Rapid decline of antibodies after hepatitis A immunization in liver and renal transplant recipients.
BACKGROUND
Hepatitis A vaccine is safe and achieves good seroconversion rates in liver (LTX) and renal (RTX) transplant recipients.


METHODS
A study was performed to determine the anti-hepatitis A virus (HAV) antibody decline in LTX and RTX patients, and in healthy controls who have been immunized with two doses of hepatitis A vaccine.


RESULTS
LTX and RTX patients had a satisfactory seroconversion rate after complete immunisation. However, 2 years later they had experienced a much more rapid antibody decline than controls, and only 59% of LTX and 26% of RTX seroconverters showed titres above the cut-off level defined as protective.


CONCLUSIONS
Patients on immunosuppressive therapy may not be adequately protected against hepatitis A a few years after vaccination and alternative vaccination schemes may have to be considered.
Institute of Tropical Medicine, Department of Surgery, Charité, Humboldt University of Berlin, Centre for Hemodialysis, Germany.
M
M
Günther
K
K
Stark
R
R
Neuhaus
P
P
Reinke
K
K
Schröder
U
U
Bienzle
D016572:Cyclosporine / Q000627:therapeutic use; D006084:Graft Rejection / Q000517:prevention & control; D035922:Hepatitis A Antibodies; D006508:Hepatitis Antibodies / Q000097:blood*; D006801:Humans; D007114:Immunization; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology*; D016031:Liver Transplantation / Q000276:immunology*; D016559:Tacrolimus / Q000627:therapeutic use; D013997:Time Factors; D014611:Vaccination
D035922:Hepatitis A Antibodies; D006508:Hepatitis Antibodies; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus