Vaccine‐induced protection against hepatitis B in pediatric solid organ transplant patients. (20th November 2020)

• Record Type: Journal Article
• Authors: Ball, Michael; Liverman, Rochelle; Serluco, Anastacia; Yildirim, Inci
• Is Part Of: Pediatric transplantation. Volume 25:Number 3(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-11-20
• Subjects: hepatitis B vaccine -- pediatrics -- Solid organ transplantation -- vaccine‐induced protection; Transplantation of organs, tissues, etc. in children -- Periodicals; 617.95408305
• DOI: 10.1111/petr.13920
• Languages: English
• ISSNs: 1397-3142

Abstract

Abstract: Background: Vaccination against hepatitis B virus (HBV) has led to a worldwide reduction in disease burden and mortality. Vaccine immunogenicity data in transplanted children are limited, and vaccine‐induced protection may be reduced. We evaluated HBV vaccination coverage, seroprotection rates, and factors influencing vaccine immunity among pediatric solid organ transplant (SOT) patients. Methods: We retrospectively identified patients ≤21 years of age evaluated for SOT and/or transplanted at our center between January 1, 2015, and December 31, 2018. A detailed chart review was conducted using a standard questionnaire to gather information on demographic, clinical, and laboratory features of patients' HBV vaccination, and hepatitis B surface antibody (HBsAb) titers. Results: A total of 381 patients undergoing evaluation and/or transplantation were included: 139 (36.5%) liver, 138 (36.2%) kidney, and 104 (27.3%) heart. Overall, HBsAb at evaluation was reactive in 216 (56.7%), indeterminate in 17 (4.5%), non‐reactive in 138 (36.2%), and not available in 10 (2.6%). Of those that completed a primary HBV vaccine series (n = 304), HBsAb was reactive in 164 (53.9%), indeterminate in 13 (4.3%), non‐reactive in 119 (39.1%), and not available in 8 (2.6%). For those up to date for age on HBV vaccinations with non‐reactive/indeterminate titers at evaluation, revaccination and a follow‐up HBsAb were available in 45 patients of which 33 (73.3%) seroconverted to a reactive HBsAb titer. Conclusion: Vaccine‐induced protection against HBV infection among high‐risk pediatric SOT recipients can be improved by serology‐based intervention. Though the absence of HBsAb does not always indicate loss of protection, boosting or completing primary series is recommended.