Immunogenicity and Safety of Hepatitis A Vaccine in Liver and Renal Transplant Recipients

Organ transplant recipients with chronic hepatitis B or hepatitis C virus infection may be at increased risk of fulminant hepatitis A. Liver transplant (LTX) recipients, renal transplant (RTX) recipients, and healthy controls received 2 doses of hepatitis A vaccine 6 months apart. Anti-hepatitis A virus (anti-HAV) seroconversion after the primary dose occurred in 41% of the LTX patients, 24% of the RTX patients, and 90% of the controls. After the booster dose, the respective rates were 97%, 72%, and 100% (P<.001). RTX patients also had significantly lower geometric mean titers (GMTs) of anti-HAV than LTX patients and controls. In the RTX group, the seroconversion rate and GMT were inversely associated with the number of immunosuppressive drugs received by the patients. The vaccine was well tolerated. Hepatitis A vaccine can be recommended to LTX and RTX patients, but the patients should receive a full course of 2 doses before imminent exposure.