Publication: Immune responses to hepatitis B vaccination after hematopoietic stem cell transplantation in pediatric and young adult patients
Issued Date
2020-01-01
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ISSN
13990012
09020063
09020063
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2-s2.0-85090143306
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Mahidol University
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SCOPUS
Bibliographic Citation
Clinical Transplantation. (2020)
Suggested Citation
Krittiya Chaichotjinda, Usanarat Anurathapan, Sophida Boonsathorn, Sujittra Chaisavaneeyakorn, Suporn Treepongkaruna, Chonnamet Techasaensiri, Nopporn Apiwattanakul Immune responses to hepatitis B vaccination after hematopoietic stem cell transplantation in pediatric and young adult patients. Clinical Transplantation. (2020). doi:10.1111/ctr.14024 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/59260
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Title
Immune responses to hepatitis B vaccination after hematopoietic stem cell transplantation in pediatric and young adult patients
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Abstract
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Background: Hematopoietic stem cell transplantation (HSCT) recipients require hepatitis B (HBV) revaccination. Hepatitis B surface antibody (anti-HBs) seroconversion rates after revaccination range from 64% to 79% in these patients. The seroconversion rate and factors associated with non-seroconversion have not been clearly elucidated in pediatric and young adult recipients after HSCT. Objectives: To evaluate anti-HBs seroconversion rates in pediatric and young adult patients revaccinated after HSCT, and to identify factors associated with non-seroconversion. Method: The current study was prospective and cross-sectional. Post-HSCT recipients aged ≤25 years who had completed a course of three HBV revaccinations were recruited, and their anti-HBs titers were assessed. Non-seroconverted patients were administered a fourth vaccination. Those who subsequently remained seronegative were administered two additional vaccinations. Those who remained seronegative after all six vaccinations were defined as non-responders. Results: A total of 118 patients were enrolled. The HBV-containing vaccines used included DTaP-IPV-HBV-Hib, DTwP-HBV-Hib, and monovalent vaccines. The anti-HBs seroconversion rate after three revaccinations was 82% (95% confidence interval [CI], 73.7-89.2). One patient (0.8%) was classified as non-responder. Factors associated with non-seroconversion after three revaccinations included cytomegalovirus (CMV) reactivation (odds ratio [OR] 10.63, 95% CI 1.16-97.00), anti-HBs seronegativity before HSCT (OR 7.01, 95% CI 1.55-31.78) and three DTwP-HBV-Hib revaccinations (OR 11.71, 95% CI 1.43-96.26). Conclusion: In the current study the anti-HBs seroconversion rate after three HBV revaccinations was excellent. CMV reactivation, anti-HBs seronegativity before HSCT, and three DTwP-HBV-Hib revaccinations were associated with non-seroconversion, but the non-responder rate was low.
