risk group, whereas age showed a weak negative correlation with antibody levels. CONCLUSIONS CRP showed a weak cross-sectional association with lower anti-HBs levels at the second measurement, whereas no association was observed between CRP or the other inflammatory indices and longitudinal change in anti-HBs levels. Therefore, the present findings do not establish systemic inflammation as a determinant of longitudinal antibody persistence. Further longitudinal studies are required to determine whether systemic inflammatory markers have clinical utility in post-vaccination immunity monitoring.
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