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A study of the immunogenicity and safety of 20 micrograms recombinant DNA yeast derived hepatitis B vaccine was conducted in 153 Pakistani adults. All participants were in good physical condition, had negative hepatitis B serological markers (HBsAg, anti-HBs, anti-HBc) and normal ALT. Anti-HBs developed in 33%, 81% and 98% of subjects one month after the first, second and third dose respectively. Minor systemic and local side-effects were observed in 39% of individuals. We conclude that yeast derived hepatitis B vaccine is safe, effective and immunogenic in Pakistani adults.

The frequency of Hepatitis Bs antigen and antibody was determined in healthy subjects and patients with acute and chronic liver disease. The frequency of HBs Ag in healthy subjects was 2.9% and HBs Ab 35%. The high prevalence of antibody in normal individuals suggests a constant non-parenteral sub-clinical exposure to hepatitis virus. Thirty-three per cent patients with acute viral hepatitis, 20% with cirrhosis and 10% with hepatocellular carcinoma were HBs Ag positive, while HBs Ab was detected in 22% cases of acute viral hepatitis and 37% with other liver disorders. This pattern of prevalence of HBs Ab suggests that hepatitis B virus may be an important etiological agent in acute and chronic liver disease in Pakistan.