Response to hepatitis B virus vaccination in individuals with chronic hepatitis C virus infection

Abstract

Background Previous reports show conflicting results regarding hepatitis B virus (HBV) vaccine efficacy in Hepatitis C virus (HCV)-infected individuals. Aims To evaluate HBV-vaccine response and identify possible factors that may contribute to lower vaccine efficacy in patients infected with HCV. Methods We retrospectively evaluated all patients with chronic HCV infection at Hennepin County Medical Center, in Minneapolis, Minnesota, between 2002 and 2018. We addressed laboratory, liver-related, virus-related as well as vaccine-related variables, and their association to HBV vaccine response. Differences were tested using either a Chi-squared test or a T test to compare means between the two populations. Multivariate regression was modeled as a logistic regression. Results 1506 patients were evaluated, of which 525 received appropriate HBV vaccination and were assessed for response. Among those, 79% were vaccine responders and 21% were nonresponders. On multivariate analysis, cirrhosis was associated with lower response to the vaccine (OR 0.6, CI 0.44-0.94). We found no significant differences for vaccine response in relation to smoking (87% vs 86%), IV drug abuse (74% vs 72%), Diabetes Mellitus (26% vs 22%) being on hemodialysis (2% vs.5%), or virus related variables.

Effectiveness of hepatitis B vaccination in chronic HCV patients after successful generic direct acting antiviral therapy: significance of isolated hepatitis B core antibodies

“…Consistent with previous reports [45][46][47][48], not only a higher number of treated HCV patients showed absent vaccine responsiveness, but also diminished anti-HBsAb levels, suggesting a status of immune compromise. This was surprisingly lower when compared to the response rates reported in the general population [49].…”

“…Apart from advanced age, we found no significant association of other demographic variables with respect to vaccine response rates. Surprisingly, with liver cirrhosis being the main risk factor for vaccine hyporesponsiveness [45,58], the presence of cirrhosis did not predict poor vaccine response in our study cohort, probably due to small sample size, although some studies have found similar results [18,48]. However, in a recent study conducted in Minnesota between 2002 and 2018, liver cirrhosis was the only identifiable risk factor for hyporesponsiveness among studied clinical and virus-related variables in a total of 1506 patients evaluated [45].…”

Low Prevalence of Vaccination or Documented Immunity to Hepatitis A and Hepatitis B Viruses Among Individuals with Chronic Liver Disease

“…While prior studies report suboptimal hepatitis vaccine response rates in human immunodeficiency virus, inflammatory bowel disease, and other immunosuppressed conditions, few have specifically focused on patients with underlying chronic liver disease. 13,[39][40][41][42] For example, Ashhab et al 43 observed a 21% nonresponse rate among chronic hepatitis C patients who received hepatitis B vaccination, with cirrhosis patients 40% less likely to have immune response compared with noncirrhotic patients. A systematic review of hepatitis B vaccine response rates in cirrhosis patients observed a mean response rate of 38% (range 16%-79%) among patients who received standard-dose hepatitis B vaccination.…”

Low response rates to hepatitis B vaccine in patients with chronic hepatitis C

“…Some studies have shown similar numbers to our result and other had a better vaccinal response. [19][20][21][22] One meta-analysis that included 11 studies compared the seroconversion rate of the hepatitis B vaccine among 704 HCV patients and a control group of 812 people. Liu et al concluded that chronic HCV infection can reduce the immune response to the standard HBV vaccination schedule.…”

“…Another study did not find the same association. 21 However, one meta-analysis studied the factors that influenced the HBV vaccine response among healthy patients and concluded that smoking and age over 40 years were factors that decrease the HBV vaccine seroconversion rate. 28 The hepatitis B vaccination for isolated anti-HBc patients was important to distinguish patients with hidden infection by HBV and patients with a lack of immune memory do HBV, which was defined by a positive vaccinal response with the production of anti-HBs.…”