title: The efficacy of accelerated, multiple, double-dose hepatitis B vaccine against hepatitis B virus infection in cancer patients receiving chemotherapy.
abstract: BACKGROUND
  Hepatitis B virus (HBV) infection in cancer patients receiving chemotherapy carries high morbidity and mortality. Conventional hepatitis B vaccination with three doses at 0, 1, and 6 months apart is ineffective in prevention of HBV infection.
  
  
  OBJECTIVE
  To compare the efficacy of accelerated, multiple, double-dose HB vaccine with conventional HB vaccine in cancer patients receiving chemotherapy (CT).
  
  
  METHODS
  Patients of cancer who were planned for CT were screened for HBV markers (HBsAg, total anti-HB core, anti-HBs antibody and HBV DNA). Patients with negative HBV serum markers received HB vaccine in two groups. Group A received three double doses (40 μg) of recombinant HB vaccine at 0, 1, and 3 weeks before CT and additional three double doses post CT. Group B received HB vaccine (20 μg) at 0, 1, and 6 months. Efficacy of vaccine in the two groups was compared by anti-HBs titers achieved at 3, 6, and 9 months and by HBsAg positivity following CT at 1 year follow up.
  
  
  RESULTS
  Protective anti-HBs titers (>10 mIU/mL) at 3, 6, and 9 months in group A and B was 41.1 %, 66.2 %, and 76% and 26 %, 37.7 %, and 49% respectively (p = 0.001). Seven of 454 (1.5%) patients in group A became HBsAg positive after vaccination compared to 19/472 (4.0%) in group B (p = 0.022).
  
  
  CONCLUSIONS
  Accelerated, multiple, double-dose HB vaccine increases seroprotection and is more effective than conventional HB vaccine in preventing HBV infection.
authors.affiliation: Department of Gastroenterology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, 190 011, India. Jassi_win@rediffmail.com.
authors.forename: Jaswinder Singh
authors.initials: JS
authors.lastname: Sodhi
authors.affiliation: Department of Gastroenterology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, 190 011, India.
authors.forename: Wasim
authors.initials: W
authors.lastname: Raja
authors.affiliation: Department of Gastroenterology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, 190 011, India.
authors.forename: Showkat Ali
authors.initials: SA
authors.lastname: Zargar
authors.affiliation: Department of Gastroenterology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, 190 011, India.
authors.forename: Abid
authors.initials: A
authors.lastname: Showkat
authors.affiliation: Department of Gastroenterology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, 190 011, India.
authors.forename: Shaheena
authors.initials: S
authors.lastname: Parveen
authors.affiliation: Department of Medical Oncology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, 190 011, India.
authors.forename: Syed
authors.initials: S
authors.lastname: Nisar
authors.affiliation: Department of Gastroenterology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, 190 011, India.
authors.forename: Manzoor Ahmad
authors.initials: MA
authors.lastname: Wani
authors.affiliation: Department of Gastroenterology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, 190 011, India.
authors.forename: Gul
authors.initials: G
authors.lastname: Javid
authors.affiliation: Department of Gastroenterology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, 190 011, India.
authors.forename: Mushtaq
authors.initials: M
authors.lastname: Khan
authors.affiliation: Department of Medical Oncology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, 190 011, India.
authors.forename: Sheikh
authors.initials: S
authors.lastname: Aejaz
authors.affiliation: Department of Medical Oncology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, 190 011, India.
authors.forename: Gul
authors.initials: G
authors.lastname: Mohd
authors.affiliation: Department of Clinical Hematology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, 190 011, India.
authors.forename: Aleem
authors.initials: A
authors.lastname: Jan
authors.affiliation: Department of Gastroenterology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, 190 011, India.
authors.forename: Gh Nabi
authors.initials: GN
authors.lastname: Yattoo
authors.affiliation: Department of Gastroenterology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, 190 011, India.
authors.forename: Altaf
authors.initials: A
authors.lastname: Shah
authors.affiliation: Department of Gastroenterology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, 190 011, India.
authors.forename: Gh Mohd
authors.initials: GM
authors.lastname: Gulzar
authors.affiliation: Department of Medical Oncology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, 190 011, India.
authors.forename: Rashid
authors.initials: R
authors.lastname: Lone
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000175:diagnosis / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D011446:Prospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines
keywords: Accelerated, multiple, double-dose recombinant HB vaccine; Cancer patients; Chemotherapy; HBV markers; HBsAg positivity; Seroprotection