Ineffectiveness of hepatitis B vaccination in cirrhotic patients waiting for liver transplantation

Cirrhotic patients who undergo liver transplantation are at risk of acquiring de novo hepatitis B virus (HBV) infection at the time of transplantation. It is common practice to immunize these patients against HBV, but the efficacy of vaccination is uncertain. The response to vaccination with a recom...

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Main Authors: Edith Villeneuve, Jean Vincelette, Jean-Pierre Villeneuve
Format: Article
Language:English
Published: Hindawi Limited 2000-01-01
Series:Canadian Journal of Gastroenterology
Online Access:http://dx.doi.org/10.1155/2000/548206
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spelling doaj-2cfd9627f72e4ed4a64ef7cb384435f22020-11-25T00:52:23ZengHindawi LimitedCanadian Journal of Gastroenterology0835-79002000-01-0114Suppl B59B63B10.1155/2000/548206Ineffectiveness of hepatitis B vaccination in cirrhotic patients waiting for liver transplantationEdith Villeneuve0Jean Vincelette1Jean-Pierre Villeneuve2Division of Hepatology, Centre Hospitalier de l’Université de Montréal, Campus Saint-Luc, Montréal, Quebec, CanadaDivision of Microbiology, Centre Hospitalier de l’Université de Montréal, Campus Saint-Luc, Montréal, Quebec, CanadaDivision of Hepatology, Centre Hospitalier de l’Université de Montréal, Campus Saint-Luc, Montréal, Quebec, CanadaCirrhotic patients who undergo liver transplantation are at risk of acquiring de novo hepatitis B virus (HBV) infection at the time of transplantation. It is common practice to immunize these patients against HBV, but the efficacy of vaccination is uncertain. The response to vaccination with a recombinant HBV vaccine was examined in 49 patients with cirrhosis before liver transplantation. Patients received three doses (20 µg) of Engerix-B (SmithKline Beecham) at zero, one and two months before transplantation, and their response was measured on the day of liver transplantation (9.3±1.2 months after the initial dose of vaccine). Results were compared with those reported in healthy adults vaccinated according to the same schedule. Fourteen of 49 cirrhotic patients (28%) developed antibodies to hepatitis B surface antigen (anti-HBs) levels of more than 10 U/L after vaccination compared with 97% of healthy controls. Four patients (8%) had anti-HBs levels of more than 100 U/L compared with 83% in healthy individuals. Mean anti-HBs titre in the 14 responders was 62 U/L compared with 348 U/L in controls. No factor was identified that predicted response to vaccination. One of 49 patients acquired de novo HBV infection at the time of liver transplantation. Current HBV vaccination of cirrhotic patients waiting for liver transplantation is ineffective, and new strategies need to be developed to increase the response rate.http://dx.doi.org/10.1155/2000/548206
collection DOAJ
language English
format Article
sources DOAJ
author Edith Villeneuve
Jean Vincelette
Jean-Pierre Villeneuve
spellingShingle Edith Villeneuve
Jean Vincelette
Jean-Pierre Villeneuve
Ineffectiveness of hepatitis B vaccination in cirrhotic patients waiting for liver transplantation
Canadian Journal of Gastroenterology
author_facet Edith Villeneuve
Jean Vincelette
Jean-Pierre Villeneuve
author_sort Edith Villeneuve
title Ineffectiveness of hepatitis B vaccination in cirrhotic patients waiting for liver transplantation
title_short Ineffectiveness of hepatitis B vaccination in cirrhotic patients waiting for liver transplantation
title_full Ineffectiveness of hepatitis B vaccination in cirrhotic patients waiting for liver transplantation
title_fullStr Ineffectiveness of hepatitis B vaccination in cirrhotic patients waiting for liver transplantation
title_full_unstemmed Ineffectiveness of hepatitis B vaccination in cirrhotic patients waiting for liver transplantation
title_sort ineffectiveness of hepatitis b vaccination in cirrhotic patients waiting for liver transplantation
publisher Hindawi Limited
series Canadian Journal of Gastroenterology
issn 0835-7900
publishDate 2000-01-01
description Cirrhotic patients who undergo liver transplantation are at risk of acquiring de novo hepatitis B virus (HBV) infection at the time of transplantation. It is common practice to immunize these patients against HBV, but the efficacy of vaccination is uncertain. The response to vaccination with a recombinant HBV vaccine was examined in 49 patients with cirrhosis before liver transplantation. Patients received three doses (20 µg) of Engerix-B (SmithKline Beecham) at zero, one and two months before transplantation, and their response was measured on the day of liver transplantation (9.3±1.2 months after the initial dose of vaccine). Results were compared with those reported in healthy adults vaccinated according to the same schedule. Fourteen of 49 cirrhotic patients (28%) developed antibodies to hepatitis B surface antigen (anti-HBs) levels of more than 10 U/L after vaccination compared with 97% of healthy controls. Four patients (8%) had anti-HBs levels of more than 100 U/L compared with 83% in healthy individuals. Mean anti-HBs titre in the 14 responders was 62 U/L compared with 348 U/L in controls. No factor was identified that predicted response to vaccination. One of 49 patients acquired de novo HBV infection at the time of liver transplantation. Current HBV vaccination of cirrhotic patients waiting for liver transplantation is ineffective, and new strategies need to be developed to increase the response rate.
url http://dx.doi.org/10.1155/2000/548206
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