Recombinant gamma-interferon as adjuvant to hepatitis B vaccine in hemodialysis patients.
Patients undergoing long-term hemodialysis are at high risk of acquiring hepatitis B yet tend to have poor rates of response to hepatitis B vaccine. The effect of recombinant human gamma-interferon (2 million units/m2) on the response to a recombinant hepatitis B vaccine was evaluated in a prospective, randomized controlled trial in 81 hemodialysis patients. A similar proportion of both groups of vaccinees ultimately developed antibody to HBsAg including 81% of the 41 recipients of vaccine alone (group I) and 89% of the 40 recipients of vaccine with gamma-interferon (group II). However, the antibody to HBsAg response occurred earlier in recipients of vaccine with gamma-interferon, so that at 4 mo 63% of group I and 88% of group II had antibody to HBsAg (p less than 0.025). Furthermore, titers of antibody to HBsAg tended to be higher in the vaccinees given interferon; the final geometric mean titers were 232 IU/L in group I and 330 IU/L in group II (p = not significant). Retrospective testing for antibody to hepatitis C virus revealed that 21 (26%) hemodialysis patients were seropositive at entry into this trial, but the presence of antibody to hepatitis C virus did not appear to affect the response rate to the hepatitis B vaccine. These results suggest that the effects of gamma-interferon as an adjuvant in increasing the response rate to hepatitis B vaccination deserve further evaluation perhaps most appropriately in persons who have not responded to an initial course of vaccine.
Quiroga
J A
JA
Department of Gastroenterology, Fundación Jiménez Díaz, Madrid, Spain.
Castillo
I
I
Porres
J C
JC
Casado
S
S
Sáez
F
F
Gracia Martínez
M
M
Gómez
M
M
Inglada
L
L
Sánchez-Sicilia
L
L
Mora
A
A
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006510:Hepatitis B Antibodies / Q000096:biosynthesis*; D017325:Hepatitis B Vaccines; D006801:Humans; D007371:Interferon-gamma / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D006435:Renal Dialysis; D013997:Time Factors; D014761:Viral Hepatitis Vaccines / Q000276:immunology*
D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines; D011994:Recombinant Proteins; D014761:Viral Hepatitis Vaccines; D007371:Interferon-gamma