Decreased immunogenicity of recombinant hepatitis B vaccine in chronic hepatitis C

Wiedmann, Marcus; Liebert, Uwe G.; Oesen, U.; Porst, H.; Wiese, Manfred; Schroeder, Sabine; Halm, Ulrich; Mössner, Joachim; Berr, Frieder

doi:10.1002/hep.510310134

Cited by 151 publications

(127 citation statements)

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“…In one study, this reduced allostimulatory capacity was associated with reduced IFN-␥ secretion in mixed lymphocyte reaction supernatants and reduced LPS-induced IL-12-secreting capacity (32). Consistent with this impairment in allostimulatory function are the findings that HCV-infected individuals have an impaired response to new antigenic stimulation with hepatitis A, hepatitis B, and influenza vaccinations (33)(34)(35), while responses to recall Ags are unimpaired (10,13,14,36). Therefore, it appears that there is an APC-based impairment in development of T cell responses in HCV infection.…”

mentioning

confidence: 77%

Selective Impairments in Dendritic Cell-Associated Function Distinguish Hepatitis C Virus and HIV Infection

Anthony

Yonkers

Post³

et al. 2004

The Journal of Immunology

153

137

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Impaired APC functions may play important roles in chronicity of hepatitis C virus (HCV) and HIV infections. To investigate the separate and combined effects of HCV and HIV infection on immature dendritic cells (DCs), we evaluated myeloid-derived DC (MDC) and plasmacytoid-derived DC (PDC) frequencies and functions, measured by Toll-like receptor ligand-induced IFN-α and IL-12, in healthy controls and subjects with chronic HCV, HIV, and HCV-HIV infection. To evaluate the relation between innate and adaptive immunity, we measured HCV-specific IFN-γ-producing T cell frequency. MDC frequencies tended to be reduced in HIV infection (1.8-fold), while PDC frequencies were minimally reduced in HCV infection (1.4-fold). In contrast, a striking reduction in non-PDC-associated IFN-α production was observed in HIV-infected subjects (17-fold), while PDC-associated IFN-α production was markedly reduced in HCV-infected subjects (20-fold). Both non-PDC and PDC functions were impaired in HCV-HIV coinfection. MDC-associated IL-12 production was markedly reduced in both HCV and HIV-infected subjects (over 10-fold). Functional defects were attenuated with slowly progressive HIV infection. The proportion of subjects with HCV-specific T cell responses, and the number of Ags recognized were reduced in HCV-HIV subjects as compared with HCV singly infected subjects. A positive association was observed between MDC-associated IL-12 production and HCV-specific T cell frequency in HCV-infected subjects. These results indicate that immature DC function is dysregulated in HIV and HCV infections, but differentially, and that these defects are attenuated in slowly progressive HIV infection. These selectively different impairments may contribute to the reduced adaptive immune response to HCV in HCV-HIV coinfection.

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mentioning

confidence: 77%

Selective Impairments in Dendritic Cell-Associated Function Distinguish Hepatitis C Virus and HIV Infection

Anthony

Yonkers

Post³

et al. 2004

The Journal of Immunology

153

137

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“…Hepatitis B vaccination is recommended for patients with chronic HCV infection (27). Among HCV-infected patients without HBV infection, the main objective is to protect them against HBV infection.…”

Section: Discussionmentioning

confidence: 99%

“…It is known that patients with hepatitis C, co-infected with HBV or HIV, had lower rates of sustained response (elimination of the virus) when treated with interferon, possibly as a consequence of interactions between these viruses. It is also known that there is less seroconversion to anti-HBs in patients with HCV who are vaccinated against HBV (27).…”

Section: Discussionmentioning

confidence: 99%

HBV vaccination of HCV-infected patients with occult HBV infection and anti-HBc-positive blood donors

Pereira

Gonçales

Silva

et al. 2006

Braz J Med Biol Res

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Anti-HBc positivity is a frequent cause of donation rejection at blood banks. Hepatitis B virus (HBV) infection may also occur in HBsAgnegative patients, a situation denoted occult infection. Similarly, very low levels of HBV-DNA have also been found in the sera of patients with chronic hepatitis C virus (HCV) infection, even in the absence of serum HBsAg. Initially we searched for HBV-DNA in serum of 100 blood donors and 50 HCV-infected patients who were HBsAg negative/anti-HBc positive by nested-PCR and by an HBV monitor commercial test for HBV-DNA. Anti-HBs seroconversion rates were measured in 100 blood donors and in 22 patients with chronic HCV infection after HBV vaccination to determine if the HBV vaccination could eliminate an occult HBV infection in these individuals. Occult HBV infection was detected in proportionally fewer blood donors (6/ 100 = 6%) than chronic hepatitis C patients (12/50 = 24%) (P < 0.05). We noted seroconversion in 6/6 (100%) HBV-DNA(+) and in 84/94 (89.4%) HBV-DNA(-) blood donors (P > 0.05). All subjects who were HBV-DNA(+) before the first dose of HBV vaccine (D1), became HBV-DNA(-) after D1, D2, and D3. Among 22 HCV-positive patients, 10 HBV-DNA(+) and 12 HBV-DNA(-), seroconversion was observed in 9/10 (90%) HBV-DNA(+) and in 9/12 (75%) HBV-DNA(-) subjects (P > 0.05). The disappearance of HBV-DNA in the majority of vaccinated patients suggests that residual HBV can be eliminated in patients with occult infection.

