Efficacy of high-dose intra-dermal hepatitis B virus vaccine in previous vaccination non-responders with chronic liver disease

S. Dhillon*, C. Moore, S. D. Li, A. Aziz, A. Kakar, A. Dosanjh, A. Beesla, L. Murphy, D. H. Van Thiel

*Corresponding author for this work

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Hepatitis B virus (HBV) vaccination is essential in chronic liver disease (CLD), because it can help prevent acute-on-chronic disease, which has potentially fatal complications. Unfortunately, this group has a significant proportion of HBV vaccination non-responders. A variety of intra-muscular (IM) vaccination methods have been used in an attempt to remedy this poor-response, but with limited success. Aims: Herein is reported the safety and efficacy of high-dose intra-dermal (ID) HBV vaccination in CLD individuals who had failed previous IM standard and boost-dosing regimens. Methods: Forty-eight CLD individuals, known HBcAb negative, who had failed both a three-dose schedule of 40 μg IM vaccination, and boost dosing of either 40 or 80 μg IM, were identified, of which 42 completed the vaccination course. Each received a 40 μg ID total dose (20 μg per arm) during their clinic visits until a response was documented or a maximum of three doses had been administered. HBsAb titer ≥10 mIU/ml was regarded as an immunologic response; the intention was to achieve an optimum response of ≥100 mIU/ml. Results: Twenty-nine of forty-two (69%) individuals had an immunologic response, with 15 (51%) of the responders having the optimum response. No changes in serologic data occurred. No serious dermatologic reactions were observed. No differences between those who responded and those who did not were observed with regard to the presence of cirrhosis, diabetes mellitus, or chronic kidney disease. Conclusions: High-dose ID HBV vaccination of previous CLD non-responders to the standard IM regimen with boost dosing is both safe and efficacious, and should be considered for all such groups.

Original languageEnglish (US)
Pages (from-to)215-220
Number of pages6
JournalDigestive diseases and sciences
Volume57
Issue number1
DOIs
StatePublished - Jan 1 2012

Fingerprint

Hepatitis B Vaccines
Hepatitis B virus
Liver Diseases
Vaccination
Chronic Disease
Skin
Ambulatory Care
Chronic Renal Insufficiency
Diabetes Mellitus
Appointments and Schedules
Fibrosis
Safety

Keywords

  • Chronic liver disease
  • HBV immunity
  • Hepatitis B virus
  • Intra-dermal vaccination

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

Cite this

Dhillon, S. ; Moore, C. ; Li, S. D. ; Aziz, A. ; Kakar, A. ; Dosanjh, A. ; Beesla, A. ; Murphy, L. ; Van Thiel, D. H. / Efficacy of high-dose intra-dermal hepatitis B virus vaccine in previous vaccination non-responders with chronic liver disease. In: Digestive diseases and sciences. 2012 ; Vol. 57, No. 1. pp. 215-220.
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abstract = "Background: Hepatitis B virus (HBV) vaccination is essential in chronic liver disease (CLD), because it can help prevent acute-on-chronic disease, which has potentially fatal complications. Unfortunately, this group has a significant proportion of HBV vaccination non-responders. A variety of intra-muscular (IM) vaccination methods have been used in an attempt to remedy this poor-response, but with limited success. Aims: Herein is reported the safety and efficacy of high-dose intra-dermal (ID) HBV vaccination in CLD individuals who had failed previous IM standard and boost-dosing regimens. Methods: Forty-eight CLD individuals, known HBcAb negative, who had failed both a three-dose schedule of 40 μg IM vaccination, and boost dosing of either 40 or 80 μg IM, were identified, of which 42 completed the vaccination course. Each received a 40 μg ID total dose (20 μg per arm) during their clinic visits until a response was documented or a maximum of three doses had been administered. HBsAb titer ≥10 mIU/ml was regarded as an immunologic response; the intention was to achieve an optimum response of ≥100 mIU/ml. Results: Twenty-nine of forty-two (69{\%}) individuals had an immunologic response, with 15 (51{\%}) of the responders having the optimum response. No changes in serologic data occurred. No serious dermatologic reactions were observed. No differences between those who responded and those who did not were observed with regard to the presence of cirrhosis, diabetes mellitus, or chronic kidney disease. Conclusions: High-dose ID HBV vaccination of previous CLD non-responders to the standard IM regimen with boost dosing is both safe and efficacious, and should be considered for all such groups.",
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Efficacy of high-dose intra-dermal hepatitis B virus vaccine in previous vaccination non-responders with chronic liver disease. / Dhillon, S.; Moore, C.; Li, S. D.; Aziz, A.; Kakar, A.; Dosanjh, A.; Beesla, A.; Murphy, L.; Van Thiel, D. H.

