Immunogenicity of two accelerated hepatitis B vaccination protocols in liver transplant candidates

Engler, S.; Sauer, Peter; Golling, M.; Klar, E.; Benz, Christine; Stremmel, Wolfgang; Kallinowski, B.

doi:10.1097/00042737-200104000-00010

Cited by 46 publications

(81 citation statements)

References 31 publications

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“…The conventional dose regimen recommended for immunocompetent adults is 20 µg at 0, 1 and 6 months, resulting in approximately 95% of seroconversion rates [1,5]. Factors such as male gender, tobacco use, age (more than 40 years old), place of vaccine application and obesity are associated with lower vaccine response rates [2,4,8]. Low response rates are also found in immunocompromised patients.…”

Section: Discussionmentioning

confidence: 99%

“…Cirrhotic patients waiting for liver transplants are particularly exposed to contamination risk [2]. Vaccine efficacy in this population is not as high as in immunocompetent individuals.…”

Section: Discussionmentioning

confidence: 99%

“…Hepatitis B virus (HBV) is transmitted through sexual and parenteral routes, including blood transfusion and organ donation [1,2]. Cirrhotic patients and those submitted to transplant procedures are potentially exposed to these risk factors [3], and infection may lead to hepatic decompensation [4][5][6] or shorter graft survival [2].…”

mentioning

confidence: 99%

“…Cirrhotic patients and those submitted to transplant procedures are potentially exposed to these risk factors [3], and infection may lead to hepatic decompensation [4][5][6] or shorter graft survival [2]. In order to reduce this risk, it is desirable to induce immunity to HBV in this type of patient.…”

mentioning

confidence: 99%

“…However, these high rates are not seen in HIV-infected patients [7], in patients undergoing dialysis [6,8,9], or in cirrhotic patients [2,4,6]. A double-dose regimen (40 µg) has been used in HIV-infected patients and hemodialysis patients, giving an improved response [6,7].…”

mentioning

confidence: 99%

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Double-dose hepatitis B vaccination in cirrhotic patients on a liver transplant waiting list

Bonazzi¹,

Bacchella²,

Freitas

et al. 2008

Braz J Infect Dis

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Development of immunity to hepatitis B virus in cirrhotic patients waiting for liver transplantation is highly desirable. Though a double-dose regimen is available, little is know about its effectiveness. We examined the efficacy of double-dose hepatitis B virus vaccination in cirrhotic patients waiting for liver transplantation. We studied 43 patients who were waiting for liver transplantation. They were vaccinated with three doses of 40 µ µ µ µ µg hepatitis B vaccine at 0, 1 and 6 months; the normal dose is 20 µ µ µ µ µg. Efficacy was measured based on seroconversion of anti-HBs. Global response to the primary vaccination scheme was 67.5% (29 patients). Forty-one per cent of responders had anti-HBs titers above 1,000 IU/mL. No factors were associated with response, based on multivariate analysis. The vaccination scheme of 40 µ µ µ µ µg at 0, 1 and 6 months was superior to conventional vaccination doses (20 µ µ µ µ µg) for cirrhotic patients on a waiting list for liver transplantation.

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Section: Discussionmentioning

confidence: 99%

“…Cirrhotic patients waiting for liver transplants are particularly exposed to contamination risk [2]. Vaccine efficacy in this population is not as high as in immunocompetent individuals.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Double-dose hepatitis B vaccination in cirrhotic patients on a liver transplant waiting list

Bonazzi¹,

Bacchella²,

Freitas

et al. 2008

Braz J Infect Dis

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Stenting of stenosed shunts in patients after a Norwood‐Sano operation

Eicken

Genz

Sebening

2006

Cathet Cardio Intervent

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Immunogenicity and safety of an experimental adjuvanted hepatitis B candidate vaccine in liver transplant patients

et al. 2006

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Patients with chronic liver disease are at higher risk of hepatitis B (HB) virus infection before and after liver transplantation, and they commonly have a suboptimal immune response to HB vaccines. In this randomized trial, we compared the immunogenicity of primary vaccination with 2 doses of an experimental adjuvanted HB vaccine (adjuvant system 04 containing aluminium and monophosphoryl lipid A [HB-AS04] ) to that of 3 double doses of a licensed HB vaccine in 93 liver transplant candidates. Depending on the waiting list for liver transplantation, a booster dose of HB-AS04 or double booster dose of the licensed HB vaccine was given before or after surgery, at 6 to 12 months after initiation of the vaccination course. The percentage of subjects with seroprotective anti-HB surface antibody concentrations 1 month after booster was twice as high in the HB-AS04 group (60.0%), vs. patients in the comparator group (32.0%) (P ϭ 0.035). In subjects who did not undergo liver transplantation before administration of the booster, better immunogenicity results were obtained: 80% of subjects were seroprotected after HB-AS04 vaccination vs. 60% with the comparator (P ϭ 0.2302). Despite a slightly higher reactogenicity, the safety profile of the HB-AS04 vaccine was clinically acceptable. In conclusion, an improved antibody response was observed in liver transplant candidates with 3 doses of HB-AS04, as compared to 4 double doses of a comparator. Liver transplant candidates could benefit from the use of this experimental adjuvanted HB vaccine to further increase their protection against HB infection. Patients undergoing liver transplantation have an increased risk of exposure to hepatitis B (HB) virus, mainly due to transmission of the virus from the donor organ and, to a lesser extent, due to multiple transfusions of blood products. [1][2][3][4] To protect these patients against de novo HB infection acquired during or after Abbreviations: HB, hepatitis B; HBsAg, hepatitis B surface antigen; anti-HBs, antibody to hepatitis B surface antigen; AS04, adjuvant system 04 containing aluminium and monophosphoryl lipid A; GMC, geometric mean concentration; SAE, serious adverse event.

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Immunogenicity of two accelerated hepatitis B vaccination protocols in liver transplant candidates

Cited by 46 publications

References 31 publications

Double-dose hepatitis B vaccination in cirrhotic patients on a liver transplant waiting list

Double-dose hepatitis B vaccination in cirrhotic patients on a liver transplant waiting list

Stenting of stenosed shunts in patients after a Norwood‐Sano operation

Immunogenicity and safety of an experimental adjuvanted hepatitis B candidate vaccine in liver transplant patients

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