One-year vaccination against hepatitis B virus with a MPL-vaccine in liver transplant patients for HBV-related cirrhosis.
Conflicting results have been reported on vaccination against hepatitis B virus (HBV) as a prophylaxis against viral recurrence after liver transplantation. We investigated the efficacy of 1-year, monthly vaccination using an adjuvant 3-deacylated monophosphoryl-lipid-A (MPL) recombinant S vaccine initially administered together with hepatitis B immunoglobulins (HBIg) in 18 patients transplanted for HBV-related cirrhosis. All received 12 vaccine doses (HBsAg, 20 mcg plus MPL, 50 mcg): the initial six doses (phase I) were administered within 7days after intravenous HBIg (2000IU), while the last 6 (phase II) following HBIg withdrawal. All patients received lamivudine during the study. Anti-HBs titers were determined before each dose and then for 1year after vaccination. After phase I anti-HBs titers were greater than 100IU/l in all patients and in three (16.6%) were greater than 500IU/l. After phase II 10 patients (55.5%) achieved anti-HBs titers greater than 100IU/l and five (27.7%) greater than 500IU/l. One year after vaccination eight patients (44.4%) maintained anti-HBs titers greater than 100IU/l, with a median titer of 234IU/l (102-1205), and 2 (11.1%) greater than 500IU/l. One-year extended monthly vaccination with a MPL-adjuvant recombinant vaccine induces a sustained protective anti-HBs response in approximately half of transplant recipients.
Di Paolo
Daniele
D
Hepatology Unit, Department of Internal Medicine, Rome, Italy  Immunoprophylaxis Center, ASL RM C, Rome, Italy. daniele.dipaolo@tin.it
Lenci
Ilaria
I
Cerocchi
Carlo
C
Tariciotti
Laura
L
Monaco
Andrea
A
Brega
Arianna
A
Lotti
Laura
L
Tisone
Giuseppe
G
Angelico
Mario
M
D000328:Adult; D005260:Female; D005355:Fibrosis / Q000517:prevention & control* / Q000821:virology*; D006509:Hepatitis B / Q000150:complications* / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000627:therapeutic use*; D006515:Hepatitis B virus / Q000737:chemistry / Q000276:immunology*; D006801:Humans; D007136:Immunoglobulins / Q000737:chemistry; D008050:Lipid A / Q000031:analogs & derivatives / Q000737:chemistry; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D014614:Vaccines, Synthetic / Q000737:chemistry
D017325:Hepatitis B Vaccines; D007136:Immunoglobulins; D008050:Lipid A; D014614:Vaccines, Synthetic; C048436:monophosphoryl lipid A