title: Response to booster hepatitis B vaccines in liver-transplanted children primarily vaccinated in infancy.
abstract: BACKGROUND
  A hepatitis B virus (HBV) universal vaccination program for infants was implemented for 24 years in Taiwan. Most of the children who received organ transplantation were primarily vaccinated before transplantation. This study investigated the efficacy of HBV vaccination and booster responses in children after liver transplantation (LT).
  
  
  METHODS
  Totally 31 children were enrolled. They were clinically stable for more than 1 year after LT. Twenty of them kept a titer of antibody to hepatitis B surface antigen (anti-HBs) more than 10 mIU/mL and received no booster, while 11 received one booster because their anti-HBs titers were less than 10 mIU/mL. Cellular immunity was checked by enzyme-linked immunospot assay with interferon-gamma surrogated for T-helper 1 cells and interleukin-5 for T-helper 2 before and after booster vaccine.
  
  
  RESULTS
  One of the non-boosters had de novo HBV infection after LT and recovered to be anti-HBs positive. The first booster restored an adequate titer in 64% (7/11) of those with anti-HBs titer less than 10 mIU/mL after LT. The four patients who failed the first booster responded well to the second dose. After the booster, the mononuclear cells of all 11 had more than one spot-forming cell for interferon-gamma or interleukin-5. Transplanted girls maintained a higher antibody titer than boys.
  
  
  CONCLUSIONS
  Primary HBV vaccination or the booster dose(s) of HBV vaccine could provide adequate humoral and cellular immunity in children with LT.
authors.affiliation: Department of Pediatrics, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan.
authors.forename: Yen-Hsuan
authors.initials: YH
authors.lastname: Ni
authors.forename: Ming-Chih
authors.initials: MC
authors.lastname: Ho
authors.forename: Jia-Feng
authors.initials: JF
authors.lastname: Wu
authors.forename: Huey-Ling
authors.initials: HL
authors.lastname: Chen
authors.forename: Yao-Ming
authors.initials: YM
authors.lastname: Wu
authors.forename: Rey-Heng
authors.initials: RH
authors.lastname: Hu
authors.forename: Po-Huang
authors.initials: PH
authors.lastname: Lee
authors.forename: Mei-Hwei
authors.initials: MH
authors.lastname: Chang
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006509:Hepatitis B / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D007371:Interferon-gamma / Q000378:metabolism; D015848:Interleukin-5 / Q000378:metabolism; D008107:Liver Diseases / Q000150:complications* / Q000821:virology*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D006377:T-Lymphocytes, Helper-Inducer / Q000378:metabolism; D014611:Vaccination
chemical_list: D017325:Hepatitis B Vaccines; D015848:Interleukin-5; D007371:Interferon-gamma