[Comparison of immunogenicity of vaccination and serovaccination against hepatitis B virus in patients with alcoholic cirrhosis].
OBJECTIVE
The association of anti-HBs immunoglobulins and anti-HBV vaccine could increase the immunogenicity of the latter. The aim of this prospective randomized trial was to compare the immunogenicity of anti-HBs vaccination and serovaccination in alcoholic patients with cirrhosis.


METHODS
Alcoholic patients with cirrhosis were randomized in 2 groups: a) Vaccination group: 3 i.m. injections of GenHevac B followed by one booster at month 9; b) Serovaccination group: same vaccination schedule followed by one i.m. injection of anti-HBs immunoglobulins (500 IU).


RESULTS
Twenty-five patients (17 males and 8 females, mean age 56 years) were included in the study: 13 received a vaccination and 12 received a serovaccination. After 12 months, the seroconversion rates were 69% and 67% in vaccination and in serovaccination groups, respectively. The predictive factors of non responsiveness were as following: Child B cirrhosis, low number of CD8, a high CD4/CD8 rate, the existence of HLA DR7 antigen, and the absence of HLA DR1 antigen.


CONCLUSIONS
In alcoholic patients with cirrhosis, serovaccination does not increase the immunogenicity of anti-HBs vaccination and should not be recommended.
Bronowicki
J P
JP
Service d'Hépato-Gastroentérologie, CHU, Strasbourg.
Weber-Larivaille
F
F
Gut
J P
JP
Doffoël
M
M
Vetter
D
D
D005260:Female; D006509:Hepatitis B / Q000517:prevention & control*; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D017325:Hepatitis B Vaccines / Q000008:administration & dosage; D006801:Humans; D007116:Immunization, Passive; D007125:Immunogenetics; D008104:Liver Cirrhosis, Alcoholic / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014611:Vaccination
D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines
Comparaison de l'immunogénicité de la vaccination et de la sérovaccination contre le virus de l'hépatite B chez les malades atteints de cirrhose alcoolique.