scholarly journals Ineffectiveness of hepatitis B vaccination in cirrhotic patients waiting for liver transplantation

2000 ◽  
Vol 14 (suppl b) ◽  
pp. 59B-63B ◽  
Author(s):  
Edith Villeneuve ◽  
Jean Vincelette ◽  
Jean-Pierre Villeneuve
Keyword(s):  
Liver Transplantation ◽  
Hepatitis B ◽  
De Novo ◽  
Hepatitis B Surface Antigen ◽  
Hbv Infection ◽  
Hepatitis B Vaccination ◽  
Hbv Vaccine ◽  
Hbv Vaccination ◽  
De Novo Hepatitis B ◽  
Cirrhotic Patients

Cirrhotic patients who undergo liver transplantation are at risk of acquiring de novo hepatitis B virus (HBV) infection at the time of transplantation. It is common practice to immunize these patients against HBV, but the efficacy of vaccination is uncertain. The response to vaccination with a recombinant HBV vaccine was examined in 49 patients with cirrhosis before liver transplantation. Patients received three doses (20 µg) of Engerix-B (SmithKline Beecham) at zero, one and two months before transplantation, and their response was measured on the day of liver transplantation (9.3±1.2 months after the initial dose of vaccine). Results were compared with those reported in healthy adults vaccinated according to the same schedule. Fourteen of 49 cirrhotic patients (28%) developed antibodies to hepatitis B surface antigen (anti-HBs) levels of more than 10 U/L after vaccination compared with 97% of healthy controls. Four patients (8%) had anti-HBs levels of more than 100 U/L compared with 83% in healthy individuals. Mean anti-HBs titre in the 14 responders was 62 U/L compared with 348 U/L in controls. No factor was identified that predicted response to vaccination. One of 49 patients acquired de novo HBV infection at the time of liver transplantation. Current HBV vaccination of cirrhotic patients waiting for liver transplantation is ineffective, and new strategies need to be developed to increase the response rate.

STUDY OF PREVALENCE OF HEPATITIS B SURFACE ANTIGEN (HBSAG) IN BLOOD DONOR POPULATION BORN PRIOR TO AND AFTER IMPLEMENTATION OF HBV VACCINATION IN KERALA, SOUTH INDIA

2021 ◽  
pp. 66-67
Author(s):  
Indu . P.K
Keyword(s):  
Hepatitis B ◽  
Blood Donor ◽  
Blood Donors ◽  
Hepatitis B Surface Antigen ◽  
Vaccination Schedule ◽  
Hbv Infection ◽  
Hepatitis B Vaccination ◽  
P Value ◽  
Hbv Vaccine ◽  
Hbv Vaccination

BACKGROUND: Since 1995 Hepatitis B vaccination became a part of Extended immunization Program (EIP) in India, neonates started getting immunoprophylaxis against Hepatitis B virus. Since vaccination started recently, exact prevalence of immunized persons were not available, but anyway vaccinated blood donors over 18 years old are progressively increasing MATERIALS AND METHODS: In this study 2400 blood donors were screened for HBsAg by enzyme linked immunosorbent assays, among the donor blood samples which are positive for HBsAg were noted. Various demographic patterns of blood donor were analyzed. To know about impact of vaccination on prevalence HBV infection among donors who born after the implementation of mandatory HBV vaccination schedule was compared with blood donors those who are born before HBV vaccination schedule RESULTS: Among the blood donors overall prevalence of HBV infection was 0.75% HBsAg. HBV vaccinated blood donor were protected from getting disease ,showing P value of 18 years (0.07), 19 years(0.01), 20 years(0.02) CONCLUSION: Young blood donors born after implementation of universal HBV vaccination in lndia presented higher prevalence of HBsAg but lower incidence of HBsAg seroconversion than older. HBV vaccine boosting for adolescents at 15–17 years old prior to reaching blood donor age may improve blood safety.

scholarly journals 1057. CpG-adjuvanted Hepatitis B vaccination improves seroprotection rates in Veterans with HIV

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S558-S558
Author(s):  
Meagan Deming ◽  
Shyam Kottilil ◽  
Eleanor Wilson
Keyword(s):  
Hepatitis B ◽  
Hepatitis B Surface Antigen ◽  
Panel Member ◽  
The Elderly ◽  
Hepatitis B Vaccination ◽  
People Living With Hiv ◽  
Research Support ◽  
Hbv Vaccine ◽  
Vaccine Responses ◽  
Hbv Vaccination

