Effects of different dose levels and vaccination schedules on immune response to a recombinant DNA hepatitis B vaccine in haemodialysis patients

Bruguera, Miquel; Rodicio, J. L.; Alcázar, J M; Oliver, Arturo; Rió, G. Del; Esteban, Rafael

doi:10.1016/0264-410x(90)90218-b

Cited by 52 publications

(35 citation statements)

References 14 publications

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“…Studies regarding vaccine response have reported an increased vaccine response following schemes with four-double doses and smaller intervals (0, 1, 2, 6) with response rates varying from 72 to 97.5% [3, 5, 17, 24, 29]. The HD unit studied had given booster doses to patients who did not respond to the standard scheme, and we observed that most of the patients who did not respond by the fourth dose would not respond after any subsequent dose.…”

Section: Discussionmentioning

confidence: 99%

“…HBV vaccination is recommended for HD patients; however, high antibody seroconversion rates have not always been observed [2]. As a result, different vaccination schemes have been tried; namely higher and more frequent doses and use of intradermal, rather than intramuscular, administration [3, 4, 5, 6]. In spite of the application of the recommended preventive measures and HBV vaccination, new cases of HBV infection are still being detected in HD facilities [7, 8].…”

Section: Introductionmentioning

confidence: 99%

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Serological and Vaccination Profile of Hemodialysis Patients during an Outbreak of Hepatitis B Virus Infection

Lewis-Ximenez

Oliveira

Mercadante

et al. 2001

Nephron

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During an outbreak of hepatitis B virus (HBV) infection in a hemodialysis unit, patients were assessed for serological viral markers and vaccination status. HBV infection was identified in 26 patients. Twenty of these were positive for hepatitis B surface antigen (HBsAg), and 6 were negative for HBsAg but positive for IgM antibody to hepatitis B core (anti-HBc) and HBV DNA. The primary source of infection was not clearly identified, although 2 patients were suspected to be the index cases. A multiple logistic regression analysis revealed low anti-HBs titers and vaccination status to be independently associated with the risk of acquiring HBV infection. Both the high prevalence of HBV infection (31%) detected in this unit and the low vaccine response (53%) observed reinforce the importance of universal and preventive measures in controlling HBV infection. The detection of HBV DNA in HBsAg-negative/IgM anti-HBc-positive patients emphasizes the value of anti-HBc testing in the routine screening of HBV in hemodialysis units.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Serological and Vaccination Profile of Hemodialysis Patients during an Outbreak of Hepatitis B Virus Infection

Lewis-Ximenez

Oliveira

Mercadante

et al. 2001

Nephron

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“…The vaccination dose scheme in HD patients is an intramuscular double dose (40 mcg) at the 0th /1st /2nd and 6th months. While the response to the vaccine is approximately 70% of hemodialysis patients with this vaccination, it is more than 90% in the general population (11). In addition, the rate of response to hepatitis B vaccine was higher in pre-dialysis patients.…”

Section: Introductionmentioning

confidence: 97%

Occult Hepatitis B Prevalence in Hepatitis B Vaccinated Dialysis Patients

Hüzmelí¹,

Şeker²,

Candan³

et al. 2017

Turk Neph Dial Transpl

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OBJECTIVE: Occult hepatitis B (OHB) virus infection is defined as the presence of hepatitis B virus (HBV) DNA in the liver tissue or serum of subjects seronegative for hepatitis B surface antigen. OHB leads to the potential risk of transmission in dialysis service. Routine HBV vaccine in dialysis patients is recommended. However, HBV vaccine response rates are lower than the community. The aim of this study was to determine the prevalence of OHB in hepatitis B vaccinated dialysis patients. MATERIAL and METHODS:This study was performed at the Nephrology Department, Faculty of Medicine, Cumhuriyet University, between 1st January -31st December 2014. Sera from 200 dialysis patients with negative HbsAg were investigated for HBV DNA using the polymerase chain reaction (PCR). RESULTS:The mean age of the patients was 59.57±14.89 (18-91) years; 179 of them were on hemodialysis and 21 were on peritoneal dialysis. Of the patients included in the study, anti-HBs positivity was present in 135 (67.5%) and anti-HBs negativity in 65 (32.5%). The OHB prevalence was 1.5% (3). CONCLUSION:In our study, the OHB prevalence was 1.5%. We assume that HBV infection would be reduced further by routinely applying HBV PCR tests for all patients who start dialysis and by taking precautions against transmission. KEy wORDS: Occult hepatitis B, Dialysis, Hepatitis B vaccineÖz AMAÇ: Occult hepatit B (OHB) virüs enfeksiyonu, hepatit B yüzey antijeni seronegatif olan hastalarda, karaciğer dokusunda ve / veya serumda hepatit B virüsü (HBV) DNA'sının tespit edilmesi olarak tanımlanır. OHB diyaliz servislerinde, potansiyel bulaşma riskine yol açar. Diyaliz hastalarına rutin HBV aşısı önerilmektedir. Fakat aşılamaya rağmen HBV aşısına yanıt oranları topluma göre düşük bulunmaktadır Çalışmanın amacı, hepatit B aşısı yapılmış diyaliz hastalarında OHB prevelansını saptamak. GEREÇ ve yÖNTEMLER: BULGULAR:Hastaların yaş ortalaması 59,57±14,89 (18-91), 179 hemodiyaliz ve 21 periton diyaliz hastasıydı. Çalışmaya alınan hastaların, anti-HBs pozitifliği 135 (67,5%), anti-HBs negatifliği 65 (32,5%) idi. OBH prevelansı 1,5% (3) tespit edildi.SONUÇ: Çalışmamızda OHB prevelansı 1,5% olarak tespit ettik. Diyalize başlanacak hastaların hepsine rutin olarak bakılması ve önlemlerin alınması ile HBV enfeksiyonunun daha da azaltılacağını düşünmekteyiz.

