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Durability of the hepatitis B vaccination in pediatric renal transplant recipients
Author(s) -
MillerHandley Hilary,
Paulsen Grant,
Hooper David K.,
Lake Michael,
Lazear Danielle,
DanzigerIsakov Lara
Publication year - 2018
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13247
Subject(s) - medicine , dialysis , vaccination , hepatitis b virus , transplantation , hepatitis b , renal transplant , population , demographics , immunology , pediatrics , virus , demography , environmental health , sociology
Abstract Since hepatitis B virus ( HBV ) vaccine implementation, HBV infection has significantly decreased. However, adult renal transplant recipients show a higher rate of seroreversion compared to the general population, leading to HBV infection risk. Data are limited in pediatric renal transplant recipients. Retrospective data were collected to determine the seroprotection and durability of HBV vaccination in pediatric renal transplant patients from 2004 to 2014. One hundred subjects were categorized based on pre‐ and post‐transplant hepatitis B surface antibody ( HB sAb). Pretransplant, 85 recipients (85%) had a positive HB sAb compared to 15 (15%) with negative HB sAb. In univariable analyses, other than age ( P < .05) no significant differences existed pretransplant by demographics, pretransplantation dialysis, or number of vaccinations. Of the 85 pretransplantation responders, 53 (62%) remained HB sAb positive post‐transplantation, 28 (32%) seroreverted, and 4 developed indeterminate titers. All seroreversions occurred within 5 years post‐transplant. Receipt of a living donor organ had higher risk of reversion ( P = .005). No significant differences were found in demographics, pretransplantation dialysis, vaccination number, or acute rejection. Despite vaccination, 15% of pediatric renal transplant candidates were seronegative, and an additional 32% lost seroprotection within 5 years post‐transplantation leaving nearly half of transplant recipients at risk for HBV infection.