Immune response of patients with congenital coagulation disorders to hepatitis B vaccine: suboptimal response and human immunodeficiency virus infection.
Seventy-eight patients with congenital coagulation disorders were treated with hepatitis B vaccine either subcutaneously or intradermally. All the children (eight vaccinated subcutaneously and eight vaccinated intradermally) responded. Seventeen of 19 (90%) anti-HIV-negative adults vaccinated subcutaneously and 14/25 (56%) anti-HIV-negative adults vaccinated intradermally showed an immune response. At 24 months, the anti-HBs level was greater than 10 IU/l in all children vaccinated subcutaneously, 83% of children vaccinated intradermally, 77% of adults vaccinated subcutaneously, and 55% of adults vaccinated intradermally. Eight of 15 (53%) adult patients who were anti-HIV positive were also anti-HBc positive before vaccination and 6/8 (75%) failed to produce an amnestic response to vaccine. Subcutaneous vaccination with regular monitoring of anti-HBs levels and appropriate boosting is recommended.
Miller
E J
EJ
Academic Department of Haematology, Royal Free Hospital School of Medicine, London, England.
Lee
C A
CA
Karayiannis
P
P
Holmes
S
S
Thomas
H C
HC
Kernoff
P B
PB
D000293:Adolescent; D000328:Adult; D000368:Aged; D001778:Blood Coagulation Disorders / Q000151:congenital / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D004306:Dose-Response Relationship, Immunologic; D006679:HIV Seropositivity / Q000276:immunology*; D006467:Hemophilia A / Q000276:immunology; D006510:Hepatitis B Antibodies / Q000096:biosynthesis*; D006801:Humans; D007223:Infant; D007279:Injections, Subcutaneous; D008875:Middle Aged; D011897:Random Allocation; D014761:Viral Hepatitis Vaccines / Q000008:administration & dosage / Q000276:immunology*
D006510:Hepatitis B Antibodies; D014761:Viral Hepatitis Vaccines