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DOSIS DE REFUERZO Y MONITORIZACION SEROLOGICA TRAS LA VACUNACION DE LA HEPATITIS B

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En individuos inmunocompetentes no parece necesario el control serológico para aplicar dosis de refuerzo de la vacunación de la hepatitis B, al menos en los primeros 5-10 años. El seguimiento posvacunación sólo es necesario en inmunodeprimidos y en pacientes con hepatitis crónica por virus C.
Autor:
José ramón Pallás álvarez
Columnista Experto de SIIC
Artículos publicados por José ramón Pallás álvarez
Coautor
Javier Llorca Díaz* 
Profesor Titular del Area de Medicina Preventiva y Salud Pública. Facultad de Medicina. Universidad de Cantabria*
Recepción del artículo
23 de Mayo, 2002 		Primera edición
20 de Junio, 2002 		Segunda edición, ampliada y corregida
7 de Junio, 2021

DOSIS DE REFUERZO Y MONITORIZACION SEROLOGICA TRAS LA VACUNACION DE LA HEPATITIS B

Resumen
La vacunación estándar (con 3 o 4 dosis) de la hepatitis B es efectiva en individuos inmunocompetentes, ya que permite en la gran mayoría de los casos un título de antiHBs protector ( >10 UI/l). Sin embargo, existen diversos grupos de riesgo en los que las tasas de seroconversión son menores (fundamentalmente en inmunodeprimidos). Pautas de vacunación con el doble de dosis y la administración intradérmica de la vacuna recombinante se han postulado como alternativas para asegurar una seroprotección vacunal. En todo caso, parece necesario realizar un seguimiento serológico posvacunación en grupos de riesgo, donde la dosis de refuerzo está indicada y generalmente es efectiva. Así, en los pacientes en hemodiálisis, HIV positivos y hepatitis crónica por virus C existen intentos de protocolización de la dosis de refuerzo, debido al alto riesgo de infección por HBV. No obstante, hacen falta estudios adicionales ya que no existe consenso unánime sobre el momento y la periodicidad para utilizarla.

Palabras clave
Vacuna de hepatitis B, hepatitis B/serología, hepatitis B/inmunología


Artículo completo
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Extensión:  +/-4.34 páginas impresas en papel A4
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Abstract
The standard hepatitis B vaccination (with 3 or 4 doses) is effective among immune-competent subjects, since elicit protective anti-HBs levels (above 10 UI/l) in most people. Nevertheless, there are various high-risk groups whose seroconvertion status is lower (especially to subjects with immunodeficiency). Schedule vaccination with double doses and intradermal administration of recombinant hepatitis B vaccine has been postulate as alternatives to make sure seroprotective vaccination. In any case, postvaccination antibody testing seems necessary among high-risk groups, in which the booster dose has been recommended and is generally effective. Like this, in patients receiving hemodialysis, anti-HIV-1 seropositives, and chronic hepatitis C there are purposes of planning booster doses, due to high risk to HBV infection. Additional studies are necessary and unanimous consensus does not exist about to the appropriate timing and periodicity for administration.

Key words
Hepatitis B vaccine, hepatitis B/serology, hepatitis B/immunology

Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Epidemiología
Relacionadas: Gastroenterología, Infectología, Salud Pública



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Bibliografía del artículo
  1. Szmunesss W, Stevens CE, Zang EA, Harley EJ, Kellner A: A controlled clinical trial of the efficacy of the hepatitis B vaccine (Heptavax B): a final report. Hepatology 1981; 1:377-85.
  2. Jilg W, Schmidt M, Deinhardt F. Immune responses to late booster doses of hepatitis B vaccine. J Med Virol 1985; 17: 249-254.
  3. Salisbury DM, Begg NT, editores. Immunisation against infectious disease. London: HM Stationery Office: 1996; p. 95-108.
  4. Centers for Disease Control. Recommendations of the Immunisation Practices Advisory Committee. Recommendations for protection against viral hepatitis. MMWR 1985; 34: 329-35.
  5. World Health Organization. Informal consultation on quadrivalent diphtheria-tetanus-pertussis-hepatitis B vaccine: final report. Geneva: WHO, 1992.
  6. Davidson M, Krugman S. Recombinant yeast hepatitis B vaccine compared with plasma-derived vaccine: immunogenicity and effect of a booster dose. J Infect 1986; 13 (suppl A): 31-8.
  7. Wismans PJ, Van Hattum J, Mudde GC, Enderman HJ, Poel J, De Gast GC. Is booster injection with hepatitis B vaccine necessary in healthy responders A study of the immune response. J Hepatol 1989; 8: 236-40.
  8. Leroux-Roels G, Van Hecke E, Michielson W, Voet P, Hauser P, Petre J. Correlation between in vivo humoral and in vitro cellular immune responses following immunisation with hepatitis B surface antigen (HbsAg) vaccines. Vaccine 1994; 12: 812-18.
  9. Avanzini MA, Belloni C, Soncini R, Ciardelli L, de Silvestri A, Pistorio A, Tinelli C, Maccario R, Rondini G. Increment of recombinant hepatitis B surface antigen-specific T-cell precursors after revaccination of slow responder children. Vaccine 2001; 19: 2819-24
  10. Jilg W, Schmidt M, Zachoval R, Deinhardt F. Hepatitis B vaccination: how long does protection last Lancet 1994; 2: 458.
  11. Hadler SC, Francis DP, Maynard JE, Thompson SE, Judson FN, Echemberg DF, et al. Long-term immunogenicity and efficacy of hepatitis B vaccine in homosexual men. N Engl J Med 1986; 315: 209-14.
  12. Bulkow LR, Wainwright RB, McMahon BJ, Parkinson AJ. Increases in levels of antibody to hepatitis B surface antigen in a immunized population. Clin Infect Dis 1998; 26: 933-7.
  13. Jilg W, Schmidt M, Deinhardt F. Immune response to hepatitis B revaccination. J Med Virol 1988; 24: 377-84.
  14. Krugman S, Davidson M. Hepatitis B vaccine: prospects for duration of immunity. Yale J Biol Med 1987; 60: 333-8.
  15. Stevens CE, Toy PT, Taylor PE, Lee T, Yip HY. Prospects for control of hepatitis B virus infection: implications of childhood vaccination and long-term protection. Pediatrics 1992; 91: 170-3.
  16. Jilg W, Schmidt M, Deinhardt F. Persistence of specific antibodies after hepatitis B vaccination. J Hepatol 1988; 1: 201-7.
  17. Zuckerman JN, Zuckerman AJ. Is there a need for boosters of hepatitis B vaccine. Viral Hepatitis Rev 1998; 4: 43-46.
  18. Iwarson S: Strategies for immunisation against hepatitis B in western Europe. Vaccine 1993; 11 (suppl 1): S 18-20.
  19. Tilzey AJ, Palmer SJ, Banatvala JE, Vines SK, Gilks WR. Hepatitis B vaccine boosting among young healthy adults. Lancet 1994; 344: 1438-40.
  20. Zuckerman JN, Zuckerman AJ. Acute hepatitis B after vaccination. Lancet 1995; 345: 261-2.
  21. Chiaramonte M, Ngatchu T, Majori S, Baldo V, Moschen ME, Renzulli G et al. Response to an extra dose of hepatitis B vaccine and specific antibody persistence in nonresponders to primary immunisation. Scan J Gastroenterol 1995; 30: 601-3.
  22. Bortolotti F, Crivellaro C, Pornaro E, Realdi G. hepatitis B in nonresponder to hepatitis B vaccine. Infection 1988; 16: 119-20.
  23. Clemens R, Sanger R, Kruppenbacher J, Hobel W, Stanbury W, Bock HL, et al. Booster immunization of low- and non-responders after a standard three dose after hepatitis B vaccine schedule. Results of a post-marketing surveillance. Vaccine 1997; 15: 349-52.
  24. West DJ, Calandra GB. Vaccine induced immunologic memory for hepatitis B surface antigen: implications for policy on booster vaccination. Vaccine 1996; 14: 1019-27.
  25. Ayerbe MC, Perez-Rivilla A and ICOVAHB group. Assessment of long-term efficacy of hepatitis B vaccine. Eur J Epidemiol 2001; 17:150-6
  26. Belloni C, Pistorio A, Tinelli C, Komakec J, Chirico G, Rovelli D, et al. Early immunisation with hepatitis B vaccine: a five-year study. Vaccine 2000; 18: 1307-11.
