Efficacy of a reinforced protocol of HBV vaccination in cirrhotic patients waiting for orthotopic liver transplantation

Macedo, Guilherme; Maia, J. Costa; Gomes, A; Teixeira, A.; Ribeiro, Tiago

doi:10.1016/s0041-1345(00)01816-9

Cited by 10 publications

(21 citation statements)

References 2 publications

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“…The type of the vaccine was recombinant hepatitis B vaccine: Engerix‐B (SmithKline Beecham, Philadelphia, Pennsylvania), Recombivax HB (Pasteuer Merieux/MD, Lyon, France), and Shanvac‐B (M/S Shantha Biotech, India) . The doses of the vaccine ranged from 20 μg to 40 μg . The route of vaccine administration was intramuscular in 10 studies .…”

Section: Resultsmentioning

confidence: 99%

“…The doses of the vaccine ranged from 20 μg to 40 μg . The route of vaccine administration was intramuscular in 10 studies . The dose schedule varied among the studies and mainly used the 0‐, 1‐, and 2‐month, 0‐, 1‐, and 6‐month, 0‐, 1‐, 2‐, and 4‐month, and 0‐, 1, 2‐, and 6‐month schedule except for 2 studies in which an accelerated hepatitis B vaccination protocol (0, 7, and 21 days) was used.…”

Section: Resultsmentioning

confidence: 99%

“…The search yielded 473 studies, and the 462 deemed as not relevant with the subject of this review because they were mainly referred to immunogenicity of hepatitis B vaccination in patients with liver disease in general, which is beyond the purpose of this study. Eleven studies met the inclusion criteria and included in this review …”

Section: Methodsmentioning

confidence: 99%

“…HBV infection in cirrhotic patients may have serious consequences as the clinical phenotype of the disease is much more severe because of the impaired functional capacity of the liver compared to the acute HBV infection in healthy individuals. However, several studies have shown that the immunogenicity following HBV vaccination in patients with liver cirrhosis seem to be ineffective . It has been shown that administration of additional vaccine doses after a primary vaccination series in subjects who do not respond to the vaccination is not associated with the development of adverse events …”

Section: Vaccination Schedulesmentioning

confidence: 99%

“…The seroconversion rates and antibody titers among these patients have been shown to be much lower compared to healthy individuals . Many attempts have been performed to improve the immunogenicity of the HBV vaccination by increasing the standard dose of the vaccine or accelerating the dose schedule …”

Section: Introductionmentioning

confidence: 99%

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Response to hepatitis B vaccination in patients with liver cirrhosis

Αγγελετοπούλου

Davoulou

Konstantakis

et al. 2017

Reviews in Medical Virology

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Hepatitis B vaccination is strongly recommended for all infants and children but also for adults who are at risk of HBV infection. Attempts to immunize patients with liver cirrhosis have been proven relatively ineffective, and several strategies have already been used to improve the immune response in this group. The primary aim of this review is to examine, discuss, and summarize the immunogenicity of hepatitis B vaccination in patients with liver cirrhosis. MEDLINE search identified 11 studies (n = 961). The dose of the vaccine and the schedule of the vaccination varied. The response rates to the HBV vaccination ranged from 16% to 87% among patients with cirrhosis regardless of the number and vaccine dose. In particular, patients who received the standard dose of vaccination achieved seroprotection rates ranged from 16% to 79% (mean response rate 38%) and those who received a double dose achieved relatively better seroprotection rates (range: 26%-87%; mean response rate 53%). The overall mean response rate to the HBV vaccination was 47%. In conclusion, cirrhotic patients achieve lower seroprotection rates after the completion of HBV vaccination series. Several strategies have tried to improve the immunogenicity; however, there is a great need for additional studies to further explore (1) the immune response in relation to poor vaccination responsiveness confounding factors, (2) novel strategies to improve immunogenicity, and (3) the immune mechanism underlying the differences in response rates to HBV vaccination.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Vaccination Schedulesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Response to hepatitis B vaccination in patients with liver cirrhosis

Αγγελετοπούλου

Davoulou

Konstantakis

et al. 2017

Reviews in Medical Virology

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Immunizations in Chronic Liver Disease: What Should be Done and What is the Evidence

Leise

Talwalkar

2012

Curr Gastroenterol Rep

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Infections are common in patients with chronic liver disease, especially those with cirrhosis. Patients with advanced liver disease, who develop bacterial infections, are at a substantially higher risk of death. As liver disease progresses, most immunizations lose their effectiveness. Overall, it is important to address immunization needs in patients with chronic liver disease early on, when immunizations are most effective. Inactivated or killed-type vaccinations rather than live, attenuated vaccinations are always preferable in patients with cirrhosis. The influenza vaccination is less effective in patients with cirrhosis and in the early post-liver transplant setting as compared to healthy individuals. The influenza vaccination may prevent hepatic decompensation, but further data are needed to confirm this. Yearly inactivated influenza vaccinations should be provided to those with chronic liver disease. The pneumonia vaccination is less effective in patients with cirrhosis, with a further decline in protective serologies after liver transplantation. Standard guidelines for the administration of Pneumovax23 for immunocompromised hosts apply to patients with chronic liver disease. Chronic liver disease also leads to higher non-response rates to the hepatitis B vaccination. Early-stage chronic liver disease patients should receive conventional hepatitis B series. Cirrhotics benefit from a double-dose hepatitis B vaccination at standard intervals. Hepatitis A superimposed on chronic viral hepatitis or chronic liver disease increases risk of mortality. Hepatitis A vaccination effectiveness wanes in cirrhosis, and should if possible be given before the development of cirrhosis. More data are needed for routine use of herpes zoster and human papillomavirus in chronic liver disease.

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Primary Care of Patients with Cirrhosis – Current and Future Challenges

Peyton

Martin

2014

Curr Hepatology Rep

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Efficacy of a reinforced protocol of HBV vaccination in cirrhotic patients waiting for orthotopic liver transplantation

Cited by 10 publications

References 2 publications

Response to hepatitis B vaccination in patients with liver cirrhosis

Response to hepatitis B vaccination in patients with liver cirrhosis

Immunizations in Chronic Liver Disease: What Should be Done and What is the Evidence

Primary Care of Patients with Cirrhosis – Current and Future Challenges

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