Immunogenicity and Safety of Hepatitis A Vaccine in Liver and Renal Transplant Recipients

Stark, Klaus; Günther, Matthias; Neuhaus, R.; Reinke, Petra; Schröder, Karsten; Linnig, Stefan; Bienzle, Ulrich

doi:10.1086/315125

Cited by 105 publications

(52 citation statements)

References 14 publications

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“…Seroprotection in renal recipients was 24% after the first dose of the vaccine and 72% after the second. However, the geometric mean titer of anti-hepatitis A virus was lower in renal recipients compared to controls and liver recipients (94).…”

Section: Hepatitis Amentioning

confidence: 78%

Vaccinations for Adult Solid-Organ Transplant Recipients: Current Recommendations and Protocols

Duchini¹,

Goss²,

et al. 2003

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Recipients of solid-organ transplantation are at risk of severe infections due to their life-long immunosuppression. Despite emerging evidence that vaccinations are safe and effective among immunosuppressed patients, most vaccines are still underutilized in these patients. The efficacy, safety, and protocols of several vaccines in this patient population are poorly understood. Timing of vaccination appears to be critical because response to vaccinations is decreased in patients with end-stage organ disease and in the first 6 months after transplantation. For these reasons, the primary immunizations should be given before transplantation, as early as possible during the course of disease. Vaccination strategy should include vaccination of household contacts and health care workers at transplant centers unless contraindicated. No conclusive data are available on the use of immunoadjuvants and screening for protective titers. Most vaccines appear to be safe in solid-organ transplantation recipients, but live vaccines should be avoided until further studies are available. The risk of rejection appears minimal. Recommended vaccines include pneumovax, hepatitis A and B, influenza, and tetanus-diphtheria. We outline specific protocols and recommendations in this particular patient population. Specific contraindications exist for other vaccines, such as yellow fever, oral polio vaccine, bacillus Calmette-Guerin, and vaccinia. We conclude that solid-organ recipients will benefit from consistent immunization practices. Further studies are recommended to improve established protocols in this patient population

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Section: Hepatitis Amentioning

confidence: 78%

Vaccinations for Adult Solid-Organ Transplant Recipients: Current Recommendations and Protocols

Duchini¹,

Goss²,

et al. 2003

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“…4,6 Recently there was an important change in the seroconversion rates [28][29][30][31] (Table 2). The response of patients with decompensated chronic hepatic disease is known to be lower, with lower antibody levels and lower seroconversion rates, when compared to those with compensated disease.…”

Section: Hepatitis a Vaccinementioning

confidence: 99%

“…The results are given in Tables 2 and 3 95.2%). 6,17,30 Nebbia et al 38 studied children and adolescents of up to 16 years of age with cirrhosis and observed an adequate response to HAV vaccine. The results are given in Table 3.…”

Section: Hepatitis a Vaccinementioning

confidence: 99%

Prevenção das hepatites virais através de imunização

Ferreira¹,

Silveira²

2006

J. Pediatr. (Rio J.)

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Objective: To present an updated review and criticism of viral hepatitis A and B prevention by immunization. Summary of the findings: Viral hepatitis prevention is an enormous challenge to the public health systems of countries and the medical and scientific communities. Hepatitis viruses produce important morbimortality in the world, causing acute and chronic hepatic disease. There are highly efficient vaccines available on the market to prevent new infections by the A and B viruses. However, A and B viruses continue to be among the most commonly notified diseases preventable by vaccines. In this article, we discuss the vaccines used to prevent these infections, with the aim of expanding knowledge and the practice of prevention of these infectious diseases.Conclusions: Although the vaccines against A and B hepatitis are recommended for various risk groups, estimated vaccine coverage is still modest and many vaccination opportunities are lost. In order to reduce the incidence of A and B hepatitis, which are preventable by vaccines, it is necessary for physicians to encourage their patients to be vaccinated.

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“…There are only limited data on the immunologic response to hepatitis A vaccination among renal transplant recipients. In one study, renal transplant recipients required a full course of two doses of hepatitis A vaccine to be able to achieve protective HAV antibody titers with a seroconversion rate of 72%, in contrast to healthy individuals, whose response rate to a single vaccine dose usually exceeds 90% (34). In addition, renal transplant recipients have demonstrated rapid decline of postvaccination antibody titers.…”

Section: General Measures and Patient Counselingmentioning

confidence: 99%

“…In some countries, routine hepatitis A vaccination of patients with chronic liver disease is already recommended. Renal transplant recipients with chronic HCV could certainly benefit from such a practice (34).…”

Section: General Measures and Patient Counselingmentioning

confidence: 99%