  27. Wiedmann M, Liebert UG, Oesen U, Porst H, Wiese M, Schroeder S, et al. Decreased immunogenicity of recombinant hepatitis B vaccine in chronic hepatitis C. Hepatology 2000; 31: 230-4.
  28. Are booster immunisations needed for lifelong hepatitis B immunity. European Consensus Group on Hepatitis B Immunity. Lancet 2000; 355:561-5.
  29. Freitas da Motta MS, Mussi-Pinhata MM, Jorge SM, Tachibana Yoshida CF, Sandoval de Souza CB. Immunogenicity of Hepatitis B vaccine in preterm and full term infants vaccinated within the first week of life. Vaccine 2002; 20:1557-1562.
  30. Kato H, Nakata K, Hamasaki K, Hida D, Ishikawa H, Aritomi T, et al. Long-term efficacy of immunization against hepatitis B virus in infants at high-risk analyzed by polymerase chain reaction. Vaccine 1999; 18: 581-7.
  31. Gregorek H, Madalinski K, Woynarowski M, Mikolajewicz J, Syczewska M, Socha J. The IgG subclass profile of anti-HBs response in vaccinated children and children seroconverted after natural infection. Vaccine 2000; 18: 1210-7.
  32. Duval B, Boulianne N, De Serres G, Laflamme N, De Wals P, Masse R, et al. Comparative immunogenicity under field conditions of two recombinant hepatitis B vaccines in 8-10-year-old children. Vaccine 2000; 18: 1467-72.
  33. Cassidy WM, Watson B, Ioli VA, Williams K, Bird S, West DJ. A randomized trial of alternative two- and three-dose hepatitis B vaccination regimens in adolescents: antibody responses, safety, and immunologic memory. Pediatrics 2001; 107:626-31.
  34. Kurugol Z, Erensoy S, Aksit S, Egemen A, Bilgic A. Low-dose intradermal administration of recombinant hepatitis B vaccine in children: 5-year follow-up study. Vaccine 2001; 19:3936-9.
  35. Williams JL, Christensen CJ, McMahon BJ, Bulkow LR, Cagle HH, Mayers JS, Zanis CL, Parkinson AJ, Margolis HS. Evaluation of the response to a booster dose of hepatitis B vaccine in previously immunized healthcare workers. Vaccine 2001; 19:4081-5.
  36. Westmoreland D, Player V, Heap DC, Hammond A. Immunisation against hepatitis B-what can we expect Results of a survey of antibody response to immunisation in persons 'at risk' of occupational exposure to hepatitis B. Epidemiol Infect 1990; 104: 499-509.
  37. Trivello R, Chiaramonte M, Ngatchu T, Baldo V, Majori S, Moschen ME, et al. persistence of anti-HBs antibodies in health care personnel vaccinated with plasma-derived Hepatitis B vaccine and response to recombinant DNA HB booster vaccine. Vaccine 1995; 13: 138-41.
  38. Playford EG, Hogan PG, Bansal AS, Harrison K, Drummond D, Looke DF, Whitby M. Intradermal recombinant hepatitis B vaccine for healthcare workers who fail to respond to intramuscular vaccine. Infect Control Hosp Epidemiol 2002; 23:87-90.
  39. Borg L, Khuri E, Wells A, Melia D, Bregaza NV, Ho A, Kreek MJ. Methadone-maintained former heroin addicts, including those who are anti-HIV-1 Seropositive, comply with and respond to hepatitis B vaccination. Addiction 1999; 94: 489-493.
  40. Idilman R, De MN, Colantoni A, Nadir A, Van T. The effect of high dose and short interval HBV vaccination in individuals with chronic hepatitis C. Am J Gastroenterol 2002; 97:435-9.
  41. Angelico M, Di Paolo D, Trinito MO, Petrolati A, Araco A, Zazza S, Lionetti R, Casciani CU, Tisone G. Failure of a reinforced triple course of hepatitis B vaccination in patients transplanted for HBV-related cirrhosis. Hepatology 2002; 35:176-81.
  42. Seaworth B, Drucker J, Starling J, Drucker R, Stevens C, Hamilton J. Hepatitis B vaccines in patients with chronic renal failure. J Infect Dis 1988; 157: 332-7.
  43. Rey D, Krantz V, Partisani M, Schmitt MP, Meyer P, Libbrecht E, et al. Increasing the number of hepatitis B vaccine injections augments anti-HBs response rate in HIV-infected patients. Effects on HIV-1 viral load. Vaccine 2000; 18: 1161-5.
  44. Tayal SC, Sankar KN. Impaired response to recombinant hepatitis B vaccine in asymptomatic HIV-infected individuals. AIDS 1994; 8: 558-9.
  45. Ly D, Yee HF Jr, Brezina M, Martin P, Gitnick G, Saab S. Hepatitis B surface antigenemia in chronic hemodialysis patients: effect of hepatitis B immunization. Am J Gastroenterol 2002; 97:138-41.
  46. Peces R, Laures AS. Persistence of immunologic memory in long-term hemodialysis patients and healthcare workers given hepatitis B vaccine: role of a booster dose on antibody response. Nephron 2001; 89:172-6.
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