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Reestablishment of active immunity against HBV graft reinfection after liver transplantation for HBV-related end stage liver disease.

Lu SC, Jiang T, Lai W, Liu Y, Zhang J, Zeng DB, Li CY, Wang ML, Lin DD, Zhu Y, Li YP, Li N - J Immunol Res (2014)

Bottom Line: Of the 50 patients, 24 discontinued HBIG without any HBV graft reinfection during a follow-up period of 26.13 ± 7.05 months. 21 patients discontinued both HBIG and antiviral agents during a follow-up period of 39.86 ± 15.47 months, and 4 patients among them appeared to be HBsAg positive.There was no recipient death or graft loss because of HBV reinfection.Vaccination preventing HBV reinfection for OLT recipients is feasible.

View Article: PubMed Central - PubMed

Affiliation: Department of Hepatobiliary Surgery and Liver Transplantation Program, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China ; Institute & Hospital of Hepatobiliary Surgery, Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLA, Chinese PLA Medical School, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.

ABSTRACT

Background: The aim of this study was to establish a hepatitis B virus (HBV) vaccination protocol among orthotopic liver transplantation (OLT) recipients under the coverage of a low-dose hepatitis B immunoglobulin (HBIG) combined with an antiviral agent prophylaxis protocol.

Method: Two hundred OLT recipients were included in this study. The vaccine was injected at months 0, 1, 2, and 6. Low-dose HBIG combined with antiviral agent prophylaxis protocol was continued before reestablishment of active immunity against HBV in order to maintain a steady anti-HBs titer.

Results: Active immunity against HBV was reestablished in 50 patients, for an overall response rate of 25%. Of the 50 patients, 24 discontinued HBIG without any HBV graft reinfection during a follow-up period of 26.13 ± 7.05 months. 21 patients discontinued both HBIG and antiviral agents during a follow-up period of 39.86 ± 15.47 months, and 4 patients among them appeared to be HBsAg positive. There was no recipient death or graft loss because of HBV reinfection.

Conclusions: Vaccination preventing HBV reinfection for OLT recipients is feasible. The strategy withdrawal of HBIG with induction of active immunity against hepatitis B is reasonable for long-term survivors of OLT; however, discontinuation nucleoside analogues should be cautious.

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Related in: MedlinePlus

No significant differences were present in baseline anti-HBs titer, titer at successful establishment of immunity, the highest titer after vaccination, the lowest titer before booster vaccination, the highest titer after booster vaccination, titer when HBIG was withdrawn, and the titer at the end of followup (vacc.: vaccination).
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Related In: Results  -  Collection


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fig2: No significant differences were present in baseline anti-HBs titer, titer at successful establishment of immunity, the highest titer after vaccination, the lowest titer before booster vaccination, the highest titer after booster vaccination, titer when HBIG was withdrawn, and the titer at the end of followup (vacc.: vaccination).

Mentions: There were 20 cases in Engerix-B group and 30 cases in Twinrix group in which active immunity against HBV was established. There was no difference between the two groups in baseline titers, titer at success of immunization, the highest titer, the lowest titer before booster vaccination, the highest titer after booster vaccinations, titer when HBIG was withdrawn, and the titer at the end of followup (Figure 2). The number of inoculation cycles required for success (1.75 ± 0.64 versus 1.63 ± 0.72, t = 0.587, and P = 0.560), dosage number (4.95 ± 2.14 versus 5.13 ± 2.57, t = −0.264, and P = 0.793), and number of booster vaccinations (1.86 ± 1.03 versus 1.46 ± 0.59, t = 1.528, and P = 0.135) were similar between the two groups. The number of cases requiring booster vaccinations (15 cases in the Engerix-B group and 24 cases in the Twinrix group) was also similar (χ2 = 0.175, P = 0.467). However, the drug withdrawal rate of the Twinrix group was greater than that of Engerix-B group (χ2 = 13.923, t = 0.001; Table 3).


