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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Online Access: | http://dx.doi.org/10.1155/2000/548206 |
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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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