Failure of a reinforced triple course of hepatitis B vaccination in patients transplanted for HBV-related cirrhosis
| Autor: | A. Petrolati, Antonio Araco, S Zazza, Raffaella Lionetti, M.O. Trinito, Mario Angelico, Daniele Di Paolo, Giuseppe Tisone, Carlo Umberto Casciani |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
HBsAg Cirrhosis Hepatology business.industry medicine.medical_treatment virus diseases Lamivudine Hepatitis B Liver transplantation medicine.disease Gastroenterology digestive system diseases Surgery Transplantation Vaccination Titer Internal medicine Medicine business medicine.drug |
| Zdroj: | Hepatology. 35:176-181 |
| ISSN: | 0270-9139 |
| DOI: | 10.1053/jhep.2002.30278 |
| Popis: | Long-term immunoprophylaxis with anti-HBs immunoglobulins (HBIg) is used to prevent hepatitis B (HBV) reinfection after liver transplantation for HBV-related cirrhosis. This approach is highly expensive. A recent report proposed posttransplant HBV vaccination with a reinforced schedule as an alternative strategy to allow HBIg discontinuation. We investigated the efficacy of a reinforced triple course of HBV vaccination in 17 patients transplanted for HBsAg-positive cirrhosis 2 to 7 years earlier. The first cycle consisted of 3 double intramuscular doses (40 microg) of recombinant vaccine at month 0, 1, and 2, respectively. This was followed, in nonresponders, by a second cycle of 6 intradermal 10 microg doses every 15 days. All nonresponders then received a third cycle identical to the first one. Vaccination started 4.5 months after HBIg discontinuation, and lamivudine (100 mg/day) was given throughout the study. All patients were seronegative for HBsAg and HBV-DNA (by PCR) and positive for anti-HBe, and 7 were positive for anti-HDV. After the first cycle one patient (#5, 53 years old, male) developed an anti-HBs titer of 154 IU/L, another (#12) reached a titer of 20 IU/L and the remainder had titers |
| Databáze: | OpenAIRE |
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