Hepatitis B Boosters Using a Different Product vs. the Same Product for Kidney Transplant Recipients: A Retrospective Study With Bayesian Inference

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2025-09-03 DOI:10.1111/ctr.70307

Kentaro Iwata, Shunkichi Ikegaki, Yoji Hyodo, Hideaki Miyake

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Abstract

Objectives

Hepatitis B vaccination is recommended for those receiving kidney transplants. When hepatitis B surface antibody (HBsAb) levels remain low, the booster dose of the vaccine should be considered. Some consider that the use of a different product as a booster might be beneficial to the patients, but the effectiveness of such a strategy has not been evaluated.

Methods

The kidney transplant recipients (KTR) who received hepatitis B vaccines (Bimmugen or Heptavax-II), and failed to develop enough antibody titer and those who received additional vaccines, were enrolled in the study. Those who received a different product were compared with those who received the same product as the booster. The outcome is the seroconversion of hepatitis B surface antibody level ≧ 10 IU/mL.

Results

A total of 26 patients were non-responders after a receipt of three-dose hepatitis B vaccines. Among those, 15 received additional hepatitis B vaccine of the different product (crossover group), and 11 received the same product (non-crossover group). Only five patients (19.2%) had seroconversion after the booster doses, three in the crossover group (20%) and two in the non-crossover group (18.2%) (p = 1.0). In the Bayesian analysis, the medial posterior probability of the seroconversion rate of the crossover group was 23% (95% CrI: 7%–47%), whereas that of the non-crossover group was 14% (95% CrI: 2%–40%).

Conclusion

The crossover strategy hepatitis B vaccines did not appear to lead to seroconversion of much significance among KTR. Other options to augment the protection should be investigated to protect these populations against the infection.

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肾移植受者使用不同产品与相同产品的乙肝增强剂：贝叶斯推断的回顾性研究

目的建议接受肾移植的患者接种乙肝疫苗。当乙型肝炎表面抗体（HBsAb）水平保持较低时，应考虑加强疫苗剂量。一些人认为使用不同的产品作为增强剂可能对患者有益，但这种策略的有效性尚未得到评估。方法将接受过乙肝疫苗（Bimmugen或Heptavax-II）的肾移植受者（KTR）和未产生足够抗体滴度的肾移植受者（KTR）纳入研究。接受不同产品的人与接受相同产品的人进行了比较。结果血清乙型肝炎表面抗体水平转化≧10 IU/mL。结果26例患者接种三剂乙肝疫苗后无应答。其中，15人额外接种了不同产品的乙肝疫苗（交叉组），11人接种了相同产品（非交叉组）。只有5名患者（19.2%）在加强剂量后发生血清转化，3名患者在交叉组（20%），2名患者在非交叉组（18.2%）（p = 1.0）。在贝叶斯分析中，交叉组血清转化率的中间后验概率为23% (95% CrI: 7%-47%)，而非交叉组的后验概率为14% （95% CrI: 2%-40%）。结论交叉乙肝疫苗对KTR患者血清转化的影响不明显。应调查加强保护的其他选择，以保护这些人群免受感染。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.