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Hepatit B Aşılama Verileri; İmmünsüpresif Hastalarda Tek Doz mu? Çift Doz mu?

Year 2020, Volume: 8 Issue: 3, 499 - 506, 20.12.2020

Servet Öztürk , Merve Kaçar Semra Toprak Onur Çolak Derya Öztürk Canan Agalar

https://doi.org/10.37696/nkmj.797988

Abstract

Amaç: Hepatit B, etkin aşı ve aşılama programlarına rağmen Dünya Sağlık Örgütü’nün verilerine göre halen yılda 1 milyona yakın ölüme neden olmaktadır. Sağlıklı popülasyonda özellikle genç yaşta hepatit B aşılamasında bağışıklama oranları oldukça yüksektir. Ancak ileri yaş, komorbiditeler ve hastanın immün yetersizliği aşı yanıtını olumsuz etkilemektedir. Özellikle immünsüpresif hastalarda hepatit b aşı dozu konusunda rehberler arasında görüş birliği yoktur. Hastanemizde hepatit B aşısı yapılan hastaları retrospektif olarak değerlendirerek, aşı yanıtını etkileyen faktörleri irdelemeyi amaçladık.
Materyal-metod: Hastanemiz aşı birimimizde hepatit b aşısı yapılan ve bağışıklaması takip edilen hastalar retrospektif olarak değerlendirildi. Hastalar yaş, komorbiditeleri, hangi aşı şemasının yapıldığı, aşı dozu, immün süpresif-biyolojik ajan kullanımı, aşılama sonrası bağışıklama başarısı, bağışıklık oluşmayan ve oluşan hastaların ortak özellikleri açısından irdelendi.
Bulgular: Anti-Hbs titreleri 50 yaş üstü olgularda istatistiksel anlamlı şekilde düşüktü. Komorbiditesi olan ve immünsüprese tedavi alan hastalarda düşük Anti-Hbs titreleri saptanmıştır. İmmünsüpresif tedavi alan hastalarda çift doz aşılama ile tek doz aşılamaya kıyasla istatistiksel olarak anlamlı olacak şekilde yüksek Anti-HBS titreleri belirlenmiştir. Aşılamanın başarısız olduğu yedi hastanın tamamına tek doz aşı protokolü uygulandığı saptanmıştır. Altısı 50 yaş üstü iken, ikisinin diyabetik, beşinin romatizmal hastalık tanılı olduğu ve biyolojik ajan kullanmakta oldukları belirlenmiştir.
Sonuç : İmmunsüpresif tedavi alacak hastalarda tedavi öncesi aşılama yapılması, immünsüpresif tedavi altında olan hastalarda yüksek doz aşı uygulaması veya aşılama sırasında immünsüpresif tedavisinin ötelenmesi uygun alternatifler olarak değerlendirilebilir. Yüksek doz hepatit B aşısının güvenilirliği ve maliyet-etkinlik göz önünde bulundurulduğunda immunsupresif hasta grubunda tercih edilmesi gereklidir.

