BACKGROUND: Patients with chronic hepatitis C are at risk of additional liver damage when infected with other hepatotropic viruses, and should be vaccinated against HAV and HBV. However, the optimal dose and schedule are still being debated. In this study we assessed hepatitis B vaccine immunogenicity in patients with chronic hepatitis C at one-year follow-up. The effect of interferon alpha treatment on vaccine safety and anti-HBs response was also evaluated. MATERIAL/ METHODS: 48 hepatitis C patients were enrolled, of whom 12 were on interferon treatment. Recombinant HBV vaccine was administered on a 0-1-6 month schedule, and anti-HBs titers were measured at months 1, 2, 7, and 18. RESULTS: The overall seroprotection rate at month 7 was 72.9% in hepatitis C patients, compared to 90.9% in the controls. Subjects with chronic hepatitis C had significantly lower percentages of good responders: 50% versus 90.9%. At month 18, only 34.1% of the HCV patients had seroprotective titers of anti-HBs, compared to 90% in the control group. At all study points there were no significant differences in seroconversion rates and seroprotection rates between subgroups of hepatitis C patients receiving interferon or those without antiviral treatment. CONCLUSIONS: Hepatitis C is associated with decreased HBV vaccine response. We suggest that postvaccination anti-HBs testing should be performed in all hepatitis C patients, and additional vaccine doses should be provided to those without protection. Alternatively, higher doses of vaccine (40 Kg) may be considered. Treatment with interferon was safe and well tolerated.
BACKGROUND:Patients with chronic hepatitis C are at risk of additional liver damage when infected with other hepatotropic viruses, and should be vaccinated against HAV and HBV. However, the optimal dose and schedule are still being debated. In this study we assessed hepatitis B vaccine immunogenicity in patients with chronic hepatitis C at one-year follow-up. The effect of interferon alpha treatment on vaccine safety and anti-HBs response was also evaluated. MATERIAL/ METHODS: 48 hepatitis C patients were enrolled, of whom 12 were on interferon treatment. Recombinant HBV vaccine was administered on a 0-1-6 month schedule, and anti-HBs titers were measured at months 1, 2, 7, and 18. RESULTS: The overall seroprotection rate at month 7 was 72.9% in hepatitis C patients, compared to 90.9% in the controls. Subjects with chronic hepatitis C had significantly lower percentages of good responders: 50% versus 90.9%. At month 18, only 34.1% of the HCV patients had seroprotective titers of anti-HBs, compared to 90% in the control group. At all study points there were no significant differences in seroconversion rates and seroprotection rates between subgroups of hepatitis C patients receiving interferon or those without antiviral treatment. CONCLUSIONS: Hepatitis C is associated with decreased HBV vaccine response. We suggest that postvaccination anti-HBs testing should be performed in all hepatitis C patients, and additional vaccine doses should be provided to those without protection. Alternatively, higher doses of vaccine (40 Kg) may be considered. Treatment with interferon was safe and well tolerated.