Recombinant γ-interferon as adjuvant to hepatitis B vaccine in hemodialysis patients

Abstract

Patients undergoing long-term hemodialysis are at high risk of acquiring hepatitis B yet tend to have poor rates of response to hepatitis B vaccine. The effect of recombinant human gamma-interferon (2 million units/m2) on the response to a recombinant hepatitis B vaccine was evaluated in a prospective, randomized controlled trial in 81 hemodialysis patients. A similar proportion of both groups of vaccinees ultimately developed antibody to HBsAg including 81% of the 41 recipients of vaccine alone (group I) and 89% of the 40 recipients of vaccine with gamma-interferon (group II). However, the antibody to HBsAg response occurred earlier in recipients of vaccine with gamma-interferon, so that at 4 mo 63% of group I and 88% of group II had antibody to HBsAg (p less than 0.025). Furthermore, titers of antibody to HBsAg tended to be higher in the vaccinees given interferon; the final geometric mean titers were 232 IU/L in group I and 330 IU/L in group II (p = not significant). Retrospective testing for antibody to hepatitis C virus revealed that 21 (26%) hemodialysis patients were seropositive at entry into this trial, but the presence of antibody to hepatitis C virus did not appear to affect the response rate to the hepatitis B vaccine. These results suggest that the effects of gamma-interferon as an adjuvant in increasing the response rate to hepatitis B vaccination deserve further evaluation perhaps most appropriately in persons who have not responded to an initial course of vaccine.

Hepatitis B Virus Infection in Dialysis Patients

“…The yeast-derived vaccine is not more immunogenic than the plasma-derived vaccine and nonresponse to one type is generally not overcome by vaccination with the other. Some authors reported an increase in anti-HBs response with co-administration of zinc [136,137], erithropoietin [100], or immunomodulators such as alfa- [138] or gamma- [139] interferon, thymopentine [140][141][142], interleukin-2 [143][144][145], and granulocytemacrophage colony-stimulator factor [146]. In addition, some investigators proposed to vaccinate uremic patients before they become dialysis-dependent [147,148].…”

Effect of Oral Levamisole Supplementation to Hepatitis B Vaccination on the Rate of Immune Response in Chronic Hemodialysis Patients

“…Despite these measures, the proportion of patients protected by vaccination could not be increased. Interleukin 2, gamma interferon, thymopentin, zinc, and colony-stimulating factor were added to standard vaccinations in order to increase the immune response [3][4][5][6][7]. These were, however, experimental protocols and cannot be recommended as routine procedures.…”

Responsiveness to Hepatitis B Vaccine in Immunocompromised Patients by Doubling the Dose Scheduling

“…Quiroga et al [ 16] used recombinant y-interferon as adjuvant to hepatitis B vaccine in HD patients. Grob et al [17,18] used interferon and thymopeptin as an adjuvant for hepa titis B vaccination in non-and low-responder popula tions.…”