Impaired antibody response rates after high dose short interval hepatitis B virus vaccination of immunosuppressed individuals.
OBJECTIVE
Because a more rapid and high dose vaccination schedule may be advantageous in immunosuppressed individuals to induce an earlier immunization, the aim of the present study was to assess the response to high dose, short interval hepatitis B virus vaccination in various immunosuppressed-patient populations.


METHODS
A total of one hundred and thirty-eight immunosuppressed patients (86 cirrhotics, 42 dialysis patients, 10 allogeneic hematopoietic cell transplants) and 26 healthy subjects as controls were vaccinated utilizing a high dose vaccine (40 mcg) and a shortened immunization schedule.


RESULTS
Ninety-two percent of the controls responded to the high dose, short interval hepatitis B virus vaccination schedule. In contrast, only 48% of the immunosuppressed patients seroconverted to anti-HBs positivity (p < 0.001). No difference in the antibody response rate was seen between the various immunosuppressed populations studied. No significant hepatitis B virus vaccination-related adverse effects were seen in any of the groups vaccinated.


CONCLUSIONS
Although a high dose, short interval hepatitis B virus vaccination schedule is safe in immunosuppressed patients, the antibody response is still significantly reduced as compared to healthy subjects and only slightly greater than that achieved with standard vaccination schedules, as reported in literature. The possibility of achieving an earlier immunization, however, may be of some advantage to protect acquired viral infection.
Idilman
Ramazan
R
Loyola University Medical Center, Dept. of Medicine, Division of Gastroenterology and Hepatology, Maywood, IL, USA. idilman1@hotmail.com
Colantoni
Alessandra
A
De Maria
Nicola
N
Ustun
Celalettin
C
Sam
Ramin
R
Ing
Todd S
TS
Akan
Hamdi
H
Koc
Haluk
H
Van Thiel
David H
DH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000917:Antibody Formation / Q000276:immunology*; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006509:Hepatitis B / Q000276:immunology* / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000276:immunology* / Q000627:therapeutic use; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology*; D007676:Kidney Failure, Chronic / Q000276:immunology*; D008107:Liver Diseases / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014181:Transplantation Immunology / Q000276:immunology*
D017325:Hepatitis B Vaccines