Decreased immunogenicity of recombinant hepatitis B vaccine in chronic hepatitis C.

Abstract

The immunogenicity of hepatitis B vaccine is unknown for patients with chronic hepatitis C, although hepatitis B vaccination is highly recommended in these patients. We therefore studied in a prospective open trial of 59 patients with chronic hepatitis C (mean age 42 years, hepatitis C for >10 years, Child-Pugh score < or = 5) and 58 healthy hospital staff persons the rate of nonresponse (anti-HBs <10 mIU/mL at 9 months) to recombinant hepatitis B vaccine (Gen H-B-Vax(R),10 microg intradeltoidal at month 0, 1, and 6). Nonresponse was observed in 18/59 (31%) patients with chronic hepatitis C and 5/58 (9%) healthy staff persons (P <.005) (vs. 7% in historical controls; P <.005), low response (anti-HBs 10-99 mIU/mL) in 19% of patients with chronic hepatitis C and 17% of staff persons. High-dose booster vaccination led to seroconversion in 12/15 (80%) of primary nonresponders. Primary nonresponse to HB vaccine was related neither to presence of early-stage liver cirrhosis nor magnitude of serum hepatitis C virus (HCV) RNA concentration, nor explained by the presence of human leukocyte antigen (HLA) types (B8 DR3, B44, DR7, DQ2) predisposing to low antibody response to hepatitis B surface antigen. The rate of primary nonresponse to the standard regimen of recombinant hepatitis B vaccine is surprisingly high in patients with longstanding chronic hepatitis C. Therefore, the antibody to HBV surface antigen (anti-HBs) titer response should be determined in these patients. Depending on the response titer, higher booster doses may be required to achieve and maintain seroprotection in these patients.

• Authors: M Wiedmann, U G Liebert, U Oesen, H Porst, M Wiese, S Schroeder, U Halm, J Mössner, F Berr
• Journal: Hepatology (Baltimore, Md.) (Hepatology) Vol. 31 Issue 1 Pg. 230-4 (Jan 2000) ISSN: 0270-9139 [Print] United States
• PMID: 10613751 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Hepatitis B Antibodies
• Hepatitis B Surface Antigens
• Hepatitis B Vaccines
• Vaccines, Synthetic

Topics

• Adult
• Aged
• Female
• Hepatitis B (prevention & control)
• Hepatitis B Antibodies (blood)
• Hepatitis B Surface Antigens (immunology)
• Hepatitis B Vaccines (immunology)
• Hepatitis C, Chronic (immunology)
• Humans
• Male
• Middle Aged
• Prospective Studies
• Vaccination
• Vaccines, Synthetic (immunology)