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High‐Dose Hepatitis B Vaccine in Patients Waiting for Lung Transplantation
Author(s) -
Hayney Mary S.,
Welter Deborah L.,
Reynolds Ann Marie,
Francois Mary,
Love Robert B.
Publication year - 2003
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.23.5.555.32194
Subject(s) - medicine , transplantation , hepatitis a vaccine , hepatitis b vaccine , vaccination , immunization , hepatitis b , gastroenterology , immunology , surgery , immune system , hepatitis b virus , virus , hbsag
Study Objective . To increase the response rate to hepatitis B vaccine in patients awaiting lung transplantation. Design . Historically controlled, open‐label study. Setting . Lung transplant clinic at a university hospital. Subjects . Twenty‐seven consecutive individuals with end‐stage pulmonary disease who were enrolled to accrue 15 subjects who would complete the vaccine series before transplantation; and 27 lung transplant recipients who were immunized with the conventional dose before the study and served as historical controls. Intervention . Intramuscular injection of high‐dose hepatitis B vaccine 40 μg at 0, 1, and 6 months. Measurements and Main Results . Hepatitis B surface antibody (anti‐HBs) concentrations were measured 1–2 months after completing the high‐dose series. Individuals with undetectable anti‐HBs received additional vaccine to a maximum of six doses. The response rate to the series was compared with that in the control group. Seventeen individuals in the high‐dose group and 14 controls met the study criterion of complete vaccine series before transplantation. The former had a much higher response rate than the latter (9 [53%] vs 1 [7%], p<0.01). Four of six patients who received additional doses of vaccine seroconverted. Two of them underwent transplantation shortly after completing the three‐dose series. Conclusion . The high‐dose hepatitis B vaccine series produced a protective immune response in lung transplant recipients; however, the response was suboptimal, and alternative immunization strategies should be studied.