Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands.
Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.
Vaccine. 2022 Oct 12;40(43):6201-6205. doi: 10.1016/j.vaccine.2022.09.006. Epub 2022 Sep 22.
Systemic immunosuppressive therapy (IS) renders patients with inflammatory bowel disease (IBD) vulnerable to fulminant hepatitis B virus (HBV) infection. Seroprotection against HBV through a full vaccination scheme is preferably obtained before IS is initiated, but often conflicts with the clinical need to initiate therapy rapidly. Consequently, the vast majority of patients will use IS during booster vaccinations. In this retrospective cohort study, we examined the serological response after a modified vaccination schedule which includes an initial double dose of Fendrix in patients with IBD and compared the results with the serological responses of patients with IBD who received the standard schedule. Seroprotection rates were 86.2 % and 88.9 % in the modified and standard schedule groups respectively. One-third of patients obtained seroprotection after only one double dose vaccine. A double dose may be considered in patients with IBD at high short-term risk of HBV infection when a rapid protective response is warranted.
系统性免疫抑制疗法 (IS) 使炎症性肠病 (IBD) 患者易感染乙型肝炎病毒 (HBV) 。通过完整的疫苗接种方案获得针对 HBV 的血清保护作用最好在开始 IS 之前获得，但这常常与迅速开始治疗的临床需求相冲突。因此，绝大多数患者将在加强疫苗接种期间使用 IS。在这项回顾性队列研究中，我们检查了修改后的疫苗接种计划后的血清学反应，该计划包括 IBD 患者初始双倍剂量的 Fendrix，并将结果与接受标准计划的 IBD 患者的血清学反应进行了比较。改良方案组和标准方案组的血清保护率分别为 86.2%和 88.9%。三分之一的患者仅接种一剂双剂量疫苗即可获得血清保护。当需要快速保护反应时，对于有 HBV 感染短期高风险的 IBD 患者，可以考虑使用双剂量。