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“…In a cross-sectional study of general population in the United States of America, more than 25% of HCV patients had also hepatitis B markers -which was nearly six times higher than in the HCV-negative group [4] . Previous studies demonstrated the safety of HBV vaccine use in patients with chronic hepatitis C. Immunisations did not aggravate the course of hepatitis C and had no effect on serum HCV-RNA levels [5][6][7] . Our earlier study proved that vaccinations could be safely delivered during treatment with interferon [5] .…”

Section: Introductionmentioning

confidence: 99%

“…Studies of the hepatitis B vaccine immunogenicity in patients with hepatitis C have yielded mixed results. Most of them (but not all) indicated a diminished response to HBV vaccine delivered in a standard dose and schedule [5][6][7][8] . In our own experience, the HBV vaccine immunogenicity in patients with hepatitis C was decreased.…”

mentioning

confidence: 99%

Four-year follow up of hepatitis C patients vaccinated against hepatitis B virus

Chlabicz¹,

Łapiński²,

Grzeszczuk³

et al. 2005

WJG

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AIM:Patients with chronic hepatitis C have been recommended to receive vaccinations against hepatitis B. Our study aimed at evaluating the hepatitis B immunogenicity and efficacy against hepatitis B virus infection 4 years after primary immunization series in a group of patients with chronic hepatitis C. METHODS:We recruited 36 out of 48 hepatitis C virus (HCV) infected individuals who were vaccinated against hepatitis B virus (20 g of recombinant HBsAg at 0-1-6 mo schedule) in 1998. Here we measured anti-HBs titers and anti-HBc 4 years after delivery of the third dose of primary immunization series. RESULTS:After 4 years a total of 13/36 (36%) HCV infected patients had seroprotective titers of anti-HBs compared with 9/10 (90%) in the control group, (P<0.05). Similarly the mean concentration of anti-HBs found in hepatitis C patients was significantly lower than that found in healthy subjects (18.3 and 156.0 mIU/mL respectively (P<0.05). None of the HCV infected patients or controls became infected with HBV during the study period as confirmed by anti-HBc negativity. CONCLUSION:We demonstrated that 4 years after HBV immunizations' more than 60% of vaccinated HCV patients did not maintain seroprotective levels of anti-HBs, which might put them at risk of clinically significant breakthrough infections. Further follow-up studies are required to clarify whether memory B and T lymphocytes can provide protection in chronic hepatitis C patients in the absence or inadequate titers of anti-HBs. INTRODUCTIONPatients with chronic hepatitis C have been recommended to receive vaccinations against hepatitis B [1,2] . The rationale behind these recommendations is based on the fact that hepatitis C patients co-infected with hepatitis B virus have an increased histological liver damage and a higher risk of hepatocellular carcinoma [3] . Additionally HCV patients may be at a higher than an average risk of acquiring hepatitis B because of the similar routes of transmission of both viruses. Several studies have shown that certain groups like intravenous drug users, haemodialysis patients, haemophiliacs, and promiscuous people frequently have markers of both infections. In a cross-sectional study of general population in the United States of America, more than 25% of HCV patients had also hepatitis B markers -which was nearly six times higher than in the HCV-negative group [4] . Previous studies demonstrated the safety of HBV vaccine use in patients with chronic hepatitis C. Immunisations did not aggravate the course of hepatitis C and had no effect on serum HCV-RNA levels [5][6][7] . Our earlier study proved that vaccinations could be safely delivered during treatment with interferon [5] . Studies of the hepatitis B vaccine immunogenicity in patients with hepatitis C have yielded mixed results. Most of them (but not all) indicated a diminished response to HBV vaccine delivered in a standard dose and schedule [5][6][7][8] . In our own experience, the HBV vaccine immunogenicity in patients with hepatitis C was decreased. On...

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Decreased immunogenicity of recombinant hepatitis B vaccine in chronic hepatitis C

Cited by 151 publications

References 50 publications

Selective Impairments in Dendritic Cell-Associated Function Distinguish Hepatitis C Virus and HIV Infection

Selective Impairments in Dendritic Cell-Associated Function Distinguish Hepatitis C Virus and HIV Infection

HBV vaccination of HCV-infected patients with occult HBV infection and anti-HBc-positive blood donors

Four-year follow up of hepatitis C patients vaccinated against hepatitis B virus

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