A Strategy to Boost the Response to Hepatitis B Vaccine

Persons who are unresponsive to the standard hepatitis B virus (HBV) vaccine regimen may benefit from a revaccination series using a double dose of the combined hepatitis A virus (HAV) and HBV vaccine.^1,2 Researchers from the Karolinska Institute in Sweden administered the combined vaccine to 48 persons who were nonresponsive and to 20 persons who were naive to the standard HBV vaccine. The combined vaccine was administered at baseline and at 1 and 6 months. Hepatitis B surface antigen (HBsAg) antibodies and HAV antibodies were analyzed before vaccination and 1 month after each vaccine dose.

HBsAg antibody levels of 10 mIU/mL or greater developed after the first vaccine dose in 26 (59%) of the 44 nonresponders who completed the study. After administration of the second dose, the cumulative number of nonresponders in whom HBsAg antibody levels of 10 mIU/mL or greater were achieved increased to 35 (80%); after administration of the final vaccine dose, the cumulative number of nonresponders who achieved target antibody levels increased to 42 (95%). HBsAg antibody titers of greater than 100 mIU/mL were achieved in 80% of nonresponders after receipt of the full revaccination series. The study authors concluded that this strategy might be highly beneficial in protecting nonresponders to the HBV vaccine who are not already immune to HAV.

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REFERENCES:

1

. Cardell K, Akerlind B, Sällberg M, Frydén A. Excellent response rate to adouble dose of the combined hepatitis A and B vaccine in previous nonrespondersto hepatitis B vaccine.

J Infect Dis.

2008;198:299-304.

2

. Diepolder HM. Can specific heterologous immunity boost hepatitis B vaccineresponse?

J Infect Dis.

2008;198:297-298.