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The efficacy of accelerated, multiple, double-dose hepatitis B vaccine against hepatitis B virus infection in cancer patients receiving chemotherapy

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Abstract

Background

Hepatitis B virus (HBV) infection in cancer patients receiving chemotherapy carries high morbidity and mortality. Conventional hepatitis B vaccination with three doses at 0, 1, and 6 months apart is ineffective in prevention of HBV infection.

Objectives

To compare the efficacy of accelerated, multiple, double-dose HB vaccine with conventional HB vaccine in cancer patients receiving chemotherapy (CT).

Methods

Patients of cancer who were planned for CT were screened for HBV markers (HBsAg, total anti-HB core, anti-HBs antibody and HBV DNA). Patients with negative HBV serum markers received HB vaccine in two groups. Group A received three double doses (40 μg) of recombinant HB vaccine at 0, 1, and 3 weeks before CT and additional three double doses post CT. Group B received HB vaccine (20 μg) at 0, 1, and 6 months. Efficacy of vaccine in the two groups was compared by anti-HBs titers achieved at 3, 6, and 9 months and by HBsAg positivity following CT at 1 year follow up.

Results

Protective anti-HBs titers (>10 mIU/mL) at 3, 6, and 9 months in group A and B was 41.1 %, 66.2 %, and 76 % and 26 %, 37.7 %, and 49 % respectively (p = 0.001). Seven of 454 (1.5 %) patients in group A became HBsAg positive after vaccination compared to 19/472 (4.0 %) in group B (p = 0.022).

Conclusion

Accelerated, multiple, double-dose HB vaccine increases seroprotection and is more effective than conventional HB vaccine in preventing HBV infection.

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Authors and Affiliations

  1. Department of Gastroenterology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, 190 011, India

    Jaswinder Singh Sodhi, Wasim Raja, Showkat Ali Zargar, Abid Showkat, Shaheena Parveen, Manzoor Ahmad Wani, Gul Javid, Mushtaq Khan, Gh Nabi Yattoo, Altaf Shah & Gh Mohd Gulzar

  2. Department of Medical Oncology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, 190 011, India

    Syed Nisar, Sheikh Aejaz, Gul Mohd & Rashid Lone

  3. Department of Clinical Hematology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, 190 011, India

    Aleem Jan

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  1. Jaswinder Singh Sodhi
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Corresponding author

Correspondence to Jaswinder Singh Sodhi.

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Conflicts of interest

JSS, WR, SAZ, AS, SP, SN, MAW, GJ, MK, SA, GM, AJ, GNY, AS, GMG, and RL declare no conflict of interest.

Ethics statement

The study was performed in a manner to conform to the Helsinki Declaration of 1975 as revised in 2000 and 2008 concerning Human and Animal Rights, and the authors followed the policy concerning informed consent as shown on springer.com.

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Sodhi, J.S., Raja, W., Zargar, S.A. et al. The efficacy of accelerated, multiple, double-dose hepatitis B vaccine against hepatitis B virus infection in cancer patients receiving chemotherapy. Indian J Gastroenterol 34, 372–379 (2015). https://doi.org/10.1007/s12664-015-0595-y

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  • DOI: https://doi.org/10.1007/s12664-015-0595-y

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