HBV vaccination in liver transplant recipients: not an effective strategy in the prophylaxis of HBV recurrence

Anti‐HBs immunoglobulins (HBIG) and lamivudine are main options to prevent hepatitis B virus (HBV) reinfection after liver transplantation. Although they are very effective, development of mutant viruses and high cost of treatment are main limitations for their application. Additionally there is an...

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Bibliographic Details
Published in:Journal of viral hepatitis 2005-03, Vol.12 (2), p.212-215
Main Authors: Karasu, Z., Ozacar, T., Akarca, U., Ersoz, G., Erensoy, S., Gunsar, F., Kobat, A., Tokat, Y., Batur, Y.
Format: Article
Language:English
Subjects:
Adult
DNA, Viral - analysis
Female
Follow-Up Studies
Graft Rejection - prevention & control
Hepatitis B - prevention & control
Hepatitis B Vaccines - administration & dosage
Hepatitis B virus
Hepatitis B virus - isolation & purification
hepatitis B virus vaccination
Humans
Liver transplantation
Liver Transplantation - adverse effects
Liver Transplantation - methods
Male
Middle Aged
Polymerase Chain Reaction
Risk Assessment
Sampling Studies
Secondary Prevention
Treatment Failure
Treatment Outcome
Vaccination
Viral Load
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Summary:Anti‐HBs immunoglobulins (HBIG) and lamivudine are main options to prevent hepatitis B virus (HBV) reinfection after liver transplantation. Although they are very effective, development of mutant viruses and high cost of treatment are main limitations for their application. Additionally there is an uncertainity for the duration of that prophylaxis regimen and its mostly applied indefinitely. Recently, post‐transplant HBV vaccination is reported to be a cheaper alternative prophylaksis strategy, that enables discontinuation of HBIG. To investigate the efficacy of HBV vaccination in patients transplanted for HBV cirrhosis, we administered double course of double dose recombinant HBV vaccine (Genhavac B; containing HBV pre‐S1, pre‐S2, and S gene products). Vaccination has been started 1 month after HBIg discontinuation, and lamivudine (100 mg/day) was given throughout the study. The first cycle consisted of 0, 1‐ and 6‐month schedule, and, in nonresponders, second cycle 0, 1‐, 2‐month schedule. Fourteen patients included into the study. Only one patient seroconverted (an anti‐HBs titre of 37 IU/L) after the first cycle. No other patient responded to second cycle. HBV vaccination in the post‐transplantation setting does not seems like an effective strategy in the prophylaxis of HBV recurrence.
ISSN:1352-0504
1365-2893
DOI:10.1111/j.1365-2893.2005.00585.x