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Hepatitis B vaccination in patients with chronic hepatitis C
1Division of Gastroenterology, Department of Medicine, Veterans General Hospital-Taipei, and National Yang-Ming University School of Medicine, Taipei, Taiwan. sdlee@vghtpe.gov.tw
Insights
Hepatitis B vaccination is safe and effective for patients with chronic hepatitis C, showing good immunogenicity and a tendency to lower ALT levels without impacting HCV RNA. This offers a potential therapeutic benefit.
Area of Science:
- Hepatology
- Immunology
- Vaccinology
Background:
- Chronic hepatitis C (HCV) infection poses risks for co-infection with hepatitis B virus (HBV).
- Assessing the impact of HBV vaccination in HCV patients is crucial for managing co-infections and liver health.
Purpose of the Study:
- To evaluate the safety and immunogenicity of recombinant hepatitis B vaccine in patients with chronic hepatitis C.
- To investigate the potential therapeutic effects, including changes in liver enzymes and viral load, of hepatitis B vaccination in this population.
Main Methods:
- A study involving three groups: chronic hepatitis C patients receiving HBV vaccine, healthy individuals receiving HBV vaccine, and chronic hepatitis C patients as controls.
- Administration of three doses of recombinant hepatitis B vaccine (20 microg/dose) at 0, 1, and 6 months.
- Serological testing for antibody to hepatitis B surface antigen (anti-HBs) and measurement of serum cytokines, HCV RNA, and ALT levels before and after vaccination.
Main Results:
- Hepatitis B vaccination demonstrated similar anti-HBs response rates and geometric mean titers in both chronic hepatitis C patients and healthy subjects.
- Patients with chronic hepatitis C showed no significant changes in serum cytokines or HCV RNA levels post-vaccination.
- A significant reduction in ALT levels was observed in chronic hepatitis C patients after completing the three-dose vaccination regimen.
Conclusions:
- Recombinant hepatitis B vaccine is safe and immunogenic in individuals with chronic hepatitis C.
- Hepatitis B vaccination in chronic hepatitis C patients may lead to a therapeutic benefit by lowering ALT levels.
- The vaccine does not significantly alter HCV RNA levels, indicating a specific effect on liver inflammation rather than viral replication.
Abstract:
The aim of the study was to evaluate the safety, immunogenicity, and possible therapeutic effect of hepatitis B vaccine in patients with chronic hepatitis C. The subjects studied included three groups: group I, 26 patients with chronic hepatitis C who were susceptible to hepatitis B virus infection; group II, 35 healthy subjects who were susceptible to both hepatitis B and hepatitis C virus infection; and group III, 30 patients with chronic hepatitis C receiving no hepatitis B vaccination as controls. Three 20 microg/dose of recombinant hepatitis B vaccines were given to subjects of groups I and II in months 0, 1, and 6. Blood samples from the subjects were collected before and 1 month after each dose of vaccination for serological testing. The subjects of groups I and II had similar antibody to hepatitis B surface antigen (anti-HBs) response rates after the first (30.8% vs. 17.1%), second (61.5% vs. 60.0%), and third (88.5% vs. 91.4%) doses of vaccination. Also, their geometric mean titers of anti-HBs did not differ much when vaccination completed in 7 months (360 vs. 581 mIU/ml). During vaccination period, patients with chronic hepatitis C demonstrated no significant change of serum cytokines and HCV RNA levels, but significantly lowered ALT levels after three doses of vaccination. Hepatitis B vaccination is safe and immunogenic in patients with chronic hepatitis C. It did not significantly affect their levels of HCV RNA, but tended to lower ALT levels.