High-dose hepatitis B vaccine in patients waiting for lung transplantation. Pharmacotherapy 2003 May;23(5):555-60
Date
05/14/2003Pubmed ID
12741428DOI
10.1592/phco.23.5.555.32194Scopus ID
2-s2.0-0038708465 (requires institutional sign-in at Scopus site) 19 CitationsAbstract
STUDY OBJECTIVE: To increase the response rate to hepatitis B vaccine in patients awaiting lung transplantation.
DESIGN: Historically controlled, open-label study.
SETTING: Lung transplant clinic at a university hospital.
SUBJECTS: Twenty-seven consecutive individuals with end-stage pulmonary disease who were enrolled to accrue 15 subjects who would complete the vaccine series before transplantation; and 27 lung transplant recipients who were immunized with the conventional dose before the study and served as historical controls.
INTERVENTION: Intramuscular injection of high-dose hepatitis B vaccine 40 microgram at 0, 1, and 6 months.
MEASUREMENTS AND MAIN RESULTS: Hepatitis B surface antibody (anti-HBs) concentrations were measured 1-2 months after completing the high-dose series. Individuals with undetectable anti-HBs received additional vaccine to a maximum of six doses. The response rate to the series was compared with that in the control group. Seventeen individuals in the high-dose group and 14 controls met the study criterion of complete vaccine series before transplantation. The former had a much higher response rate than the latter (9 [53%] vs 1 [7%], p<0.01). Four of six patients who received additional doses of vaccine seroconverted. Two of them underwent transplantation shortly after completing the three-dose series.
CONCLUSION: The high-dose hepatitis B vaccine series produced a protective immune response in lung transplant recipients; however, the response was suboptimal, and alternative immunization strategies should be studied.
Author List
Hayney MS, Welter DL, Reynolds AM, Francois M, Love RBMESH terms used to index this publication - Major topics in bold
AdultDose-Response Relationship, Drug
Female
Hepatitis B
Hepatitis B Antibodies
Hepatitis B Vaccines
Humans
Lung Transplantation
Male
