Center of Excellence in Thai Pediatric Gastroenterology, Hepatology and Immunology (TPGHAI), Faculty of Medicine, Department of Pediatrics, King Chulalongkorn Memorial Hospital and Thai Red Cross Society, Chulalongkorn University, Bangkok, 10330, Thailand.
Center of Excellence in Clinical Virology, Faculty of Medicine King Chulalongkorn Memorial Hospital and Thai Red Cross Society, Chulalongkorn University, Bangkok, 10330, Thailand.
Sci Rep. 2024 Sep 27;14(1):22202. doi: 10.1038/s41598-024-73390-z.
The hepatitis A virus (HAV) vaccine is highly immunogenic in general, yet data on its use in liver-transplanted (LT) children is limited. This study aimed to determine the seroimmunity to HAV in all LT children, and the immunogenicity of an inactivated HAV vaccine in seronegative LT children at King Chulalongkorn Memorial Hospital. Seronegative LT children received the inactivated HAV vaccine at 0 and 6-8 months with adverse events monitored for 3 days post-immunization. The result reviewed that among 105 LT children, vaccination records were available for 81%, of which 7.1% and 16.5% with one and two doses of HAV vaccine were immunized before transplantation, respectively. Post-transplantation, 20.1% were seropositive for HAV, with 9.5% due to pre-transplant immunization. Eighty-three seronegative LT children (aged 7.25 ± 4.40 years; 48.6% male) received two vaccine doses. The seropositive rate increased following the first and second doses and reached to 51.5%, and 92.9%, respectively (p < 0.001), with no serious adverse events reported. Age at vaccination and the interval from transplantation to vaccination were risk factors for non-responsiveness (p < 0.001). The study highlighted inadequate HAV vaccination coverage, leaving most LT children susceptible to infection. HAV vaccine proved highly immunogenic and safe, emphasizing the need for improved vaccination strategies before and after liver transplantation.Trial registration TCTR20220110001.
甲型肝炎病毒（HAV）疫苗通常具有高度的免疫原性，但关于其在肝移植（LT）儿童中应用的数据有限。本研究旨在确定所有 LT 儿童的 HAV 血清抗体免疫情况，以及在朱拉隆功国王纪念医院的 HAV 阴性 LT 儿童中使用灭活 HAV 疫苗的免疫原性。HAV 阴性 LT 儿童在 0 个月和 6-8 个月时接受灭活 HAV 疫苗接种，接种后 3 天内监测不良反应。研究结果显示，在 105 名 LT 儿童中，81%的儿童有疫苗接种记录，其中分别有 7.1%和 16.5%的儿童在移植前接受了一剂和两剂 HAV 疫苗接种。移植后，20.1%的儿童 HAV 血清抗体呈阳性，其中 9.5%是由于移植前免疫接种。83 名 HAV 阴性 LT 儿童（年龄 7.25±4.40 岁；48.6%为男性）接受了两剂疫苗接种。第一剂和第二剂接种后 HAV 血清抗体阳性率增加，分别达到 51.5%和 92.9%（p<0.001），未报告严重不良事件。接种年龄和移植到接种的时间间隔是无反应的危险因素（p<0.001）。该研究强调了 HAV 疫苗接种覆盖率不足，使大多数 LT 儿童易感染。HAV 疫苗具有高度的免疫原性和安全性，强调了在肝移植前后需要改进疫苗接种策略。试验注册 TCTR20220110001。
