Response to HBV vaccination in patients with severe liver disease. Absence of an HLA effect.

Abstract

HLA antigen profiles have been used to identify individuals who are likely not to respond to HBV vaccination. The majority of these reports have included either normal individuals or individuals with severe abnormalities of their immune system. The present investigation assessed the rate of HBV vaccination seroconversion in 132 individuals with chronic advanced liver disease who were referred for possible liver transplantation. Each was vaccinated using a serum-derived vaccine administered intramuscularly at three consecutive monthly clinic visits. As part of their transplant evaluation, each subject also underwent HLA typing for class I and class II antigens. Of the 132 subjects vaccinated, only 47% seroconverted and became HBsAb positive. There was no difference between types of liver disease. As expected, individuals older than 55 years of age responded less well than those younger than this cutoff age. No difference between seroconverters and nonresponders was evident for gender or any individual or combination of HLA antigens. In conclusion, individuals with advanced chronic liver disease seroconvert less often in response to HBV vaccination than do normal individuals. Moreover, unlike normals and the experience with other disease groups, no difference in conversion rates was evident for gender. Similarly, no difference in seroconversion rates was evident for the two major pathophysiologic types of chronic liver disease. Age greater than 55 years was associated with a reduced rate of seroconversion.