Immunogenicity of recombinant hepatitis B vaccine in treatment-naive and treatment-experienced chronic hepatitis C patients: the effect of pegylated interferon plus ribavirin treatment.
OBJECTIVE
To retrospectively evaluate the vaccination-induced anti-HBs seroconversion rates in treatment-naive and treatment-experienced chronic hepatitis C (CHC) patients. Also to prospectively evaluate the seroconversion rates in CHC patients during pegylated interferon (PEG) plus ribavirin (RIB) treatment.


METHODS
Seventy treatment-naive CHC patients (group A), 22 sustained virological responders-SVR following interferon (IFN) plus RIB treatment CHC patients (group B) and 121 healthy subjects (group C) had been participated in the same HBV vaccination schedule (20 microg, 0-1-6 mo). Seroconversion was considered if anti-HBs levels were above 10 mIU/mL within 3 mo following the third dose of the vaccine. Moreover, we prospectively selected 30 non-cirrhotic CHC patients and evaluated them for the efficacy of the same vaccine schedule randomizing them in two groups: Group-1, 15 CHC patients received the first dose of the vaccine in parallel with the initiation of PEG plus RIB treatment and Group-2, 15 patients received the same vaccination schedule without concomitant treatment. Determination of anti-HBs was performed at mo 1, 2, and 7. Statistical analysis of data was based on ANOVA student's t-test and chi-square analysis (P < 0.05).


RESULTS
Fifty-eight of 70 group A patients (82.85%), 20/22 group B (90.9%) and 112/121 healthy subjects (92.56%) had been seroconverted. The seroconversion rates were significantly higher in the control group than in treatment-naive CHC patients (P = 0.04). The corresponding rates were comparable between group A and group B CHC patients (P = 0.38). The vast majority of non-responders (10/14, 71.43%) had been infected by genotype-1 of HCV. The seroconversion rates were comparable between group 1 and 2 CHC patients at mo 1 (20% versus 26.7%, P = 0.67), mo 2 (46.7% vs 60%, P = 0.46) and mo 7 (86.7% versus 93.3%, P = 0.54) of follow-up.


CONCLUSIONS
The immunogenicity of HBV vaccine seems to be lower in CHC patients compared to healthy subjects. SVR following IFN plus RIB treatment does not affect the antibody response to HBV vaccine. Infection by genotype-1 seems to negatively influence the seroconversion rates. Vaccination against HBV during PEG plus RIB combination treatment is not beneficial in terms of anti-HBs seroconversion rates.
Elefsiniotis
Ioannis-S
IS
Department of Internal Medicine, Hepatology Unit, Hippokration Hospital of Athens, Athens, Greece. ielefs@acn.gr
Vezali
Elena
E
Kamposioras
Konstantinos
K
Pantazis
Konstantinos-D
KD
Tontorova
Radostina
R
Ketikoglou
Ioannis
I
Moulakakis
Antonios
A
Saroglou
George
G
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005802:Genes, MHC Class II / Q000235:genetics*; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006510:Hepatitis B Antibodies / Q000235:genetics / Q000378:metabolism; D017325:Hepatitis B Vaccines / Q000276:immunology / Q000627:therapeutic use*; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology; D018937:Hepatitis C Antibodies / Q000235:genetics / Q000378:metabolism; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000276:immunology / Q000517:prevention & control*; D006801:Humans; D007115:Immunization Schedule; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011446:Prospective Studies; D011994:Recombinant Proteins; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use*; D014614:Vaccines, Synthetic / Q000276:immunology / Q000627:therapeutic use
D000998:Antiviral Agents; D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines; D018937:Hepatitis C Antibodies; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D014614:Vaccines, Synthetic; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a