Response to a vaccination schedule with 4 doses of 40 microg against hepatitis B virus in cirrhotic patients evaluated for liver transplantation.

Publisher: Elsevier Science Inc Country of Publication: United States NLM ID: 0243532 Publication Model: Print Cited Medium: Print ISSN: 0041-1345 (Print) Linking ISSN: 00411345 NLM ISO Abbreviation: Transplant Proc Subsets: MEDLINE

Publication: New York, N.Y. : Elsevier Science Inc.
Original Publication: New York Stratton.

Hepatitis B/*immunology ; Hepatitis B Vaccines/*therapeutic use ; Liver Cirrhosis/*surgery ; Liver Transplantation/*immunology; Diabetes Complications/immunology ; Diabetes Complications/virology ; Dose-Response Relationship, Drug ; Female ; Hepatitis B Antibodies/blood ; Hepatitis B Vaccines/administration & dosage ; Humans ; Immunization Schedule ; Liver Cirrhosis/immunology ; Liver Cirrhosis/pathology ; Male ; Retrospective Studies

We conducted a retrospective study to evaluate the response to recombinant hepatitis B vaccine after 4 intramuscular doses (40 microg) administered at 0, 1, 2, and 6 months in 157 cirrhotic patients who were liver transplant candidates. Seventeen nonresponders were revaccinated with the same schedule. We studied the association between the following variables and the vaccine response: age, gender, etiology of cirrhosis, diabetes, severity of liver disease (Child-Pugh class and Model for End-Stage Liver Disease [MELD] score), and the number of administered doses. The response rates were: 1 dose, 40% (2/5); 2 doses, 0% (0/7); 3 doses, 32.7% (16/49); and 4 doses, 31.3% (30/96) of patients. The median hepatitis B surface antibody (anti-HBs) titer was 45 mU/mL (range, 11-620 mU/mL). The response rate to revaccination was 41.2% (median anti-HBs titer, 88 mU/mL; range, 18-190 mU/mL). Diabetics showed a lower response rate than nondiabetic patients (17.2% vs 35.3%; P = .046). No association was observed between the response rate to vaccine and the other variables. In conclusion, the response rate to hepatitis B vaccine reached a little more than 30% in cirrhotic patients who received 3 or 4 doses. No higher response rate was observed among patients who received 4 doses. Diabetes was associated with a lower response rate. Anti-HBs seroconversion rates were not associated with the other variables. Revaccination may significantly increase the response rate to hepatitis B vaccine in cirrhotic patients, and may be considered in nonresponders after the third dose. Early vaccination against HBV should be considered in such patients.

0 (Hepatitis B Antibodies)
0 (Hepatitis B Vaccines)

Date Created: 20081118 Date Completed: 20090623 Latest Revision: 20081117

20221213

10.1016/j.transproceed.2008.09.029

19010154