الفهرس 
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Abstract
Infection with the Hepatitis B virus (HBV) is a worldwide public health issue. Over two billion individuals have already been infected worldwide, and health care workers (HCWs) are at significant risk of contracting hepatitis B. Because of the massive volumes of blood that must be treated outside of the body, hemodialysis patients are also at high risk of contracting hepatitis B. Hepatitis B vaccination promotion among HCW, especially hemodialysis patients, is indeed an integral part of the HBV infection control technique. The advancement of hepatitis B virus surface antigen antibodies (anti-HBs) determines a response to HBV vaccination, and there is a gradual decline in the anti-HBs titer over time in vaccinated individuals, so partially vaccinated individuals, in addition to substantial proportion of fully vaccinated HCWs and dialysis patients, might also have titers inadequate to safeguard them against HBV infection.
HBV vaccination is an important strategy in prevention of HBV primary infection to reduce the threat of chronic HBV infection and its successive complications. HBVvaccine stimulate an immune reaction by introducing the HBsAg in the body thus stimulating the innate and the adaptive immune system to develop anti HBs antibodies. Seroprotection against HBV is define as having an anti HBs level above 10 IU\L one to three months after immunization ;90% or more of healthy adults demonstrating anti-HBs seroconversion after a vaccination series.
Anti-HBs levels after vaccination decrease over time. Many factors may play a role in the immunological response to the vaccine and reduce vaccine immunogenicity, including age, obesity, dialysis length, and immune weakness.
This study was carried out to evaluate anti HBs level among the vaccinated Hemodialysis patients and HCW working in hemodialysis Unit to study risk factor. Quantitative enzyme Link Immunosorbent Assay ELISA was used on blood samples collected from Hemodialysis patients and HCW workers who were HBV vaccine
compliant from hemodialysis unit in Alexandria Medical Research Institute Alexandria University.
Our study included fifty (50) HD 30 male individuals and 20 female individuals haemodialysis unit, and HCW (5 male individuals and 24female) individuals.
According to the HBsAg titer miu/ml HD patients and HCP where classified into 4 groups according to titer.
For group A=(<10 n=15 HD 8HCW) B=(10-<100 n=12 HD and 4HCW) C=(>100-<200 n=7 HD and4 HCW) D=(>200 n=16 HD and13 HCW).
According to the duration of HBV vaccination 25(5.0%) HD patients, 7(24%) HCP were vaccinated less than 5 years 20(40.0%) HD patients, 22 (75.9%) HCP were vaccinated between510years, and only 5 (10.0%) HD patients were vaccinated more than 10 years while none of HCP were vaccinated more than 10 years.
According to BMI none of HD patients were under weight compared 3.4% of HCW, 32% of HD pts were normal weight compared to 20% of HCW while 37.9% of HCW were classified class 1 obesity compared to 18.0% in HD patients moreover 6.0% of HD patients were classified class 2 obesity compared to 3.4% of HCW Finally non of HCW found among the class 3 obesity compared to 2.0% of HD patients respectively.
No significant difference was found in HBsAb titer between both sex in HD patients and that of HCP too. p= 0.828, p=0.492.
Comparison between different groups of HBsAb titer as regard the duration of vaccination using kruskal wallis test revealed for HD that as the duration of vaccination increases the antiHBs titer decrease, but as for HCW the test revealed no significant difference between groups p=0.192.
F)As regard toHBsAb titer and BMI, no significant difference was found between HD patients and HCP P=0.259 P=0.813.As regard to rest no significance difference was found between HBsAb and duration of HD P=0.136.