Expectation of Impaired Response to Recombinant Hepatitis B Vaccination

Fanelli, Vincenzo; Sanna, Giovanni; Solinas, Angela

doi:10.1159/000186909

Cited by 7 publications

(8 citation statements)

References 4 publications

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“…The concomitant presence of HCV infection and of the uraemic state is accompanied by a further decrease of total lymphocytes and in particular of CD4+ cells, compared to HCV– uraemic patients. The absolute number of CD4+ cells in non- responders was significantly lower (p < 0.01) than in responders, in agreement with a previous study [4]. Since the rate of non-responders in HCV+ uraemic patients is higher than in HCV– uraemics (36%) we can hypothesize that the further decrease of total lymphocytes and in particular of CD4+ cells cannot be ascribed to the HCV infection (which per se does not induce any modification in non uraemic patients), but rather to a particular immunodeficient state, present in some patients, favoured by the uraemia and haemodialysis.…”

Section: Untitledsupporting

confidence: 92%

Lymphocyte Subsets in Hemodialyzed HCV+ and HCV– Patients

Cucciaioni

Pellegrini

Giombini

et al. 1998

Nephron

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The aim of our study was to get information on the immune status of patients who undergo haemodialysis in the presence of an HCV infection. This virus infects not only hepatocytes, but also blood mononuclear cells, in particular B cells [1], but we do not know the role of this lymphocyte involvement in the maintenance and progression of hepatitis. The impairment of the cell-mediated immune response in uraemic patients is well known, for example only 50–60% of uraemic patients undergo a seroconversion after HBV vaccine, compared to 95% of the normal population. Paradoxically the immunodeficiency is concomitant with an activation of related cells which is increased rather than ameliorated by the dialysis treatment [2]. In these patients lymphocytopenia is also present with a reduction of the absolute number of T lymphocytes which remain normal in percentage. The study was performed on the following groups of subjects.

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Section: Untitledsupporting

confidence: 92%

Lymphocyte Subsets in Hemodialyzed HCV+ and HCV– Patients

Cucciaioni

Pellegrini

Giombini

et al. 1998

Nephron

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“…Dialysis patients are at high risk for hepatitis B virus (HBV) infection and thus a target population for hepatitis B vaccination [1][2][3][4], If left unvaccinated, such patients may easily become carriers of the hepatitis B virus and thereby constitute an infection hazard.…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of HbsAg in Saudi Arabia varies from one province to another, being highest in the Southwest ern province, particularly in the Gizan area where it reaches 36% in females and 24% in males [6], HBV vaccine is 85-95% effective in preventing infec tion in healthy young adults [2,3], The antibody response diminishes with the presence of renal failure, diabetes, chronic liver disease, AIDS, smoking or obesity [12].…”

Section: Introductionmentioning

confidence: 99%

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Responsiveness to Hepatitis B Vaccine in Immunocompromised Patients by Doubling the Dose Scheduling

1996

Nephron

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The protective efficacy of three schedules of a recombinant hepatitis B vaccine was evaluated in 42 patients undergoing dialysis at a teaching hospital. The rate of seroconversion after vaccination was highest (82.3%) among the recipients of three 20-μg doses (i.e. double the conventional dose for healthy adult) at 0, 1 and 2 months (group II). The response was satisfactory (80%) among the recipients of three 20-μg doses at 0, 1 and 6 months (group III) but was lowest with the single dose schedule of three 10-μg doses at 0, 1 and 2 months (group I). Seroconverters from all the three groups received a booster dose (each equal to his scheduled dose) at 12 months. Those who did not seroconvert from groups I and II were shifted to group III. The rate of seroconversion was higher in female (88.9%) than in male patients (66.7%) and in younger patients less than 30 years (83.3%) than in elderly patients more than 50 years. Patients undergoing peritoneal dialysis also responded much better (93.3%) than the hemodialysis patients (66.7%). In conclusion, a schedule of double the conventional dose of the vaccination for healthy adults at 0, 1, 2, and 12 months seems to give a better seroconversion and higher response to the HB vaccine, but a further large-scale study is needed to confirm this finding and also to look into the difference in response between male and female, younger and older patients and the difference in response between HD and PD patients.

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“…The seroconversion rate of patients with chronic renal failure was 61.1% [6], and even lower (16-54%) in patients with chronic liver failure [7,8].…”

Section: Introductionmentioning

confidence: 91%

Prolonged Suppression of Humoral Immune Response after Organ Transplantation

Gu¹,

Dahmen²,

Li³

et al. 2002

Eur Surg Res

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Rats receiving either kidney or liver grafts were vaccinated with recombinant hepatitis B virus (HBV) vaccine either 1 or 10 weeks post-transplantation to explore the nonspecific immunosuppressive effect of transplantation surgery on antibody development. Response rate and geometric mean titer of the anti-HBs antibody were significantly lower in organ-transplanted animals undergoing early vaccination compared to unoperated control animals. Both parameters were affected when vaccination was performed early after kidney transplantation, but also in case of late vaccination in liver graft recipients. The nonspecific suppressive effect of transplantation surgery on the humoral immune response was related to the time point of vaccination after surgery and the extent of the surgical intervention and lasted longer than previously reported.

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Expectation of Impaired Response to Recombinant Hepatitis B Vaccination

Cited by 7 publications

References 4 publications

Lymphocyte Subsets in Hemodialyzed HCV+ and HCV– Patients

Lymphocyte Subsets in Hemodialyzed HCV+ and HCV– Patients

Responsiveness to Hepatitis B Vaccine in Immunocompromised Patients by Doubling the Dose Scheduling

Prolonged Suppression of Humoral Immune Response after Organ Transplantation

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