Low Immune Responses to Hepatitis B Vaccination Among Healthy Subjects

Pead, P.J.; Saeed, Ahmed; Hewitt, W G; Brownfield, R.N.

doi:10.1016/s0140-6736(85)92449-3

Cited by 27 publications

(13 citation statements)

References 5 publications

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“…Early reports suggested that women respond less well to vaccine than men [11] but other studies have suggested a similar pattern to that we describe in which women are consistently better responders. This was particularly marked in studies where vaccine was given as a low dose intradermally.…”

Section: Discussionsupporting

confidence: 87%

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Immunization against hepatitis B-what can we expect?: Results of a survey of antibody response to immunization in persons ‘at risk’ of occupational exposure to hepatitis B

et al. 1990

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SUMMARYOne thousand three hundred and twenty adults at risk of occupational exposure to hepatitis B were immunized using genetically engineered surface antigen and their antibody response (anti-HBs IU/l) assessed. Sex was known for all subjects and age for 1120 (range from 17-71 years). Seven hundred and sixty-four subjects were immunized in the local Department of Occupational Health, the remainder mainly by general practitioners.Analysis of 'good responders' (anti-HBs > 100 IU/l) according to age and sex showed that increasing age and male sex had independent adverse effects on the likelihood of developing a satisfactory level of antibody to HBsAg. Furthermore even those most likely to respond well (young women), had a 1/5 to 1/6 failure rate to achieve > 100 IU/l anti-HBs.Of 63 persons who received a fourth dose of vaccine, 26 developed anti-HBs titres > 100 IU/l when tested after 6 months. Subjects who had a low level of antiHBs following primary immunization were more likely to develop > 100 IU/l anti-HBs following a booster dose than were non-responders (< 10 IU/l).

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Section: Discussionsupporting

confidence: 87%

“…Also, early immunizations were performed in the gluteal region, found to be an unsatisfactory route for hepatitis B immunization 17,8,11,12,18,19,[21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Immunization against hepatitis B-what can we expect?: Results of a survey of antibody response to immunization in persons ‘at risk’ of occupational exposure to hepatitis B

et al. 1990

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“…The type and route of administration of the vaccine gave optimal HbsAb titres in the control group, suggesting that the deltoid region (and not the gluteal region in which a high prevalence of low responses has been observed [15]) should be the site of preference for the administration of B hepatitis vaccine. Genetic factors may be involved but it is likely that immunological disturbance is mainly responsible for the impaired HbsAb titre observed in patients with Type 1 diabetes.…”

Section: Discussionmentioning

confidence: 93%

Reduced protection against hepatitis B virus following vaccination in patients with Type 1 (insulin-dependent) diabetes

Pozzilli

Visalli

et al. 1987

Diabetologia

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Summary. Twenty patients with well controlled Type I (insulin-dependent) diabetes of at least 10 years duration and 47 control subjects were vaccinated against the hepatitis B virus using the Hevac B vaccine. The vaccine was administered into the deltoid region on three occasions at intervals of 1 month. Thereafter a fourth dose was given to subjects still negative for antibody to hepatitis B surface antigen (HbsAb). The median rise of HbsAb titres was 230 mlU/ml in normal subjects and 50mlU/ml in diabetic patients (p<0.001). Eight patients (40%) failed to reach HbsAb titres above 30 mlU/ml, the level considered to give optimal protection against the infection, whereas only one normal control subject failed to reach this level. Five patients (25%) showed no response despite a fourth dose of the vaccine. There was an increased frequency of HLA-DR7 in low responders and a decreased (< 1.5) helper/suppressor lymphocyte ratio. Diabetic patients are thus less likely to mount a protective antibody response following vaccination against hepatitis. Since hepatitis B surface antigen is reported to be considerably more common in diabetic patients than control subjects, infection with hepatitis B virus may have a greater risk of chronicity in diabetes.

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“…The vaccine was made of subviral particles isolated from human plasma and inactivated by successive treatments with pepsin, urea, and formalin (5). However, subsequent applications of this hepatitis B vaccine, could not always reproduce the high efficacy of the original trial (6,7). In patients on maintenance hemodialysis, with depressed immune responses, the efficacy ran as low as 50% (8).…”

mentioning

confidence: 99%

A synthetic peptide vaccine involving the product of the pre-S(2) region of hepatitis B virus DNA: protective efficacy in chimpanzees.

Itoh¹,

Takai²,

Ohnuma³

et al. 1986

Proc. Natl. Acad. Sci. U.S.A.

210

105

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The S gene encoding the major surface polypeptide of hepatitis B virus is preceded by the region pre-S(2) with a capacity to code for 55 amino acid residues. In the product of region pre-S(2), the sequence of 19 amino acid residues (amino acids 14-32 from the N terminus) representing an area of high local hydrophilicity is shared by viral strains of subtypes adr, ayw, and ayr; residue 22, phenylalanine, is replaced by leucine in a strain of the other subtype, adw. A synthetic peptide vaccine involving these 19 amino acid residues, when given to two chimpanzees, raised antibodies that bound to viral particles and protected the animals from challenge with 106 chimpanzee infectious doses of hepatitis B virus.

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Low Immune Responses to Hepatitis B Vaccination Among Healthy Subjects

Cited by 27 publications

References 5 publications

Immunization against hepatitis B-what can we expect?: Results of a survey of antibody response to immunization in persons ‘at risk’ of occupational exposure to hepatitis B

Immunization against hepatitis B-what can we expect?: Results of a survey of antibody response to immunization in persons ‘at risk’ of occupational exposure to hepatitis B

Reduced protection against hepatitis B virus following vaccination in patients with Type 1 (insulin-dependent) diabetes

A synthetic peptide vaccine involving the product of the pre-S(2) region of hepatitis B virus DNA: protective efficacy in chimpanzees.

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