Long-Term Effectiveness of Accelerated Hepatitis B Vaccination Schedule in Drug Users

Abstract

Objectives. We demonstrated the effectiveness of an accelerated hepatitis B vaccination schedule in drug users. Methods. We compared the long-term effectiveness of accelerated (0–1–2 months) and standard (0–1–6 months) hepatitis B vaccination schedules in preventing hepatitis B virus (HBV) infections and anti-hepatitis B (anti-HBs) antibody loss during 2-year follow-up in 707 drug users (HIV and HBV negative at enrollment and completed 3 vaccine doses) from February 2004 to October 2009. Results. Drug users in the accelerated schedule group had significantly lower HBV infection rates, but had a similar rate of anti-HBs antibody loss compared with the standard schedule group over 2 years of follow-up. No chronic HBV infections were observed. Hepatitis C positivity at enrollment and age younger than 40 years were independent risk factors for HBV infection and antibody loss, respectively. Conclusions. An accelerated vaccination schedule was more preferable than a standard vaccination schedule in preventing HBV infections in drug users. To overcome the disadvantages of a standard vaccination schedule, an accelerated vaccination schedule should be considered in drug users with low adherence. Our study should be repeated in different cohorts to validate our findings and establish the role of an accelerated schedule in hepatitis B vaccination guidelines for drug users.

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

“…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]. …”

A large proportion of people who inject drugs are susceptible to hepatitis B: Results from a bio-behavioural study in eight German cities

“…Options to increase vaccination coverage among PWID, as recommended by the WHO and EMCDDA, include the immediate availability of on-site vaccination during information and vaccination campaigns targeting PWID, prison-based vaccination programmes, cash incentives, and accelerated immunization schedules (Campbell et al, 2007;Sutton et al, 2006;Weaver et al, 2014;Shah et al, 2015); however, these are not routinely implemented in Germany. Integrating vaccination campaigns into needle exchange programmes may also be a cost-effective option (Hu et al, 2008).…”

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

“…The introduction of HBV vaccine in countries with a high burden of HBV infection has significantly reduced the prevalence of this infection and related complications 27 . Several clinical trials have previously shown that an accelerated vaccination schedule increases the likelihood of inducing high ab response in highly HBV endemic areas and in individuals who are at risk of acquiring HBV infection, especially immuno-compromised patients 28 – 33 . In our prospective vaccination study, healthy controls and HIV-1 infected children received three doses of HBV vaccine and 96% of the children responded to this vaccine with an increased titer of anti-HBV vaccine abs at 1 month from the last vaccination dose.…”