Hepatitis B vaccination in patients receiving oral antiviral therapy without hepatitis B immunoglobulin after liver transplant

Abstract

Introduction: Our study aimed to determine if a double-dose pre-S containing HBV vaccination (Sci-B-VacTM) could elicit an adequate and sustainable immune response in HBV patients who developed spontaneous anti-HBs response after liver transplantation.

Patients & Methods: All patients who were transplanted for HBV related disease for >1 year with normal graft function and HBsAg seronegativity were evaluated. They received a 40mcg HBV vaccine if they were responders in our previous vaccine trial, or anti-HBs was positive for >1 year after LT or a peak anti-HBs at any time point after LT was >100mIU/ml. Primary endpoint was the development of anti-HBs ≥10mIU/ml from previous negative value or a 1-log increase from baseline.

Results: Eighty-six patients were recruited; 5 were responders from previous trial; 45 patients had detectable anti-HBs >1 year after LT and 36 patients had an anti-HBs >100mIU/ml. All (5/5,100%) previous responders responded to booster vaccination. For the remaining 81 patients, 10/81 (12.3%) responded.

Conclusion: All previous responders responded to booster vaccination, implying durability and memory of HBV immune response, which is an important prerequisite for definitive host immunity for HBV. In patients who had spontaneous anti-HBs production after LT, a single vaccination can induce response in 12.3% of patients.