Wong T C L, Fung J Y Y, Chok K S H, Cheung T T, Chan A C Y, Dai W C, Ng K K C, Chan S C, Lo C M
Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
Transplant Proc. 2018 Dec;50(10):3681-3688. doi: 10.1016/j.transproceed.2018.07.008. Epub 2018 Jul 7.
Our study aimed to determine if a double-dose pre-S containing hepatitis B virus (HBV) vaccination (Sci-B-Vac) could elicit an adequate and sustainable immune response in HBV patients who developed spontaneous hepatitis B surface antibody (anti-HBs) response after liver transplant.
All patients who received transplants for HBV-related disease for >1 year with normal graft function and hepatitis B surface antigen seronegativity were evaluated. They received a 40-μg HBV vaccine if they were responders in our previous vaccine trial, if anti-HBs was positive for >1 year after liver transplant (LT), or if a peak anti-HBs at any time point after LT was >100 mIU/mL. Primary endpoint was the development of anti-HBs ≥ 10 mIU/mL from previous negative value or a 1-log increase from baseline.
A total of 86 patients were recruited; 5 were responders from a previous trial; 45 patients had detectable anti-HBs >1 year after LT, and 36 patients had an anti-HBs >100 mIU/mL. All (5/5, 100%) previous responders responded to booster vaccination. For the remaining 81 patients, 10 of 81 (12.3%) responded.
All previous responders responded to booster vaccination, implying durability and memory of HBV immune response, which is an important prerequisite for definitive host immunity for HBV. In patients who had spontaneous anti-HBs production after LT, a single vaccination can induce response in 12.3% of patients.
我们的研究旨在确定含乙肝病毒（HBV）前S双剂量疫苗接种（Sci - B - Vac）能否在肝移植后自发产生乙肝表面抗体（抗 - HBs）反应的HBV患者中引发充分且可持续的免疫反应。
评估所有因HBV相关疾病接受肝移植超过1年、移植肝功能正常且乙肝表面抗原血清学阴性的患者。如果他们在我们之前的疫苗试验中是应答者、肝移植（LT）后抗 - HBs阳性超过1年，或者LT后任何时间点抗 - HBs峰值>100 mIU/mL，则接受40μg乙肝疫苗接种。主要终点是抗 - HBs从先前的阴性值发展至≥10 mIU/mL，或较基线增加1个对数。
共招募86例患者；5例是先前试验的应答者；45例患者在LT后1年以上可检测到抗 - HBs，36例患者抗 - HBs>100 mIU/mL。所有（5/5，100%）先前的应答者对加强疫苗接种有反应。对于其余81例患者，81例中有10例（12.3%）有反应。
所有先前的应答者对加强疫苗接种有反应，这意味着HBV免疫反应具有持久性和记忆性，这是宿主对HBV产生确定免疫力的重要前提。在LT后自发产生抗 - HBs的患者中，单次疫苗接种可使12.3%的患者产生反应。
