Comparison of Accelerated and Standard Hepatitis B Vaccination Schedules in High-Risk Healthy Adults: A Meta-Analysis of Randomized Controlled Trials

Jin, Hui; Tan, Zhaoying; Zhang, Xuefeng; Wang, Bei; Zhao, Yang; Liu, Pei

doi:10.1371/journal.pone.0133464

Cited by 18 publications

(13 citation statements)

References 27 publications

(58 reference statements)

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“…This is within the expected range of non-response rate to hepatitis B vaccination of 4–10% [57,58] and these vaccine non-responders were excluded from the hepatitis B vaccine response analysis. The remaining 95 individuals (63% controls, 31% Sm+ and 6% STH+) all produced more than10 mIU/ml anti-HBs antibody levels after receiving the second or third dose of the vaccine series, indicating that they had achieved or exceeded the minimum level of protection.…”

Section: Resultsmentioning

confidence: 99%

Schistosoma mansoni Infection Can Jeopardize the Duration of Protective Levels of Antibody Responses to Immunizations against Hepatitis B and Tetanus Toxoid

et al. 2016

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BackgroundSchistosomiasis is a disease of major public health importance in sub-Saharan Africa. Immunoregulation begins early in schistosome infection and is characterized by hyporesponsiveness to parasite and bystander antigens, suggesting that a schistosome infection at the time of immunization could negatively impact the induction of protective vaccine responses. This study examined whether having a Schistosoma mansoni infection at the time of immunization with hepatitis B and tetanus toxoid (TT) vaccines impacts an individual’s ability to achieve and maintain protective antibody levels against hepatitis B surface antigen or TT.MethodsAdults were recruited from Kisumu Polytechnic College in Western Kenya. At enrollment, participants were screened for schistosomiasis and soil transmitted helminths (STHs) and assigned to groups based on helminth status. The vaccines were then administered and helminth infections treated a week after the first hepatitis B boost. Over an 8 month period, 3 blood specimens were obtained for the evaluation of humoral and cytokine responses to the vaccine antigens and for immunophenotyping.Results146 individuals were available for final analysis and 26% were S. mansoni positive (Sm+). Schistosomiasis did not impede the generation of initial minimum protective antibody levels to either hepatitis B or TT vaccines. However, median hepatitis B surface antibody levels were significantly lower in the Sm+ group after the first boost and remained lower, but not significantly lower, following praziquantel (PZQ) treatment and final boost. In addition, 8 months following TT boost and 7 months following PZQ treatment, Sm+ individuals were more likely to have anti-TT antibody levels fall below levels considered optimal for long term protection. IL-5 levels in response to in vitro TT stimulation of whole blood were significantly higher in the Sm+ group at the 8 month time period as well.ConclusionsIndividuals with schistosomiasis at the start the immunizations were capable of responding appropriately to the vaccines as measured by antibody responses. However, they may be at risk of a more rapid decline in antibody levels over time, suggesting that treating schistosome infections with praziquantel before immunizations could be beneficial. The timing of the treatment as well as its full impact on the maintenance of antibodies against vaccine antigens remains to be elucidated.

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Section: Resultsmentioning

confidence: 99%

Schistosoma mansoni Infection Can Jeopardize the Duration of Protective Levels of Antibody Responses to Immunizations against Hepatitis B and Tetanus Toxoid

et al. 2016

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“…Studies conducted in high-risk healthy adults, drug users, lung transplantation candidates, and HIV-infected patients elicited similar or better anti-HBs responses and could be advantageous for the short term in this population. However, additional studies on long-term protection and effectiveness of accelerated schedules are necessary [12,13,14,15]. …”

Section: Discussionmentioning

confidence: 99%

A Randomized Study Comparing the Efficacy of Three Hepatitis B Vaccine Induction Regimens in Adult Patients with Hematological Malignancies

