[Immune response to a single dose of a novel kind of hepatitis A vaccine following splenectomy].
OBJECTIVE
The immune response to parenteral antigens is reduced in persons without spleen. The seroconversion rate was measured after application of a new type of vaccine against hepatitis A (immunopotentiating reconstituted influenza virus virosome [IRIV]) in patients who had undergone a splenectomy after trauma.


METHODS
26 patients (23 men and 3 women, mean age 34.9 +/- 9.7 [25-65] years) with anti-hepatitis A virus (HAV) antibody titres < 20 mIU/ml (maximally 17 mIU/ml) were given a single dose of 0.5 ml of the IRIV hepatitis A vaccine 1 to 14 (mean 9.4) years after splenectomy. Immediately after the immunisation and 14 and 28 days afterwards anti-HAV titres were determined. A titre rise to < 20 mIU/ml was counted as seroconversion. At the first and last titre measurement immunoglobulins, neopterin and beta-microglobulin levels were also measured as additional markers.


RESULTS
The seroconversion rate was 69.2% (18/26) after 14 days (geometric titre mean: 39 mIU/ml) and rose to 88.5% (23/26) after 28 days (geometric titre mean 74 mIU/ml). Seroconversion occurred in the three nonresponders after a second dose of the vaccine. All measurements of the immunological markers were within normal limits.


CONCLUSIONS
A single dose of a new type of vaccine against hepatitis A confers adequate protection even in those persons who had a splenectomy.
Simmen
H P
HP
Departement Chirurgie, Universitätsspital Zürich.
Robustelli
L
L
Althaus
B
B
Glück
R
R
Trentz
O
O
Vogt
M
M
D000328:Adult; D000368:Aged; D005260:Female; D035922:Hepatitis A Antibodies; D022362:Hepatitis A Vaccines; D006508:Hepatitis Antibodies / Q000302:isolation & purification*; D006507:Hepatovirus / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013156:Splenectomy; D015164:Vaccines, Inactivated / Q000276:immunology*; D014761:Viral Hepatitis Vaccines / Q000276:immunology*
D035922:Hepatitis A Antibodies; D022362:Hepatitis A Vaccines; D006508:Hepatitis Antibodies; D015164:Vaccines, Inactivated; D014761:Viral Hepatitis Vaccines
Immunantwort einer Einzeldosis eines neuartigen Hepatitis-A-Impfstoffes nach Splenektomie.