Abstract Background Hepatitis B virus (HBV) remains a global health issue, leading to complications including cirrhosis and hepatocellular carcinoma. Individuals co-infected with Human Immunodeficiency Virus (HIV) and HBV have increased liver-related morbidity and mortality compared to those with HBV mono-infection. Vaccination can effectively prevent HBV infection, but certain critical populations including people living with HIV (PLWH) are less likely to achieve seroprotection (antibody to hepatitis B surface antigen (HBsAb) titer ≥ 10 IU/mL) after vaccination; seroprotection rates (SPR) in PLWH range from 34 to 88% in clinical trials, with improved SPR in those with immunologic reconstitution and viral suppression. With improved immunologic status, SPR have dramatically improved in our Veteran Infectious Disease clinic population. However, a subset of patients remain HBV vaccine nonresponders despite re-vaccination attempts, perhaps due to intrinsic immunologic anergy. We hypothesized that Veterans with HIV who were nonresponders to prior HBV vaccines may respond to a more immunogenic vaccine. Heplisav-B is a 2-dose series, with improved SPR in other classically difficult to vaccinate groups (including the elderly and those with diabetes), but has not yet been studied in individuals with HIV. Methods HBV vaccine nonresponders who had previously been vaccinated and boosted with median 3 and up to 8 doses of alum-adjuvanted HBV vaccines were re-vaccinated with Heplisav-B. HBsAb titers were assessed at days 0, 30, and 60 to follow vaccine responses. Results Participants had a median age of 65 (range 44 to 83) and were virologically suppressed on antiretroviral therapy. Enrollment and vaccination was interrupted by the COVID-10 pandemic, but 8 of 10 (80%) enrolled participants had seroprotective titers at day 60, with 6 having titers > 1000 IU/mL. Of the 8 additional participants who had available serologies after the first dose, all were seroprotected, and 3 had titers > 1000 IU/mL.16 of 18 (89%) participants achieved seroprotection with Heplisav-B. Conclusion Heplisav-B is immunogenic in persons with HIV and should be a reasonable option for HBV vaccination of PLWH who are previous nonresponders. Disclosures Shyam Kottilil, MD PhD, Arbutus Pharmaceuticals (Grant/Research Support)Gilead Sciences (Grant/Research Support)Merck Inc (Grant/Research Support, Advisor or Review Panel member)

scholarly journals 1066. Immune Escape Mutant Detection Using Commercially Available Methods for Hepatitis B Surface Antigen Serological Testing

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S562-S562
Author(s):  
Robert Gish ◽  
Vincent Streva
Keyword(s):  
Hepatitis B ◽  
Immune Escape ◽  
Hepatitis B Surface Antigen ◽  
Panel Member ◽  
The United States ◽  
Hbv Infection ◽  
Hepatitis B Vaccination ◽  
Review Panel ◽  
B Virus ◽  
Escape Mutants

Abstract Background Although overall infection rates of Hepatitis B virus (HBV) in the United States (US) remain stable, as many as 2.2 million persons are still chronically infected with Hepatitis B Virus (HBV)1. Persons who inject drugs (PWID) are at a higher risk of HBV infection and since 2009 three states (KY, TN, WV) have reported up to a 114% increase in cases of acute HBV infection due to higher infection rates among a non-Hispanic white populations (30–39 years), and injection drug users2. Hepatitis B vaccination is recommended as primary prevention for adults who are at increased risk for HBV infection, including PWID. However, data from the National Health Interview Survey indicate that hepatitis B vaccination coverage is low among adults in the general population3, and it is likely to be lower among injection drug users. Hepatitis B Surface Antigen (HBsAg) is the first serological marker to appear after HBV exposure and infection; this marker is included in the recommended panel for acute hepatitis diagnosis and accurate detection is necessary for early and accurate diagnosis. Serological testing challenges exist for HBsAg due to the high degree of genetic variability which can further be exacerbated by endogenous and exogenous pressures. The immuno-dominant region may have one or more mutations described as immune escape mutations which can decrease or abrogate HBsAg binding to antibodies used in immunoassays. Although the prevalence of these mutations is not well documented in the United States, international studies have shown that up to 79% of HBV-reactivated patients (vs 3.1% of control patients; p< 0.001) carry HBsAg mutations localized in immune-active HBsAg regions4. Methods A study was conducted using a panel of 10 unique recombinant HBsAg immune escape mutants. Panel members were tested by commercially available HBsAg serological immunoassays. Results It was found that although commercially available HBsAg immunoassays are the primary diagnostic tool for HBV diagnosis, not all HBsAg immune escape mutants are detected, with some method detecting as few as 5 out of 10 of these mutant samples. Figure 1 Conclusion Improvement is needed in commercially available methods for the accurate detection of HBsAg. Disclosures Robert Gish, MD, Abbott (Consultant)AbbVie (Consultant, Advisor or Review Panel member, Speaker’s Bureau)Access Biologicals (Consultant)Antios (Consultant)Arrowhead (Consultant)Bayer (Consultant, Speaker’s Bureau)Bristol Myers (Consultant, Speaker’s Bureau)Dova (Consultant, Speaker’s Bureau)Dynavax (Consultant)Eiger (Consultant, Advisor or Review Panel member)Eisai (Consultant, Speaker’s Bureau)Enyo (Consultant)eStudySite (Consultant, Advisor or Review Panel member)Exelixis (Consultant)Fujifilm/Wako (Consultant)Genentech (Consultant)Genlantis (Consultant)Gilead (Consultant, Advisor or Review Panel member, Speaker’s Bureau)GLG (Consultant)HepaTX (Consultant, Advisor or Review Panel member)HepQuant (Consultant, Advisor or Review Panel member)Intercept (Consultant, Speaker’s Bureau)Ionis (Consultant)Janssen (Consultant)Laboratory for Advanced Medicine (Consultant)Lilly (Consultant)Merck (Consultant)Salix (Consultant, Speaker’s Bureau)Shionogi (Consultant, Speaker’s Bureau)Viking (Consultant)

scholarly journals The Impact of Universal Infant Hepatitis B Immunization on Reducing the Hepatitis B Carrier Rate in Pregnant Women

2018 ◽  
Vol 220 (7) ◽  
pp. 1118-1126 ◽  
Author(s):  
Wei-Ju Su ◽  
Shu-Fong Chen ◽  
Chin-Hui Yang ◽  
Pei-Hung Chuang ◽  
Hsiu-Fang Chang ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Pregnant Women ◽  
Screening Program ◽  
Hepatitis B Surface Antigen ◽  
Carrier Rate ◽  
Cross Sectional ◽  
Hbv Vaccine ◽  
Hbv Vaccination ◽  
The Impact ◽  
Universal Infant

Abstract Background The hepatitis B virus (HBV) status of pregnant women affects HBV vaccine failure in their offspring. This study is aimed to investigate the impact of the universal infant HBV vaccination program on the long-term hepatitis B surface antigen (HBsAg) rate in pregnant women. Methods Using the National Immunization Information System, we examined a 32-year period of cross-sectional data on a maternal HBsAg and hepatitis B e antigen (HBeAg) screening program launched in July 1984. An age-period-cohort model analysis of 940 180 pregnant women screened for July 1996–June 1997 and the years 2001, 2006, 2011, and 2016 was applied. Results The annual HBsAg- and HBeAg-seropositive rates decreased from 13.4% and 6.4%, respectively, for the period 1984–1985 to 5.9% and 1.0% in 2016 (P for both trends < .0001). Pregnant women with birth years after July 1986 (the HBV vaccination cohort) had the lowest relative risk (0.27 [95% confidence interval, .26–.28]) of HBsAg positivity compared with birth years before June 1984. Conclusions The birth cohort effect in relation to the universal infant HBV immunization program has effectively reduced the HBV carrier rate in pregnant women and the burden of perinatal HBV infection on the next generation.

scholarly journals Hepatitis B vaccination status and vaccine immune response among children in rural Senegal

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Perieres ◽  
M Coste ◽  
S Ndiour ◽  
P Halfon ◽  
C Sokhna ◽  
...  
Keyword(s):  
Immune Response ◽  
Hepatitis B ◽  
Chronic Infection ◽  
Vaccination Status ◽  
Hbv Infection ◽  
Hepatitis B Vaccination ◽  
Chronic Hbv Infection ◽  
Hbv Vaccination ◽  
Chronic Hbv ◽  
Vaccine Immunity

Abstract Background Hepatitis B vaccination during childhood is key to reduce the prevalence of Hepatitis B virus (HBV) infection. In Senegal, a highly endemic country, the three-dose hepatitis B vaccine and the birth dose vaccine were introduced in the Expanded Programme on Immunization (EPI) in 2004 and 2016 respectively. This study aimed to determine chronic HBV infection prevalence, hepatitis B vaccination status and vaccine immunity among children in Senegal. Methods A cross-sectional study including HBV screening was conducted at home among children aged 6 months to 15 years (i.e. born after the introduction of the HBV vaccine in the EPI) in the rural zone of Niakhar. Dried Blood Spot (DBS) samples were collected for the detection of HBsAg, anti-HBc Ab and anti-HBs Ab using chemoluminescence. Vaccination status was assessed using information on vaccination cards. Detectable vaccine immunity was defined with an adjusted DBS threshold of DOI≥0.36 IU/mL (corresponding to 10 IU/mL in venous blood sampling). Results Between October and December 2018, 455 children were enrolled. Preliminary results show that 7/455 (1.5%) had been in contact with HBV (positive anti-HBc Ab) and 5/455 (1.1%) had chronic HBV infection (positive HBsAg). Only 161/455 (35.4%) children had a vaccination card available. Among those, 150/161 (93.2%) received at least 3 doses of hepatitis B vaccine, of which 83/150 (55.3%) had detectable vaccine immunity. The proportion of children with detectable vaccine immunity was significantly higher in children &lt;5 years than in children aged 5-9 and 10-15 (72.3% versus 47.3%, p = 0.006 and 72.3% versus 14.3%, p &lt; 0.001). Conclusions Preliminary results suggest a low prevalence of HBV chronic infection among children born after the introduction of HBV vaccination in Senegal. However, detectable vaccine immunity rapidly decreases with age among vaccinated children, signalling a need for further studies on the immune response to HBV vaccination in this context. Key messages HBV chronic infection is low among children born after the introduction of HBV vaccination in Senegal. Further studies on the immune response to HBV vaccination in this context are needed.

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