Liver Unit, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain.
J Viral Hepat. 2021 Jul;28(7):1019-1024. doi: 10.1111/jvh.13509. Epub 2021 Apr 1.
The hepatitis B (HBV) vaccine is recommended in unvaccinated adults with cirrhosis, despite its low efficacy. We aimed to evaluate the response to a double-dose/accelerated vaccine schedule in patients with cirrhosis admitted into a hepatology ward. All patients with cirrhosis admitted to the hepatology ward without exclusion criteria were offered the HBV HBVAXPRO 40mcg vaccine at months 0, 1 and 2. Non-responders received a second cycle. We evaluated 468 patients and only 19% were seroprotected against HBV. In 196 patients without exclusion criteria for HBV vaccination, the per protocol response rate (anti-HBs >10 U/ml) was 23% after a first cycle and 59% after a second cycle. The overall response per intention to treat was only 23%. We have not identified predictors of response. Only one patient had a mild adverse event. Most patients with cirrhosis admitted in the hepatology ward are unprotected against HBV. Although a second HBV vaccination cycle increases the response rate, the poor overall response reinforces the implementation of HBV vaccination before the development of cirrhosis.
乙型肝炎（HBV）疫苗推荐用于未接种疫苗且患有肝硬化的成年人，尽管其疗效较低。我们旨在评估在进入肝病病房的肝硬化患者中，双剂量/加速疫苗接种方案的反应。所有没有排除标准的肝硬化患者在第 0、1 和 2 个月时都被提供 HBV HBVAXPRO 40mcg 疫苗。无应答者接受第二周期治疗。我们评估了 468 名患者，只有 19%的患者对 HBV 具有血清保护作用。在 196 名没有 HBV 疫苗接种排除标准的患者中，第一周期后的方案反应率（抗-HBs >10 U/ml）为 23%，第二周期后为 59%。按意向治疗的总体反应率仅为 23%。我们尚未确定反应的预测因素。只有一名患者出现轻度不良反应。大多数在肝病病房住院的肝硬化患者未对 HBV 具有保护作用。尽管第二周期 HBV 疫苗接种可提高反应率，但总体反应不佳表明在肝硬化发生之前应实施 HBV 疫苗接种。
