title: Immunization with an adjuvant hepatitis B vaccine in liver transplant recipients: antibody decline and booster vaccination with conventional vaccine.
abstract: Patients after orthotopic liver transplantation (OLT) due to hepatitis B virus (HBV)-related disease are at risk of endogenous hepatitis B reinfection and may receive life long prophylaxis with hepatitis B hyperimmunoglobulin (HBIG). In a previous study 16 of 20 OLT patients were immunized successfully with an adjuvant hepatitis B vaccine. To maintain protective antibody levels under immunosuppressive therapy, 11 of these patients were revaccinated with a double dosed conventional hepatitis B vaccine. Median interval between last vaccination and booster was 24 months (range 22-31 months). Antibody titres against hepatitis B surface antigen (anti-HBs) were monitored at the day of booster vaccination (day 0), at day 7 and day 28. At day 0, all vaccinees but one had anti-HBs titres greater than 500 IU/L (median 1,925 IU/L, range 196-7,612 IU/L). Maximum antibody titres after previous vaccination declined by a median of 82% (range 47-96%). After booster vaccination the anti-HBs titre increased significantly by a median factor of 2.42 (P<0.05). In conclusion, the majority of liver transplant recipients who previously had responded to adjuvant hepatitis B vaccine exhibited sufficient immunocompetence to produce a substantial antibody response after booster immunization with a conventional vaccine.
authors.affiliation: Institute of Tropical Medicine, Humboldt University, Berlin, Germany. matthias.guenther@charite.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Günther
authors.forename: Ruth
authors.initials: R
authors.lastname: Neuhaus
authors.forename: Tanja
authors.initials: T
authors.lastname: Bauer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Jilg
authors.forename: Jan Arne
authors.initials: JA
authors.lastname: Holtz
authors.forename: Ulrich
authors.initials: U
authors.lastname: Bienzle
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000517:prevention & control; D006085:Graft Survival; D006510:Hepatitis B Antibodies / Q000032:analysis / Q000378:metabolism*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D019694:Hepatitis B, Chronic / Q000517:prevention & control*; D006801:Humans; D007117:Immunization, Secondary; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D055502:Secondary Prevention; D012720:Severity of Illness Index; D014181:Transplantation Immunology / Q000502:physiology; D023001:Transplantation Tolerance / Q000276:immunology*; D016896:Treatment Outcome
chemical_list: D000276:Adjuvants, Immunologic; D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines