Currently, patients who receive liver transplantation for hepatitis B virus (HBV)-related diseases are treated with hepatitis B hyperimmunoglobulin (HBIG). This prevents reinfection of the graft.
However, the active immunization of these patients with standard hepatitis B vaccines has been reported. This has produced conflicting results.
In this study, researchers from Belgium and Germany assessed patients on continuous HBIG who were hepatitis B surface antigen (HBsAg) positive and HBV DNA negative prior to transplantation.
|80% of patients responded.|
Patients received differing concentrations of hepatitis B s antigen, formulated with 3-deacylated monophosphoryl lipid A (MPL) and Quillaja saponaria (QS21).
The team ensured that patients remained on HBIG prophylaxis. The patients were then vaccinated at weeks 0, 2, 4, 16, and 18.
The patients received further doses of vaccine at bimonthly intervals if they did not reach an antibody titer against hepatitis B surface antigen (anti-HBs) greater than 500 IU/L.
The researchers found that 80% of patients responded and were able to discontinue HBIG.
The team found that the vaccine was well tolerated.
Dr Ulrich Bienzle's team concluded, "Most patients immunized with the new vaccine can stop HBIG immunoprophylaxis for a substantial, yet to be determined period of time".