Efficacy of a recombinant hepatitis B vaccine (Euvax-B) in adult patients awaiting liver transplantation: preliminary results

Brandão, Ajácio; Álvarez, Ramón; Famer, Sirlei; Marroni, C; Cassal, Alvaro; Zanotelli, Maria Lúcia; Cantisani, Guido Pio Gracco

doi:10.1016/s0041-1345(99)00668-5

Cited by 2 publications

(4 citation statements)

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“…37 However, a concern is that seroprotection rates in these SOT candidates are still suboptimal even with the double-dose (40 µg) hepatitis B immunization schedule. [12][13][14][15][16][17][18][19][20][21][22][23][24][25] The expectation of low effectiveness of currently licensed HBV vaccines in renal transplant recipients was shown to be the most important barrier to guideline adherence among Dutch nephrologists. 38 Similarly for liver transplant candidates, HBV immunity rate was significantly lower in patients with more advanced liver dis- should be immunized with the hepatitis B vaccine.…”

Section: Discussionmentioning

confidence: 99%

“…The management of HBV infection within the haemodialysis unit focuses on identifying the virology status of all patients starting haemodialysis, offering a hepatitis B immunization schedule if indicated and monitoring anti‐HBs levels with repeat immunization in those without protective antibody levels 37 . However, a concern is that seroprotection rates in these SOT candidates are still suboptimal even with the double‐dose (40 µg) hepatitis B immunization schedule 12‐25 . The expectation of low effectiveness of currently licensed HBV vaccines in renal transplant recipients was shown to be the most important barrier to guideline adherence among Dutch nephrologists 38 …”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14][15][16][17][18][19] In cirrhotic patients waiting for liver transplantation, only 10%-36% develop protective antibody levels after a standard vaccination schedule with 3 or 4 doses of 20 µg HBsAg. 12,[20][21][22] Providing a double-dose (40 µg) schedule increases the seroprotection rate to 26%-68%. 14,20,23,24 A recent systematic review also reported a poorer immune response in patients with end-stage renal disease with 24%-42% seroprotection after standard-dose (20 µg) HBV vaccination and 51%-69% after double-dose (40 µg) vaccination.…”

Section: Introductionmentioning

confidence: 99%

“…It is well‐known that HBV vaccines are less effective in SOT candidates 12‐19 . In cirrhotic patients waiting for liver transplantation, only 10%‐36% develop protective antibody levels after a standard vaccination schedule with 3 or 4 doses of 20 µg HBsAg 12,20‐22 . Providing a double‐dose (40 µg) schedule increases the seroprotection rate to 26%‐68% 14,20,23,24 .…”

Section: Introductionmentioning

confidence: 99%

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The effect of universal infant vaccination on the prevalence of hepatitis B immunity in adult solid organ transplant candidates

Koc

Dupont

Vos

et al. 2020

Journal of Viral Hepatitis

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Background Hepatitis B virus (HBV) immunity is recommended to optimize outcomes after solid organ transplantation (SOT). This study assessed the prevalence and predictors of HBV immunity at the time patients were placed on transplant waiting list over a period from 1997 to 2019 in a low HBV endemic region. Methods Data were obtained from the University Hospitals Leuven transplant database. Minors and patients with past/current HBV infection were excluded. From 1986, Belgian patients are covered by the universal infant vaccination; therefore, birth cohort was stratified in those born ≥1986 vs <1986. Results The study population consisted of 3297 SOT candidates. HBV immunity rate was superior in renal transplant candidates (55.3%), and this number was 21.5%, 15.4% and 16.8% for liver, cardiac and pulmonary transplant candidates, respectively, P < .001. Among liver transplant candidates, HBV immunity rate was 14.8% in decompensated cirrhotic patients and 27.9% in those without advanced cirrhosis (P < .001). The overall immunity rate increased from 19.3% in period 1997‐2008 to 32.8% in 2009‐2019, P < .001. In multivariable analyses, younger age (odds ratio (OR) 95% confidence interval (CI): 0.97‐0.98, P < .001) and birth cohort ≥ 1986 (OR 95% CI: 1.18‐2.66, P = .006) were associated with increased HBV immunity. Conclusion An increase in HBV immunity was observed over a 20‐year period related to the introduction of universal infant HBV vaccination. Nevertheless, this study highlights the low overall HBV immunity at the time of listing for organ transplantation and points out the need of an increased awareness and vaccination strategy at an early disease stage.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The effect of universal infant vaccination on the prevalence of hepatitis B immunity in adult solid organ transplant candidates

Koc

Dupont

Vos

et al. 2020

Journal of Viral Hepatitis

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Teles

Martins

Lopes

et al. 2001

European Journal of Epidemiology

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Hepatitis B vaccine is the most effective strategy for preventing the transmission of hepatitis B virus (HBV) in haemodialysis centers. Nevertheless, lower vaccine responses have been reported in haemodialysis patients as compared with healthy subjects. This study examines the response to Euvax-B in Brazilian haemodialysis patients and staff. A total of 102 eligible patients (n = 42) and staff members (n = 60) consented to be studied. Patients were immunized intramuscularly with four doses of 40 microg of Euvax-B vaccine at 0, 1, 2 and 6 months. In staff members, the vaccine was administered in three doses of 20 microg at 0, 1, and 6 months. Post-vaccine samples were taken from all subjects I month after each dose. The vaccine response was determined by measuring antibody to the hepatitis B surface antigen (anti-HBs) levels using ELISA. Subjects with anti-HBs titres equal to or higher than 10 UI/L were considered immune protected. Of the haemodialysis patients who received four doses of hepatitis B vaccine, 89.5% responded to Euvax-B vaccine. The geometric mean of anti-HBs titres was 322.8 IU/L (95% CI: 317.7-328). Among staff members, 93.3% reached anti-HBs protective titres after the third vaccine dose. The geometric mean of anti-HBs titres was 2,209 IU/L (Cl: 2,198-2,219). Age, male gender and body mass index were not associated with vaccine response in either group. This study showed a good immunogenicity response to Euvax-B in haemodialysis patients and staff.

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Efficacy of a recombinant hepatitis B vaccine (Euvax-B) in adult patients awaiting liver transplantation: preliminary results

Cited by 2 publications

References 4 publications

The effect of universal infant vaccination on the prevalence of hepatitis B immunity in adult solid organ transplant candidates

The effect of universal infant vaccination on the prevalence of hepatitis B immunity in adult solid organ transplant candidates

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