title: Immune response of HLA DQ2 positive subjects, vaccinated with HBsAg/AS04, a hepatitis B vaccine with a novel adjuvant.
abstract: About 5-10% of the general adult population respond inadequately to hepatitis B vaccination. The histocompatibility leucocyte antigen (HLA) DQ2, DR3 and DR7 phenotypes have been linked with non-responsiveness to hepatitis B vaccination. A first part of our study determined the prevalence of the HLA DQ2 allele in a healthy population, aged 15-50 years. We found 35% of our study population (n=1008) positive for the HLA DQ2 allele. Positive subjects for HLA DQ2 were subsequently invited to participate in a trial and were to be given either the HBsAg/AS04 hepatitis B vaccine or a licensed hepatitis B vaccine (Engerix-B).(1) Both contained 20 microg of recombinant HBsAg. The HBsAg/AS04 vaccine was administered on a 0 and 6 months schedule whilst the comparator vaccine was given according to the standard 0, 1 and 6 months schedule. The experimental vaccine was formulated on a novel adjuvant containing 3' deacylated monophosphoryl lipid A (3D-MPL) and alum. A total of 230 subjects were enrolled into the vaccination study. At month 7, 99% of the subjects had a protective titre (>or=10mIU/ml) with a geometric mean titre (GMT) of 6613mIU/ml in the group receiving HBsAg/AS04 versus 97% seroprotected with a GMT of 2315mIU/ml in the other group. Both vaccines, with their respective schedule, give very high seroprotection rates (>96%). Our data suggest that HLA DQ2 positivity is not a good marker for non- or poor-responsiveness. The HBsAg/AS04 vaccine was more reactogenic mainly because of an increased local reactogenicity. Both vaccines, especially HBsAg/AS04, are highly immunogenic and well tolerated by the study subjects.
authors.affiliation: Centre for Vaccinology, Ghent University Hospital, De Pintelaan 185 9000, Ghent, Belgium.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Desombere
authors.forename: Marie
authors.initials: M
authors.lastname: Van der Wielen
authors.forename: Pierre
authors.initials: P
authors.lastname: Van Damme
authors.forename: Michel
authors.initials: M
authors.lastname: Stoffel
authors.forename: Norbert
authors.initials: N
authors.lastname: De Clercq
authors.forename: Christian
authors.initials: C
authors.lastname: Goilav
authors.forename: Geert
authors.initials: G
authors.lastname: Leroux-Roels
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006683:HLA-DQ Antigens / Q000097:blood*; D006514:Hepatitis B Surface Antigens / Q000008:administration & dosage* / Q000276:immunology; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D006683:HLA-DQ Antigens; C053186:HLA-DQ2 antigen; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines