Efficacy of Hepatitis B Virus Vaccination and Antibody Response to Reactivation Dose Among Adult Non-Responders to Primary Hepatitis B Vaccination in Chronic Hepatitis C Egyptian Patients

Amgad Al-zahaby, Samy Zaky, Mahmoud Hussien, Diaa El-Tiby, Nabil Mohammad Alnoomani, Hany Awadallah, Fathiya El-Raey, Mohammad Abdel-Raheem Almoghazy

Abstract


BACKGROUND AND AIMS: Acute HBV infection in patients with chronic HCV-related liver disease is associated with a severe and often fulminant course of the disease. Additionally, HCV patients may be at a higher than an average risk of acquiring hepatitis B because of the similar routes of transmission of both viruses. HBV infection can be prevented by the administration of a safe and immunogenic vaccine. Insufficient immune response to hepatitis B virus (HBV) vaccine in patients with chronic hepatitis C virus is frequently encountered and anti-HBs levels may persist for a shorter time than among immune competent persons. The purpose of present study was to determine long-term persistence of anti-HBs among Egyptian patients with chronic hepatitis C infection. It also assesses the need and response to a subsequent challenge with vaccine booster doses.

METHODS: 200 individuals were enrolled; (GI) 100 patients suffered from chronic HCV infection and 100 healthy individuals as a control (GII). Both groups were matched in regard to age and sex. Each individual received a standard 3-dose series of HBV vaccine; 20µg recombinant DNA vaccine of HBV(Euvax-B LG Life science, Korea) administered by IM injection into deltoid muscle at 0, 1, 6 months interval. HBs antibody titer was measured after 4 weeks. Suboptimal or Non-responders (anti-HBs titer < 10 IU/L) received a booster dose and reevaluated after 4 weeks; Suboptimal response of group I (42 patients) divided into 2 subgroups: GIa (21 patients), which received 40 µg(double dose) recombinant HBV vaccine and GIb (21 patients), received standard adult dose 20 µg HBV vaccine. 11 individuals with suboptimal response of G II received standard adult dose 20 µg HBV vaccine too.

CONCLUSION: Chronic HCV patients showed lower response rate for standard doses of HBV vaccine especially with advancing age, diabetes and hypoalbuminemia. A double booster dose (40 μg) vaccine would be recommended for them which are better than revaccination with the standard 3 doses recombinant HBV vaccine.


Keywords


Chronic HCV patients; HBV vaccine

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