Keywords

hepatit b aşısı çift(yüksek) doz aşılama immünsüpresyon biyolojik ajan

Supporting Institution

yok

Project Number

yok

References

  • 1-https://www.who.int/news-room/fact-sheets/detail/hepatitis-b#:~:text=WHO%20estimates%20that%20in%202015,(i.e.%20primary%20liver%20cancer).
  • 2-Yang S, Tian G, Cui Y, Ding C, Deng M, Yu C et al. Factors influencing immunologic response to hepatitis B vaccine in adults. SciRep. 2016 Jun 21;6:27251.
  • 3- Hyer R, McGuire DK, Xing B, Jackson S, Janssen R. Safety of a two-dose investigational hepatitis B vaccine, HBsAg-1018, using a toll-like receptor 9 agonist adjuvant in adults. Vaccine. 2018 May 3;36(19):2604-2611.
  • 4-Asan A, Demirhan H, Sorkun HÇ, Özkan S, Aydın M, Akın D, Tatar B, Çatak B, Şener A, Köse Ş. Factors affecting responsiveness to hepatitis B immunization in dialysis patients. IntUrolNephrol. 2017 Oct;49(10):1845-1850.
  • 5-Okay G, Biberci Keskin E, Akkoyunlu Y, Bolukcu S, Betül Uslu A, MericKoc M. Evaluation of hepatitis B vaccine efficacy and factors affecting vaccine nonresponse in patients receiving anti-tumor necrosis factor agents. Eur J GastroenterolHepatol. 2020 Jul 14.
  • 6-Fan W, Chen XF, Shen C, Guo ZR, Dong C. Hepatitis B vaccineresponse in obesity: A meta-analysis. Vaccine. 2016 Sep 14;34(40):4835-41.
  • 7- https://www.eacsociety.org/files/guidelines-10.0_final_2_2.pdf
  • 8-Aberg JA, Gallant JE, Ghanem KG, Emmanuel P, Zingman BS, Horberg MA; Infectious Diseases Society of America. Primary care guidelines for the management of persons infected with HIV: 2013 update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2014 Jan;58(1):1-10.
  • 9-Van Den Ende C, Marano C, Van Ahee A, Bunge EM, De Moerlooze L. The immunogenicity and safety of GSK's recombinant hepatitis B vaccine in adults: a systematic review of 30 years of experience. ExpertRevVaccines. 2017 Aug;16(8):811-832.
  • 10- Weinberger B, Haks MC, de Paus RA, Ottenhoff THM, Bauer T, Grubeck-Loebenstein B. Impaired Immune Response to Primary but Not to Booster Vaccination Against Hepatitis B in Older Adults. Front Immunol. 2018 May 15;9:1035.
  • 11- Guidelines for vaccination in patients with chronic kidney disease. Indian J Nephrol. 2016 Apr;26(Suppl 1):S15–8.
  • 12- Elhanan E, Boaz M, Schwartz I, Schwartz D, Chernin G, Soetendorp H et al. A randomized, controlled clinical trial to evaluate the immunogenicity of a PreS/S hepatitis B vaccine Sci-B-Vac™, as compared to Engerix B®, among vaccine naïve and vaccine non-responder dialysis patients. Clin Exp Nephrol. 2018 Feb;22(1):151-158.
  • 13-https://academic.oup.com/cid/article/58/3/e44/336537
  • 14- https://www.bhiva.org/file/NriBJHDVKGwzZ/2015-Vaccination-Guidelines.pdf
  • 15- de Vries-Sluijs TE, Hansen BE, van Doornum GJ, Springeling T, Evertsz NM, de Man RA et al. A prospective open study of the efficacy of high-dose recombinant hepatitis B rechallenge vaccination in HIV-infected patients. J Infect Dis. 2008 Jan 15;197(2):292-4.
  • 16- Schillie SF, Spradling PR, Murphy TV. Immune response of hepatitis B vaccine among persons with diabetes: a systematic review of the literature. Diabetes Care. 2012 Dec;35(12):2690-7.
  • 17- Van Der Meeren O, Peterson JT, Dionne M, Beasley R, Ebeling PR, Ferguson M et al. Prospective clinical trial of hepatitis B vaccination in adults with and without type-2 diabetes mellitus. Hum Vaccin Immunother. 2016 Aug 2;12(8):2197-2203.
  • 18- Jiang HY, Wang SY, Deng M, Li YC, Ling ZX, Shao L et al. Immune response to hepatitis B vaccination among people with inflammatory bowel diseases: A systematic review and meta-analysis. Vaccine. 2017 May 9;35(20):2633-2641.
  • 19- Intongkam S, Samakarnthai P, Pakchotanon R, Narongroeknawin P, Assavatanabodee P, Chaiamnuay S. Efficacy and Safety of Hepatitis B Vaccination in Rheumatoid Arthritis Patients Receiving Disease-Modifying Antirheumatic Drugs and/or Biologics Therapy. J Clin Rheumatol. 2019 Dec;25(8):329-334.
  • 20- Richi P, Alonso O, Martín MD, González-Hombrado L, Navío T, Salido M et al. Evaluation of the immune response to hepatitis B vaccine in patients on biological therapy: results of the RIER cohort study. Clin Rheumatol. 2020 Sep;39(9):2751-2756.
  • 21-HaykirSolay A, Eser F. High dose hepatitis B vaccine is not effective in patients using immunomodulatory drugs: a pilot study. Hum VaccinImmunother. 2019;15(5):1177-1182.
  • 22- Gisbert JP, Menchén L, García-Sánchez V, Marín I, Villagrasa JR, Chaparro M. Comparison of the effectiveness of two protocols for vaccination (standard and double dosage) against hepatitis B virus in patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2012 Jun;35(12):1379-85.
  • 23- Karadağ Ö, Kaşifoğlu T, Özer B, Kaymakoğlu S, Kuş Y, İnanç M ve ark. Romatolojik hastalarda biyolojik ilaç kullanımı öncesi (viral) hepatit tarama kılavuzu. j TurkSocRheumatol 2015;7:28-32.

