Efficacy of Hepatitis B Vaccine in Adults with Chronic Liver Disease

• Published in: Journal of pharmacy practice 2023-08, Vol.36 (4), p.839-844
• Main Authors: Kim, Yaeji, Loucks, Jennifer, Shah, Meera
• Format: Article
• Language: English
• Subjects: Adult; Hepatitis B - prevention & control; Hepatitis B Antibodies; Hepatitis B Vaccines; Hepatitis B virus; Humans; Liver Cirrhosis; Liver Diseases; Retrospective Studies
• ISSN: 0897-1900; 1531-1937
• DOI: 10.1177/08971900221078742

Background & Aims: Although HBV vaccine has a 95% seroconversion rate in the general population, patients with chronic liver disease have reduced seroconversion rates (16-79%). The aim of the study was to describe seroconversion rates with HBV vaccines in patients with chronic liver disease. Approach & Results: Retrospective chart review was performed among 652 patients who received a complete HBV vaccine series in the hepatology clinic. Of those, 126 patients that were included, 111 received a single dose series, and 15 patients received a double dose series. The seroconversion rate was overall low at 35%, and stayed the same at 35% with double dose and at 33% with single dose. Patients who received a single dose series were further analyzed to review risk factors for seroconversion. Overall, 65% of patients had cirrhosis. Patients were more likely to seroconvert if no cirrhosis (51% vs 72%, P=.04), higher aminotransferase levels, intermediate anti-HBs (2.5-11.9 mIU/mL) at baseline (87.5% vs 14%). Conclusion: Patients with chronic liver disease had a low rate (35%) of response to HBV vaccination. The response rates did not improve in patients that received double dose series. Patients with cirrhosis, lower aminotransferase levels and with a lower baseline anti-HBs had decreased response rates.