Author:
Prasoppokakorn Thaninee,Vanichanan Jakapat,Chaiteerakij Roongruedee,Jutivorakool Kamonwan,Udomkarnjananun Suwasin,Pongpirul Krit,Taesombat Wipusit,Wattanatorn Salin,Avihingsanon Yingyos,Tungsanga Kriang,Eiam-Ong Somchai,Praditpornsilpa Kearkiat,Townamchai Natavudh
Abstract
AbstractHepatitis A virus (HAV) is able to cause a spectrum of illnesses ranging from no symptom to fulminant hepatitis which may lead to acute kidney injury. Although hepatitis A vaccine is recommended in non-immune solid organ transplant recipients who live in or travel to endemic areas, the standard 2-dose vaccination regimen demonstrated less favorable immunogenicity among these population. The 3-dose regimen showed higher response rate and immune durability in patients with human immunodeficiency virus. However, this strategy has never been studied in solid organ transplant recipients. A single-center, open-labeled, computer-based randomized controlled trial (RCT) with a 2:1 allocation ratio was conducted from August 2017 to December 2018. The study compared the seroconversion rate after receiving 2- or 3-dose regimen of hepatitis A vaccine at 0, 6 and 0, 1, 6 months, respectively, in non-immune kidney transplant recipients. A total of 401 adult kidney transplant recipients were screened for anti-HAV IgG and 285 subjects had positive results so the seroprevalence was 71.1%. Of 116 seronegative recipients, 93 (80.2%) completed vaccination; 60 and 33 participants completed 2- and 3-dose vaccination, respectively. The baseline characteristics were comparable between both groups. The seroconversion rate at 1 month after vaccination was 51.7% in the standard 2-dose regimen and 48.5% in the 3-dose regimen (p = 0.769). Overall, the seroconversion rate appeared to be associated with high estimated glomerular infiltration rate, high serum albumin, and low intensity immunosuppressive regimen. Seroconversion rate after hepatitis A vaccination in kidney transplant recipients was less favorable than healthy population. Three-dose regimen did not show superior benefit over the standard 2-dose regimen. Other strategies of immunization may increase immunogenicity among kidney transplant recipients.
Publisher
Springer Science and Business Media LLC
Reference31 articles.
1. Akriviadis, E. A. & Redeker, A. G. Fulminant hepatitis A in intravenous drug users with chronic liver disease. Ann. Intern. Med. 110, 838–839 (1989).
2. Jeong, S. H. & Lee, H. S. Hepatitis A: clinical manifestations and management. Intervirology 53, 15–19. https://doi.org/10.1159/000252779 (2010).
3. Mackinney-Novelo, I. et al. Clinical course and management of acute hepatitis A infection in adults. Ann. Hepatol. 11, 652–657 (2012).
4. Sa-nguanmoo, P. et al. Declining trend of hepatitis a seroepidemiology in association with improved public health and economic status of Thailand. PLoS ONE 11, e0151304. https://doi.org/10.1371/journal.pone.0151304 (2016).
5. Fiore AE, W. A., Bell BP. Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm. Rep., 1–23 (2006).
Cited by
8 articles.
订阅此论文施引文献
订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献