Suyanı¹,

Haznedar²,

Yağcı³

2016

Tjh

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Objective:Non-responsiveness to hepatitis B virus (HBV) vaccines is not rare in hemato-oncological patients due to disease-associated or treatment-induced immune suppression. Although different strategies have been employed to improve the response rates, to date there is not an approved schedule for HBV immunization in patients with hematological malignancies. We designed a prospective randomized study to evaluate the efficacy of 3 different induction regimens for HBV vaccination.Materials and Methods:In the standard-dose (SD) group, total vaccine dose delivered was 40 µg and patients were vaccinated with 20 µg at weeks 0 and 4. In the high-dose dose-intensive (HDDI) group, total vaccine dose delivered was 80 µg and patients were vaccinated with 40 µg at weeks 0 and 4. In the high-dose time-intensive (HDTI) group, total vaccine dose delivered was 80 µg and patients were vaccinated with 20 µg at weeks 0, 2, 4, and 6.Results:In a cohort of 114 patients, 38.6% responded to HBV vaccination. The response rate in the SD arm, HDDI arm, and HDTI arm was 26.2%, 29.7%, and 44.4%, respectively (p>0.05). Age was the only variable identified as having a negative impact on response.Conclusion:Short of achieving statistical significance, a higher response rate was observed in the HDTI arm. Therefore, this study supports a high-dose, time-intensive HBV vaccine induction regimen in patients with hematological malignancies who are not on chemotherapy.

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“…The rapid decline in protective abs to HBV vaccine in HIV-1 infected individuals is a known phenomenon which requests special attention; in this group of patients a second series of vaccination or increasing the vaccine dose may be alternative strategies 34 , 35 . Despite the rapid decline in protection previously noticed following HBV vaccination and the recommendation formulated by experts to introduce a fourth booster of HBV vaccine in order to slow down the rapidly declining HBV vaccine ab levels 30 , 36 , most African countries still provide only three doses of HBV vaccine.…”

Section: Discussionmentioning

confidence: 99%

“…The vaccine used in our study was the Hepatitis B vaccine (rDNA), (Serum Institute of India, India) which consists of purified HBsAg. All children received 3 doses (each of 10 μg) with 4 weeks interval (accelerated vaccination schedule) in between the doses 30 . There was no severe adverse event reported upon vaccination in either healthy controls or HIV-1 infected children.…”

Section: Methodsmentioning

confidence: 99%

T follicular helper cells and antibody response to Hepatitis B virus vaccine in HIV-1 infected children receiving ART

Bekele

Yibeltal

Bobosha

et al. 2017

Sci Rep

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HBV vaccine has 95% efficacy in children to prevent HBV infection and related cancer. We conducted a prospective study in HIV-1 infected children receiving ART (n = 49) and controls (n = 63) to assess humoral and cellular responses to HBV vaccine provided with three doses under an accelerated schedule of 4 weeks apart. At 1 month post-vaccination all children, except 4 HIV-1 infected, displayed protective antibody (ab) titers to HBV vaccine; ab titers were lower in infected children (P < 0.0001). Ab titers decreased (P < 0.0001) in both HIV-1 infected and control children at 6 months. The frequency of circulating Tfh (cTFh) cells was 20.3% for controls and 20.8% for infected children prior to vaccination and remained comparable post-vaccination. Cytokine expression by cTfh cells upon activation with HBV antigen was comparable in the two groups at baseline and 1 month post-vaccination. Higher plasma levels (P < 0.0001) of CXCL13 were found in infected children which correlated with cTfh cell frequency at baseline. In conclusion, a lower ab response to HBV vaccine was measured in HIV-1 infected children. The frequency and activation profile of cTfh cells was comparable in infected children and controls suggesting that cells other than Tfh cells are responsible for impaired ab response to HBV vaccine.

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Comparison of Accelerated and Standard Hepatitis B Vaccination Schedules in High-Risk Healthy Adults: A Meta-Analysis of Randomized Controlled Trials

Cited by 18 publications

References 27 publications

Schistosoma mansoni Infection Can Jeopardize the Duration of Protective Levels of Antibody Responses to Immunizations against Hepatitis B and Tetanus Toxoid

Schistosoma mansoni Infection Can Jeopardize the Duration of Protective Levels of Antibody Responses to Immunizations against Hepatitis B and Tetanus Toxoid

A Randomized Study Comparing the Efficacy of Three Hepatitis B Vaccine Induction Regimens in Adult Patients with Hematological Malignancies

T follicular helper cells and antibody response to Hepatitis B virus vaccine in HIV-1 infected children receiving ART

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