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Simultaneous passive and active immunization against hepatitis B: Noninterference of hepatitis B immune globulin with the anti‐HBs response to reduced doses of heat‐inactivated hepatitis B vaccine
Author(s) -
Lelie P. Nico,
Reesink Henk W.,
Grijm Rob,
de JongVan Manen Sonja Th.,
ReerinkBrongers Eveline E.
Publication year - 1986
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840060527
Subject(s) - medicine , hepatitis a vaccine , hepatitis b vaccine , booster dose , hepatitis b immune globulin , hepatitis b , antibody , immunology , titer , hepatitis a , hepatitis , immune system , vaccination , immunization , virology , hepatitis b virus , hbsag , virus
The effect of simultaneous administration of hepatitis B immune globulin on the antibody response to a low dose of heat‐inactivated hepatitis B vaccine was investigated in 175 health care workers. Subjects were divided into four groups: Groups I and II received 3 monthly injections of a reduced dose (0.6 μg) of a heat‐inactivated hepatitis B vaccine (the usual dose being 3 μg) along with 500 IU of hepatitis B immune globulin simultaneously with the first injection of vaccine; Groups III and IV received the vaccine only. In addition, Groups I and III received a final booster injection with 0.6 μg of the vaccine 8 months after the initial injection. Anti‐HBs passively acquired from hepatitis B immune globulin did not interfere with the development of an active antibody response to the vaccine: the anti‐HBs conversion rates were similar in persons treated with the combined regimen (89%) as in those who received the vaccine only (91%). At 3 and 5 months after the first injection, however, anti‐HBs titers in the recipients of vaccine alone were slightly but statistically significantly higher than those of persons who received both hepatitis B immune globulin and vaccine; but at 8 months, this difference was no longer statistically significant. After a booster inoculation at 8 months, the geometric mean titer of anti‐HBs increased 7‐ to 8‐fold in antibody‐positive vaccinees, regardless of whether hepatitis B immune globulin had been given earlier. Moreover, 6 of 13 nonresponders to the initial three vaccine injections developed anti‐HBs after the booster inoculation. Thus, passively acquired anti‐HBs does not interfere with an active antibody response to hepatitis B vaccine even when a low dose of vaccine is used. Furthermore, a final booster vaccine inoculation, several months after the initial series of injections, is important in providing high response rates and sustained high titers of anti‐HBs.