title: Response to Hepatitis A Vaccination in Immunocompromised Travelers.
abstract: BACKGROUND
  Hepatitis A vaccines are highly immunogenic in healthy patients, but there is uncertainty about their immunogenicity in immunocompromised patients.
  
  
  METHODS
  Our study included immunocompromised patients who received 1 or 2 hepatitis A vaccinations between January 2011 and June 2013. We assessed factors that influenced the serologic response to vaccination. We performed a literature review of previous studies on hepatitis A vaccination in immunocompromised patients.
  
  
  RESULTS
  Of 85 immunocompromised patients, 65 used immunosuppressive drugs, 13 had received stem cell transplants, and 7 were infected with human immunodeficiency virus. After vaccination, 65 of 85 (76.5%) developed antibodies. Tumor necrosis factor α blocker use was associated with better serologic responses than other immunosuppressive drugs. Female patients were more compliant than male patients with postvaccination antibody titer measurements. In 11 relevant studies, antibody responses after the first and second vaccination averaged 37% and 82%, respectively. Factors that negatively influenced serologic response rates were high doses of immunosuppressive drugs, fewer hepatitis A vaccinations, and a short interval between vaccination and antibody measurement.
  
  
  CONCLUSIONS
  Immunocompromised patients showed moderate to good serologic responses to hepatitis A vaccination, but may need more time to develop immunity. Tumor necrosis factor α blocker use was associated with better antibody responses than other drugs. Specifically, male patients should be motivated to return for antibody titer measurements.
authors: Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.
authors: Hannah M
authors: HM
authors: Garcia Garrido
authors: Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.
authors: Rosanne W
authors: RW
authors: Wieten
authors: Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.
authors: Martin P
authors: MP
authors: Grobusch
authors: Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.
authors: Abraham
authors: A
authors: Goorhuis
mesh_terms: D015331:Cohort Studies; D005260:Female; D015658:HIV Infections; D006506:Hepatitis A / Q000276:immunology / Q000517:prevention & control*; D035922:Hepatitis A Antibodies / Q000097:blood / Q000276:immunology*; D022362:Hepatitis A Vaccines / Q000008:administration & dosage / Q000276:immunology*; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology*; D007166:Immunosuppressive Agents; D008297:Male; D014195:Travel; D057236:Travel Medicine; D014611:Vaccination
chemical_list: D035922:Hepatitis A Antibodies; D022362:Hepatitis A Vaccines; D007166:Immunosuppressive Agents
keywords: hepatitis A vaccination; immunocompromised; serologic response; travelers