Efficacy of a two-dose hepatitis B vaccination with a novel immunostimulatory sequence adjuvant (Heplisav-B) on patients with chronic liver disease: a retrospective study.

IF 3 4区 医学 Q1 Medicine Translational gastroenterology and hepatology Pub Date : 2023-01-25 eCollection Date: 2023-01-01 DOI:10.21037/tgh-22-12
Joshua Y Kwon, Nader Daoud, Hassan Ghoz, Maria L Yataco, Francis A Farraye
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Abstract

Background: Patients with chronic liver disease (CLD) are more likely to have severe morbidity and mortality due to superimposed acute or chronic hepatitis B virus (HBV) infection and should receive routine vaccination against the virus. Heplisav-B is a two-dose, inactivated, yeast-derived vaccine that uses a novel immunostimulatory adjuvant. Our primary objective was to determine the efficacy of hepatitis B vaccination with Heplisav-B in patients with CLD.

Methods: This retrospective cohort analysis included patients ≥18 years old with CLD who received Heplisav-B from January 2018 to January 2021. All patients had anti-HBs <10 IU/L prior to vaccination and received two doses of Heplisav-B. Post-vaccination anti-HBs of ≥10 IU/L was considered successful vaccination. Basic demographic information, laboratory markers, and medical history were collected from the electronic health record.

Results: A total of 120 patients were included in analysis. The average age of patients was 59 years, 37% were female, and the most common etiology of liver disease was nonalcoholic fatty liver disease. Median days from 2nd vaccination to post-vaccination HBsAb levels was 121 days. 81/120 (67.5%) of patients had evidence of active immunity after receipt of Heplisav-B. On multivariable analysis, age >50 was associated with reduced odds of successful vaccination (OR =0.19, 95% CI: 0.03-0.76).

Conclusions: In patients with CLD, Heplisav-B's overall efficacy (67.5%) is greater than reports of Engerix-B (33-45%), and thus is an effective hepatitis B vaccine in this patient population, particularly in cirrhotic patients. Further studies regarding this vaccine are needed in patients with CLD and after liver transplantation.

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使用新型免疫刺激序列佐剂(Heplisav-B)对慢性肝病患者进行两剂乙肝疫苗接种的疗效:一项回顾性研究。
背景:慢性肝病(CLD)患者更有可能因合并急性或慢性乙型肝炎病毒(HBV)感染而导致严重的发病率和死亡率,因此应常规接种乙型肝炎病毒疫苗。Heplisav-B 是一种使用新型免疫刺激佐剂的两剂酵母衍生灭活疫苗。我们的主要目的是确定 CLD 患者接种 Heplisav-B 乙型肝炎疫苗的疗效:这项回顾性队列分析包括 2018 年 1 月至 2021 年 1 月期间接种 Heplisav-B 的年龄≥18 岁的 CLD 患者。所有患者均有抗-HBs 结果:共有 120 名患者纳入分析。患者平均年龄为 59 岁,37% 为女性,最常见的肝病病因是非酒精性脂肪肝。从第二次接种疫苗到接种后 HBsAb 水平的中位天数为 121 天。81/120(67.5%)例患者在接种 Heplisav-B 后有主动免疫的证据。多变量分析显示,年龄大于 50 岁与成功接种的几率降低有关(OR =0.19,95% CI:0.03-0.76):结论:在慢性阻塞性肺病患者中,Heplisav-B 的总体有效率(67.5%)高于 Engerix-B 的报告(33-45%),因此在这一患者群体中是一种有效的乙肝疫苗,尤其是在肝硬化患者中。还需要在慢性肝病患者和肝移植患者中进一步研究这种疫苗。
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来源期刊
CiteScore
8.20
自引率
0.00%
发文量
1
期刊介绍: Translational Gastroenterology and Hepatology (Transl Gastroenterol Hepatol; TGH; Online ISSN 2415-1289) is an open-access, peer-reviewed online journal that focuses on cutting-edge findings in the field of translational research in gastroenterology and hepatology and provides current and practical information on diagnosis, prevention and clinical investigations of gastrointestinal, pancreas, gallbladder and hepatic diseases. Specific areas of interest include, but not limited to, multimodality therapy, biomarkers, imaging, biology, pathology, and technical advances related to gastrointestinal and hepatic diseases. Contributions pertinent to gastroenterology and hepatology are also included from related fields such as nutrition, surgery, public health, human genetics, basic sciences, education, sociology, and nursing.
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