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“…Compared to adults with normal immune status, pre-haemodialysis and haemodialysis patients have a suboptimal response to standard HBV vaccination with aluminium adjuvanted vaccines, because their immune system is impaired. These patients require double dosage of HBV vaccine and a four-dose schedule, followed by frequent boosters to maintain protection [86][87][88][89][90]. For that reason GSK Bio developed an alternative HBV vaccine formulation targeted to this specific population [91].…”

Section: Hbvmentioning

confidence: 99%

Designing Vaccines against Human Papillomavirus and Hepatitis B Virus: Similarities and Differences for Preventable Viral Infections and role of AS04 Adjuvant System in Addressing Specific Challenges

Garçon¹

2012

J Vaccines Vaccin

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IntroductionSeveral intracellular pathogens can establish long-lasting chronic infections and may lead to clinical disease. Two examples of such pathogens are the Human papillomavirus (HPV) and the Hepatitis B virus (HBV). Immunological mechanisms are involved both in the establishment and maintenance of the tolerance to these infections. Chronic infections and diseases are the results of a delicate interplay between the pathogen's actions to survive in the host and the attempts of the immune system to eradicate it.HPV is one of the most common chronic viral infections in humans. The virus consists of circular, double stranded DNA and has no envelope. Approximately 130 different HPV types have been identified so far [1] and about 40 of these infect the human genital tract, including 15 of types considered as oncogenic [2]. It is estimated that up to 80% of women will acquire a HPV infection in their lifetime [3]. Cervical HPV infections are asymptomatic; although most of them clear spontaneously and only 5-10% will become persistent infection possibly leading to the development of clinical pre-cancerous lesions and cancer.Upon natural infection, HPV remains at the site of infection, evades the immune system, and does not reliably induce protective immunity as the virus does not kill infected cells and hence neither inflammation nor release of danger signals to be recognised by the immune system is triggered. As a result, new infections and re-infection can occur [4]. A prophylactic HPV vaccine should therefore induce a better immune response than natural infection by overcoming the challenges due to the pathogen (i.e. have the ability to block the virus at the site of entrance), hence induce higher level of antibodies, and provide longterm protection [4].HBV infects hepatocytes and consists of a double-stranded circular DNA genome, an outer envelope protein (HBsAg), an inner nucleocapsid protein, (HBcAg), and a soluble small molecular weight protein (HBeAg) produced by the core gene. The HBsAg envelope protein can be shed and is also found as a non-infectious self-assembling tubular or spherical particle in the bloodstream of infected patients [5]. Overall eight genotypes of HBV are known [6,7]. AbstractPathogen characteristics and the mechanism of host/pathogen interaction play a key role in design, formulation, and development of vaccines. Here we present the experience of GSK Bio in developing two vaccines with a novel Adjuvant System (AS04) against two viral infections, Human papillomavirus (HPV) and Hepatitis B virus (HBV), that have some similarities and many differences.Developing a vaccine against HPV is difficult because the virus remains local, evades the immune system, and does not induce a reliable long lasting protection upon natural infection. Vaccination of pre-haemodialysis and haemodialysis patients against hepatitis B represents a challenge as well, because these patients are immunocompromised and develop a reduced and short lasting immune response to administration of conventional HBV vaccine...

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Effects of different dose levels and vaccination schedules on immune response to a recombinant DNA hepatitis B vaccine in haemodialysis patients

Cited by 52 publications

References 14 publications

Serological and Vaccination Profile of Hemodialysis Patients during an Outbreak of Hepatitis B Virus Infection

Serological and Vaccination Profile of Hemodialysis Patients during an Outbreak of Hepatitis B Virus Infection

Occult Hepatitis B Prevalence in Hepatitis B Vaccinated Dialysis Patients

Designing Vaccines against Human Papillomavirus and Hepatitis B Virus: Similarities and Differences for Preventable Viral Infections and role of AS04 Adjuvant System in Addressing Specific Challenges

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