肝移植术后无乙型肝炎免疫球蛋白的口服抗病毒治疗患者的

StephenW

Transplant Proc. 2018 Dec;50(10):3681-3688. doi: 10.1016/j.transproceed.2018.07.008. Epub 2018 Jul 7.
Hepatitis B Vaccination in Patients Receiving Oral Antiviral Therapy Without Hepatitis B Immunoglobulin After Liver Transplant.
Wong TCL1, Fung JYY2, Chok KSH1, Cheung TT1, Chan ACY1, Dai WC1, Ng KKC1, Chan SC1, Lo CM3.
Author information

1
    Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
2
    Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
3
    Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China. Electronic address: [email protected].

Abstract

Our study aimed to determine if a double-dose pre-S containing hepatitis B virus (HBV) vaccination (Sci-B-Vac) could elicit an adequate and sustainable immune response in HBV patients who developed spontaneous hepatitis B surface antibody (anti-HBs) response after liver transplant.
PATIENTS AND METHODS:

All patients who received transplants for HBV-related disease for >1 year with normal graft function and hepatitis B surface antigen seronegativity were evaluated. They received a 40-μg HBV vaccine if they were responders in our previous vaccine trial, if anti-HBs was positive for >1 year after liver transplant (LT), or if a peak anti-HBs at any time point after LT was >100 mIU/mL. Primary endpoint was the development of anti-HBs ≥ 10 mIU/mL from previous negative value or a 1-log increase from baseline.
RESULTS:

A total of 86 patients were recruited; 5 were responders from a previous trial; 45 patients had detectable anti-HBs >1 year after LT, and 36 patients had an anti-HBs >100 mIU/mL. All (5/5, 100%) previous responders responded to booster vaccination. For the remaining 81 patients, 10 of 81 (12.3%) responded.
CONCLUSION:

All previous responders responded to booster vaccination, implying durability and memory of HBV immune response, which is an important prerequisite for definitive host immunity for HBV. In patients who had spontaneous anti-HBs production after LT, a single vaccination can induce response in 12.3% of patients.

Copyright © 2018. Published by Elsevier Inc.

PMID:
    30577255
DOI:
    10.1016/j.transproceed.2018.07.008

StephenW

移植程序2018年12月; 50（10）：3681-3688。 doi：10.1016 / j.transproceed.2018.07.008。 Epub 2018年7月7日。
肝移植术后无乙型肝炎免疫球蛋白的口服抗病毒治疗患者的乙型肝炎疫苗接种。
Wong TCL1，Fung JYY2，Chok KSH1，Cheung TT1，Chan ACY1，Dai WC1，Ng KKC1，Chan SC1，Lo CM3。
作者信息

1
    香港大学玛丽医院外科，香港，中国。
2
    香港大学玛丽医院医学系，中国香港。
3
    香港大学玛丽医院外科，香港，中国。电子地址：[email protected]。

抽象

我们的研究旨在确定含有乙型肝炎病毒（HBV）疫苗的双剂量前S（Sci-B-Vac）是否能够在发生自发性乙型肝炎表面抗体的HBV患者中引发充分和可持续的免疫反应（抗-HBs） ）肝移植后的反应。
患者和方法：

所有接受HBV相关疾病移植> 1年且移植物功能正常和乙型肝炎表面抗原血清阳性的患者均进行了评估。如果他们在我们之前的疫苗试验中是反应者，他们接受了40-μgHBV疫苗，如果抗-HBs在肝移植（LT）后> 1年是阳性，或者在LT后任何时间点抗-HBs峰值> 100 mIU / mL。主要终点是从之前的负值开始抗-HBs≥10mIU / mL或从基线开始增加1-log。
结果：

共招募了86名患者; 5名是先前试验的回应者; 45名患者在LT后1年内检测到抗-HBs，36名患者的抗-HBs> 100 mIU / mL。所有（5 / 5,100％）之前的反应者都对加强免疫接种做出了回应。对于其余81名患者，81名患者中有10名（12.3％）做出了回应。
结论：

所有先前的应答者都对加强免疫接种做出了反应，这意味着HBV免疫应答的持久性和记忆力，这是HBV最终宿主免疫力的重要先决条件。在LT后自发抗HBs产生的患者中，单次疫苗接种可诱导12.3％的患者反应。

版权所有©2018。由Elsevier Inc.出版

结论：
    30577255
DOI：
    10.1016 / j.transproceed.2018.07.008