Immunogenicity of recombinant hepatitis B vaccine in treatment-naive and
treatment-experienced chronic hepatitis C patients: The effect of
pegylated interferon plus ribavirin treatment
AIM: To retrospectively evaluate the vaccination-induced anti-HBs
seroconversion rates in treatment-naive and treatment-experienced
chronic hepatitis C (CHC) patients. Also to prospectively evaluate the
seroconversion rates in CHC patients during pegylated interferon (PEG)
plus ribavirin (RIB) treatment.
METHODS: Seventy treatment-naive CHC patients (group A), 22 sustained
virological responders-SVR following interferon (IFN) plus RIB treatment
CHC patients (group B) and 121 healthy subjects (group C) had been
participated in the same HBV vaccination schedule (20 mu g, 0-1-6 mo).
Seroconversion was considered if anti-HBs levels were above 10 mIU/mL
within 3 mo following the third dose of the vaccine. Moreover, we
prospectively selected 30 non-cirrhotic CHC patients and evaluated them
for the efficacy of the same vaccine schedule randomizing them in two
groups: Group-1, 15 CHC patients received the first dose of the vaccine
in parallel with the initiation of PEG plus RIB treatment and Group-2,
15 patients received the same vaccination schedule without concomitant
treatment. Determination of anti-HBs was performed at mo 1, 2, and 7.
Statistical analysis of data was based on ANOVA student’s t-test and
chi-square analysis (P < 0.05).
RESULTS: Fifty-eight of 70 group A patients (82.85%), 20/22 group B
(90.9%) and 112/121 healthy subjects (92.56%) had been seroconverted.
The seroconversion rates were significantly higher in the control group
than in treatment-naive CHC patients (P = 0.04). The corresponding rates
were comparable between group A and group B CHC patients (P = 0.38). The
vast majority of non-responders (10/14, 71.43%) had been infected by
genotype-1 of HCV. The seroconversion rates were comparable between
group I and 2 CHC patients at mo 1 (20% versus 26.7%, P = 0.67), mo 2
(46.7% vs 60%, P = 0.46) and mo 7 (86.7% versus 93.3%, P = 0.54) of
follow-up.
CONCLUSION: The immunogenicity of HBV vaccine seems to be lower in CHC
patients compared to,healthy subjects. SVR following IFN plus RIB
treatment does not affect the antibody response to HBV vaccine.
Infection by genotype-1 seems to negatively influence the seroconversion
rates. Vaccination against HBV during PEG plus RIB combination treatment
is not beneficial in terms of anti-HBs seroconversion rates. (C) 2006
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