Year 2020, Volume: 8 Issue: 3, 499 - 506, 20.12.2020

Servet Öztürk , Merve Kaçar Semra Toprak Onur Çolak Derya Öztürk Canan Agalar

https://doi.org/10.37696/nkmj.797988

Abstract

Project Number

yok

References

  • 1-https://www.who.int/news-room/fact-sheets/detail/hepatitis-b#:~:text=WHO%20estimates%20that%20in%202015,(i.e.%20primary%20liver%20cancer).
  • 2-Yang S, Tian G, Cui Y, Ding C, Deng M, Yu C et al. Factors influencing immunologic response to hepatitis B vaccine in adults. SciRep. 2016 Jun 21;6:27251.
  • 3- Hyer R, McGuire DK, Xing B, Jackson S, Janssen R. Safety of a two-dose investigational hepatitis B vaccine, HBsAg-1018, using a toll-like receptor 9 agonist adjuvant in adults. Vaccine. 2018 May 3;36(19):2604-2611.
  • 4-Asan A, Demirhan H, Sorkun HÇ, Özkan S, Aydın M, Akın D, Tatar B, Çatak B, Şener A, Köse Ş. Factors affecting responsiveness to hepatitis B immunization in dialysis patients. IntUrolNephrol. 2017 Oct;49(10):1845-1850.
  • 5-Okay G, Biberci Keskin E, Akkoyunlu Y, Bolukcu S, Betül Uslu A, MericKoc M. Evaluation of hepatitis B vaccine efficacy and factors affecting vaccine nonresponse in patients receiving anti-tumor necrosis factor agents. Eur J GastroenterolHepatol. 2020 Jul 14.
  • 6-Fan W, Chen XF, Shen C, Guo ZR, Dong C. Hepatitis B vaccineresponse in obesity: A meta-analysis. Vaccine. 2016 Sep 14;34(40):4835-41.
  • 7- https://www.eacsociety.org/files/guidelines-10.0_final_2_2.pdf
  • 8-Aberg JA, Gallant JE, Ghanem KG, Emmanuel P, Zingman BS, Horberg MA; Infectious Diseases Society of America. Primary care guidelines for the management of persons infected with HIV: 2013 update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2014 Jan;58(1):1-10.
  • 9-Van Den Ende C, Marano C, Van Ahee A, Bunge EM, De Moerlooze L. The immunogenicity and safety of GSK's recombinant hepatitis B vaccine in adults: a systematic review of 30 years of experience. ExpertRevVaccines. 2017 Aug;16(8):811-832.
  • 10- Weinberger B, Haks MC, de Paus RA, Ottenhoff THM, Bauer T, Grubeck-Loebenstein B. Impaired Immune Response to Primary but Not to Booster Vaccination Against Hepatitis B in Older Adults. Front Immunol. 2018 May 15;9:1035.
  • 11- Guidelines for vaccination in patients with chronic kidney disease. Indian J Nephrol. 2016 Apr;26(Suppl 1):S15–8.
  • 12- Elhanan E, Boaz M, Schwartz I, Schwartz D, Chernin G, Soetendorp H et al. A randomized, controlled clinical trial to evaluate the immunogenicity of a PreS/S hepatitis B vaccine Sci-B-Vac™, as compared to Engerix B®, among vaccine naïve and vaccine non-responder dialysis patients. Clin Exp Nephrol. 2018 Feb;22(1):151-158.
  • 13-https://academic.oup.com/cid/article/58/3/e44/336537
  • 14- https://www.bhiva.org/file/NriBJHDVKGwzZ/2015-Vaccination-Guidelines.pdf
  • 15- de Vries-Sluijs TE, Hansen BE, van Doornum GJ, Springeling T, Evertsz NM, de Man RA et al. A prospective open study of the efficacy of high-dose recombinant hepatitis B rechallenge vaccination in HIV-infected patients. J Infect Dis. 2008 Jan 15;197(2):292-4.
  • 16- Schillie SF, Spradling PR, Murphy TV. Immune response of hepatitis B vaccine among persons with diabetes: a systematic review of the literature. Diabetes Care. 2012 Dec;35(12):2690-7.
  • 17- Van Der Meeren O, Peterson JT, Dionne M, Beasley R, Ebeling PR, Ferguson M et al. Prospective clinical trial of hepatitis B vaccination in adults with and without type-2 diabetes mellitus. Hum Vaccin Immunother. 2016 Aug 2;12(8):2197-2203.
  • 18- Jiang HY, Wang SY, Deng M, Li YC, Ling ZX, Shao L et al. Immune response to hepatitis B vaccination among people with inflammatory bowel diseases: A systematic review and meta-analysis. Vaccine. 2017 May 9;35(20):2633-2641.
  • 19- Intongkam S, Samakarnthai P, Pakchotanon R, Narongroeknawin P, Assavatanabodee P, Chaiamnuay S. Efficacy and Safety of Hepatitis B Vaccination in Rheumatoid Arthritis Patients Receiving Disease-Modifying Antirheumatic Drugs and/or Biologics Therapy. J Clin Rheumatol. 2019 Dec;25(8):329-334.
  • 20- Richi P, Alonso O, Martín MD, González-Hombrado L, Navío T, Salido M et al. Evaluation of the immune response to hepatitis B vaccine in patients on biological therapy: results of the RIER cohort study. Clin Rheumatol. 2020 Sep;39(9):2751-2756.
  • 21-HaykirSolay A, Eser F. High dose hepatitis B vaccine is not effective in patients using immunomodulatory drugs: a pilot study. Hum VaccinImmunother. 2019;15(5):1177-1182.
  • 22- Gisbert JP, Menchén L, García-Sánchez V, Marín I, Villagrasa JR, Chaparro M. Comparison of the effectiveness of two protocols for vaccination (standard and double dosage) against hepatitis B virus in patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2012 Jun;35(12):1379-85.
  • 23- Karadağ Ö, Kaşifoğlu T, Özer B, Kaymakoğlu S, Kuş Y, İnanç M ve ark. Romatolojik hastalarda biyolojik ilaç kullanımı öncesi (viral) hepatit tarama kılavuzu. j TurkSocRheumatol 2015;7:28-32.
There are 23 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Orginal Article
Authors

