Finding
The rate of primary nonresponse to the standard regimen of recombinant hepatitis B vaccine is surprisingly high in patients with longstanding chronic hepatitis C. Therefore, the antibody to HBV surface antigen (anti‐HBs) titer response should be determined in these patients.
Paper
Decreased immunogenicity of recombinant hepatitis B vaccine in chronic hepatitis C
Citations: 161
Full textAbstract
The immunogenicity of hepatitis B vaccine is unknown for patients with chronic hepatitis C, although hepatitis B vaccination is highly recommended in these patients. We therefore studied in a prospective open trial of 59 patients with chronic hepatitis C (mean age 42 years, hepatitis C for >10 years, Child‐Pugh score ≤5) and 58 healthy hospital staff persons the rate of nonresponse (anti‐HBs <10 mIU/mL at 9 months) to recombinant hepatitis B vaccine (Gen H‐B‐VaxR,10μg intradeltoidal at month 0, 1, and 6). Nonresponse was observed in 18/59 (31%) patients with chronic hepatitis C and 5/58 (9%) healthy staff persons (P< .005) (vs. 7% in historical controls; P< .005), low response (anti‐HBs 10‐99 mIU/mL) in 19% of patients with chronic hepatitis C and 17% of staff persons. High‐dose booster vaccination led to seroconversion in 12/15 (80%) of primary nonresponders. Primary nonresponse to HB vaccine was related neither to presence of early‐stage liver cirrhosis nor magnitude of serum hepatitis C virus (HCV) RNA concentration, nor explained by the presence of human leukocyte antigen (HLA) types (B8 DR3, B44, DR7, DQ2) predisposing to low antibody response to hepatitis B surface antigen. The rate of primary nonresponse to the standard regimen of recombinant hepatitis B vaccine is surprisingly high in patients with longstanding chronic hepatitis C. Therefore, the antibody to HBV surface antigen (anti‐HBs) titer response should be determined in these patients. Depending on the response titer, higher booster doses may be required to achieve and maintain seroprotection in these patients.
Authors
M. Wiedmann, U. Liebert, U. Oesen
Journal
Hepatology