Reestablishment of active immunity against HBV graft reinfection after liver transplantation for HBV-related end stage liver disease.

Lu SC, Jiang T, Lai W, Liu Y, Zhang J, Zeng DB, Li CY, Wang ML, Lin DD, Zhu Y, Li YP, Li N - J Immunol Res (2014)

No significant differences were present in baseline anti-HBs titer, titer at successful establishment of immunity, the highest titer after vaccination, the lowest titer before booster vaccination, the highest titer after booster vaccination, titer when HBIG was withdrawn, and the titer at the end of followup (vacc.: vaccination).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4352506&req=5

fig2: No significant differences were present in baseline anti-HBs titer, titer at successful establishment of immunity, the highest titer after vaccination, the lowest titer before booster vaccination, the highest titer after booster vaccination, titer when HBIG was withdrawn, and the titer at the end of followup (vacc.: vaccination).
Mentions: There were 20 cases in Engerix-B group and 30 cases in Twinrix group in which active immunity against HBV was established. There was no difference between the two groups in baseline titers, titer at success of immunization, the highest titer, the lowest titer before booster vaccination, the highest titer after booster vaccinations, titer when HBIG was withdrawn, and the titer at the end of followup (Figure 2). The number of inoculation cycles required for success (1.75 ± 0.64 versus 1.63 ± 0.72, t = 0.587, and P = 0.560), dosage number (4.95 ± 2.14 versus 5.13 ± 2.57, t = −0.264, and P = 0.793), and number of booster vaccinations (1.86 ± 1.03 versus 1.46 ± 0.59, t = 1.528, and P = 0.135) were similar between the two groups. The number of cases requiring booster vaccinations (15 cases in the Engerix-B group and 24 cases in the Twinrix group) was also similar (χ2 = 0.175, P = 0.467). However, the drug withdrawal rate of the Twinrix group was greater than that of Engerix-B group (χ2 = 13.923, t = 0.001; Table 3).

Bottom Line: Of the 50 patients, 24 discontinued HBIG without any HBV graft reinfection during a follow-up period of 26.13 ± 7.05 months. 21 patients discontinued both HBIG and antiviral agents during a follow-up period of 39.86 ± 15.47 months, and 4 patients among them appeared to be HBsAg positive.There was no recipient death or graft loss because of HBV reinfection.Vaccination preventing HBV reinfection for OLT recipients is feasible.

View Article: PubMed Central - PubMed

Affiliation: Department of Hepatobiliary Surgery and Liver Transplantation Program, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China ; Institute & Hospital of Hepatobiliary Surgery, Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLA, Chinese PLA Medical School, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.

ABSTRACT

Background: The aim of this study was to establish a hepatitis B virus (HBV) vaccination protocol among orthotopic liver transplantation (OLT) recipients under the coverage of a low-dose hepatitis B immunoglobulin (HBIG) combined with an antiviral agent prophylaxis protocol.

Method: Two hundred OLT recipients were included in this study. The vaccine was injected at months 0, 1, 2, and 6. Low-dose HBIG combined with antiviral agent prophylaxis protocol was continued before reestablishment of active immunity against HBV in order to maintain a steady anti-HBs titer.

Results: Active immunity against HBV was reestablished in 50 patients, for an overall response rate of 25%. Of the 50 patients, 24 discontinued HBIG without any HBV graft reinfection during a follow-up period of 26.13 ± 7.05 months. 21 patients discontinued both HBIG and antiviral agents during a follow-up period of 39.86 ± 15.47 months, and 4 patients among them appeared to be HBsAg positive. There was no recipient death or graft loss because of HBV reinfection.

Conclusions: Vaccination preventing HBV reinfection for OLT recipients is feasible. The strategy withdrawal of HBIG with induction of active immunity against hepatitis B is reasonable for long-term survivors of OLT; however, discontinuation nucleoside analogues should be cautious.

Show MeSH
Related in: MedlinePlus