Servet Öztürk 0000-0002-9114-5090

Merve Kaçar This is me 0000-0002-7139-9106

Semra Toprak This is me 0000-0002-0919-8733

Onur Çolak This is me 0000-0002-0834-0902

Derya Öztürk This is me

Canan Agalar 0000-0001-9221-7706

Project Number yok
Publication Date December 20, 2020
Published in Issue Year 2020 Volume: 8 Issue: 3

Cite

APA Öztürk, S., Kaçar, M., Toprak, S., Çolak, O., et al. (2020). Hepatit B Aşılama Verileri; İmmünsüpresif Hastalarda Tek Doz mu? Çift Doz mu?. Namık Kemal Tıp Dergisi, 8(3), 499-506. https://doi.org/10.37696/nkmj.797988
AMA Öztürk S, Kaçar M, Toprak S, Çolak O, Öztürk D, Agalar C. Hepatit B Aşılama Verileri; İmmünsüpresif Hastalarda Tek Doz mu? Çift Doz mu?. NKMJ. December 2020;8(3):499-506. doi:10.37696/nkmj.797988
Chicago Öztürk, Servet, Merve Kaçar, Semra Toprak, Onur Çolak, Derya Öztürk, and Canan Agalar. “Hepatit B Aşılama Verileri; İmmünsüpresif Hastalarda Tek Doz Mu? Çift Doz Mu?”. Namık Kemal Tıp Dergisi 8, no. 3 (December 2020): 499-506. https://doi.org/10.37696/nkmj.797988.
EndNote Öztürk S, Kaçar M, Toprak S, Çolak O, Öztürk D, Agalar C (December 1, 2020) Hepatit B Aşılama Verileri; İmmünsüpresif Hastalarda Tek Doz mu? Çift Doz mu?. Namık Kemal Tıp Dergisi 8 3 499–506.
IEEE S. Öztürk, M. Kaçar, S. Toprak, O. Çolak, D. Öztürk, and C. Agalar, “Hepatit B Aşılama Verileri; İmmünsüpresif Hastalarda Tek Doz mu? Çift Doz mu?”, NKMJ, vol. 8, no. 3, pp. 499–506, 2020, doi: 10.37696/nkmj.797988.
ISNAD Öztürk, Servet et al. “Hepatit B Aşılama Verileri; İmmünsüpresif Hastalarda Tek Doz Mu? Çift Doz Mu?”. Namık Kemal Tıp Dergisi 8/3 (December 2020), 499-506. https://doi.org/10.37696/nkmj.797988.
JAMA Öztürk S, Kaçar M, Toprak S, Çolak O, Öztürk D, Agalar C. Hepatit B Aşılama Verileri; İmmünsüpresif Hastalarda Tek Doz mu? Çift Doz mu?. NKMJ. 2020;8:499–506.
MLA Öztürk, Servet et al. “Hepatit B Aşılama Verileri; İmmünsüpresif Hastalarda Tek Doz Mu? Çift Doz Mu?”. Namık Kemal Tıp Dergisi, vol. 8, no. 3, 2020, pp. 499-06, doi:10.37696/nkmj.797988.
Vancouver Öztürk S, Kaçar M, Toprak S, Çolak O, Öztürk D, Agalar C. Hepatit B Aşılama Verileri; İmmünsüpresif Hastalarda Tek Doz mu? Çift Doz mu?. NKMJ. 2020;8(3):499-506.