title: Efficacy of double dose recombinant hepatitis B vaccination in chronic hepatitis C patients, compared to standard dose vaccination.
abstract: BACKGROUND
  Hepatitis B virus (HBV) vaccination is a well-known, safe and effective way for protection against HBV infection; however, non-responders remain susceptible to infection with HBV. This is so important in patients with any kind of chronic liver disease, especially chronic hepatitis C virus (HCV) patients in whom acute HBV infection may lead to decompensation of liver disease. Some of the studies have shown that immunogenicity of HBV vaccination is decreased in these patients. The aim of this study was to evaluate the efficacy and safety of double dose vaccination of HBV in these patients, compared with standard dose vaccination in similar patients and healthy adults.
  
  
  METHODS
  A total of 64 patients with chronic HCV infection were randomized into 2 groups of 32. Group A received standard dose HBV vaccine, at 0, 1, 6 months, whereas group B received double dose HBV vaccine. Group C consisted of 32 healthy adults who also received standard dose vaccination. At 1 month after the end of vaccination, Hepatitis B surface antibody (HBsAb) titer was checked in all participants and the results were compared.
  
  
  RESULTS
  There was no significant difference in age or sex among three groups. The response rate in groups B and C was 100% (all had HBsAb titer >10 mIU/mL), while in group A, 4 patients (12.5%) were non-responders (HBsAb titer < 10 mIU/mL). The difference in response rate was statistically significant between Group A and the other two groups (P < 0.05).
  
  
  CONCLUSIONS
  The efficacy of standard dose HBV vaccination in patients with chronic HCV infection was suboptimal. Using double dose vaccination in these patients was an effective way to increase the antibody response.
authors.affiliation: Department of Gastroenterology, Infectious Disease and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Alzahra University Hospital, Isfahan, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Minakari
authors.affiliation: Department of Internal Medicine, Isfahan University of Medical Sciences, Alzahra University Hospital, Isfahan, Iran.
authors.forename: Afshin
authors.initials: A
authors.lastname: Tahmasebi
authors.affiliation: Department of Infectious Disease, Infectious Disease and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Alzahra University Hospital, Isfahan, Iran.
authors.forename: Mahyar Hosseini
authors.initials: MH
authors.lastname: Motlagh
authors.affiliation: Department of Infectious Disease, Infectious Disease and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Alzahra University Hospital, Isfahan, Iran.
authors.forename: Behrooz
authors.initials: B
authors.lastname: Ataei
authors.affiliation: Infectious Disease and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Alzahra University Hospital, Isfahan, Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Yaran
authors.affiliation: Department of Gastroenterology, Isfahan University of Medical Sciences, Alzahra University Hospital, Isfahan, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Kalantari
authors.affiliation: Department of Gastroenterology, Isfahan University of Medical Sciences, Alzahra University Hospital, Isfahan, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Tavakkoli
keywords: Chronic hepatitis C; Double dose vaccination; Hepatitis B vaccination