Roni D Ajith, Pathapati Rama Mohan, Kumar A Sathish, Nihal Lalit, Sridhar K, Tumkur Rajashekar Sujith
Medical Gastroenterology, Narayana Medical College Hospital, Nellore, Andhra Pradesh 524002, India.
Adv Virol. 2013;2013:196704. doi: 10.1155/2013/196704. Epub 2013 Jun 6.
Introduction. Patients with chronic liver disease (CLD) are more likely to have severe morbidity and fatality rate due to superimposed acute or chronic hepatitis B (HBV) infection. The literature has shown that hepatitis B vaccines are safe and effective in patients with CLD, but the data in cirrhosis liver is lacking. We assessed the safety and immunogenicity of HBV vaccine in patients with cirrhosis liver. Methods. CTP classes A and B CLD patients negative for hepatitis B surface antigen and antibody to hepatitis B core antigen were included. All patients received three doses of hepatitis B vaccine 20 mcg intramuscularly at 0, 30, and 60 days. Anti-HBs antibody was measured after 120 days. Results. 52 patients with mean age 47.48 ± 9.37 years were studied. Response rates in CTP classes A and B were 88% and 33.3%. We observed that the alcoholic chronic liver disease had less antibody response (44%) than other causes of chronic liver disease such as cryptogenic 69% and HCV 75%. Conclusions. Patients with cirrhosis liver will have low antibody hepatitis B titers compared to general population. As the age and liver disease progress, the response rate for hepatitis B vaccination will still remain to be weaker.
引言。慢性肝病（CLD）患者因叠加急性或慢性乙型肝炎（HBV）感染而更易出现严重发病情况和较高死亡率。文献表明，乙肝疫苗在CLD患者中安全有效，但肝硬化患者的数据尚缺。我们评估了乙肝疫苗在肝硬化患者中的安全性和免疫原性。方法。纳入乙肝表面抗原和乙肝核心抗原抗体均为阴性的CTP A级和B级CLD患者。所有患者在第0、30和60天分别肌肉注射20微克乙肝疫苗，共3剂。120天后检测抗-HBs抗体。结果。研究了52例平均年龄为47.48±9.37岁的患者。CTP A级和B级患者的应答率分别为88%和33.3%。我们观察到，酒精性慢性肝病的抗体应答率（44%）低于其他慢性肝病病因，如隐源性肝病为69%，丙型肝炎病毒（HCV）感染为75%。结论。与普通人群相比，肝硬化患者的乙肝抗体滴度较低。随着年龄增长和肝病进展，乙肝疫苗接种的应答率仍会较弱。