In: Digestive diseases and sciences, Vol. 57, No. 1, 01.01.2012, p. 215-220.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Efficacy of high-dose intra-dermal hepatitis B virus vaccine in previous vaccination non-responders with chronic liver disease

AU - Dhillon, S.

AU - Moore, C.

AU - Li, S. D.

AU - Aziz, A.

AU - Kakar, A.

AU - Dosanjh, A.

AU - Beesla, A.

AU - Murphy, L.

AU - Van Thiel, D. H.

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Y1 - 2012/1/1

N2 - Background: Hepatitis B virus (HBV) vaccination is essential in chronic liver disease (CLD), because it can help prevent acute-on-chronic disease, which has potentially fatal complications. Unfortunately, this group has a significant proportion of HBV vaccination non-responders. A variety of intra-muscular (IM) vaccination methods have been used in an attempt to remedy this poor-response, but with limited success. Aims: Herein is reported the safety and efficacy of high-dose intra-dermal (ID) HBV vaccination in CLD individuals who had failed previous IM standard and boost-dosing regimens. Methods: Forty-eight CLD individuals, known HBcAb negative, who had failed both a three-dose schedule of 40 μg IM vaccination, and boost dosing of either 40 or 80 μg IM, were identified, of which 42 completed the vaccination course. Each received a 40 μg ID total dose (20 μg per arm) during their clinic visits until a response was documented or a maximum of three doses had been administered. HBsAb titer ≥10 mIU/ml was regarded as an immunologic response; the intention was to achieve an optimum response of ≥100 mIU/ml. Results: Twenty-nine of forty-two (69%) individuals had an immunologic response, with 15 (51%) of the responders having the optimum response. No changes in serologic data occurred. No serious dermatologic reactions were observed. No differences between those who responded and those who did not were observed with regard to the presence of cirrhosis, diabetes mellitus, or chronic kidney disease. Conclusions: High-dose ID HBV vaccination of previous CLD non-responders to the standard IM regimen with boost dosing is both safe and efficacious, and should be considered for all such groups.

AB - Background: Hepatitis B virus (HBV) vaccination is essential in chronic liver disease (CLD), because it can help prevent acute-on-chronic disease, which has potentially fatal complications. Unfortunately, this group has a significant proportion of HBV vaccination non-responders. A variety of intra-muscular (IM) vaccination methods have been used in an attempt to remedy this poor-response, but with limited success. Aims: Herein is reported the safety and efficacy of high-dose intra-dermal (ID) HBV vaccination in CLD individuals who had failed previous IM standard and boost-dosing regimens. Methods: Forty-eight CLD individuals, known HBcAb negative, who had failed both a three-dose schedule of 40 μg IM vaccination, and boost dosing of either 40 or 80 μg IM, were identified, of which 42 completed the vaccination course. Each received a 40 μg ID total dose (20 μg per arm) during their clinic visits until a response was documented or a maximum of three doses had been administered. HBsAb titer ≥10 mIU/ml was regarded as an immunologic response; the intention was to achieve an optimum response of ≥100 mIU/ml. Results: Twenty-nine of forty-two (69%) individuals had an immunologic response, with 15 (51%) of the responders having the optimum response. No changes in serologic data occurred. No serious dermatologic reactions were observed. No differences between those who responded and those who did not were observed with regard to the presence of cirrhosis, diabetes mellitus, or chronic kidney disease. Conclusions: High-dose ID HBV vaccination of previous CLD non-responders to the standard IM regimen with boost dosing is both safe and efficacious, and should be considered for all such groups.

KW - Chronic liver disease

KW - HBV immunity

KW - Hepatitis B virus

KW - Intra-dermal vaccination

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