gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLCgastro-j-1508Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL ARTICLESЭффективность вакцинации против гепатита B у больных, ожидающих трансплантацию печени, в профилактике развития HBV-инфекции трансплантата de novoEfficacy of hepatitis B vaccination in patients awaiting liver transplantation in prophylaxis of de novo HBV-infection of a graftСюткинВ. Е.SyutkinV. Ye.АндрейцеваО. И.AndreytsevaO. I.СалиенкоА. А.SaliyenkoA. A.ЧжаоА. В.ChzhaoA. V.НИИ скорой помощи им. Н.В. СклифосовскогоRussian Federation2010300420102022024Copyright © Сюткин В.Е., Андрейцева О.И., Салиенко А.А., Чжао А.В., 20102010Сюткин В.Е., Андрейцева О.И., Салиенко А.А., Чжао А.В.Syutkin V.Y., Andreytseva O.I., Saliyenko A.A., Chzhao A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/1508

Цель исследования. Оценить эффективность вакцинации против гепатита B больных, находящихся в Листе ожидания трансплантации печени, в профилактике развития гепатита В трансплантата de novo.Материал и методы. Проанализированы результаты вакцинации против гепатита В у 41 больного циррозом печени, находящихся в Листе ожидания ортотопической трансплантации печени (ОТП), и динамика сывороточных маркеров HBV у 72 пациентов до и после ее проведения.Результаты. Только у 9 (22%) больных, вакцинированных против гепатита В, содержание анти­HBs к моменту проведения ОТП составляло более 100 мМЕ/мл. У трети пациентов, у которых до операции отсутствовали признаки перенесенной HBV­инфекции, после ОТП были выявлены анти­HBc. У половины из них отмечено развитие HBV­инфекции трансплантата de novo. Наличие анти­HBs в сыворотке крови реципиентов препятствовало развитию HBV­инфекции даже в случае появления анти­HBc после ОТП.Заключение. Вакцинация против гепатита В больных циррозом печени, этиологически не связанным с HBV­-инфекцией, стандартными дозами вакцины по ускоренной схеме в большинстве случаев не позволяет обеспечить эффективный и устойчивый иммунитет и не предотвращает развитие HBV- ­инфекции в трансплантате de novo.

Aim of investigation

Aim of investigation. To estimate the efficacy of vaccination against hepatitis B in patients in the Waiting list for liver transplantation, in prophylaxis of de novo infection of a graft.

Material and methods

Material and methods. Results of vaccination against hepatitis B in 41 patients with liver cirrhosis included into the Waiting list for orthotopic liver transplantation (OLT), and dynamics of HBV seromarkers in 72 patients before and after liver transplantation were analyzed.

Results

Results. Only in 9 (22%) of the patients vaccinated against hepatitis B, the level of anti-HBs to the moment of OLT was over 100 mMU/ml. At one third of patients who had no signs of HBV-infection in past history before operation, anti-HBc have been revealed after OLT. In half of them de novo graft HBV-infection developed. Presence of anti-HBs in blood serum of recipients prevented infection even if anti-HBc appeared after OLT.

Conclusion

Conclusion. Vaccination against hepatitis B of patients with liver cirrhosis, etiologically not related to HBV-infection, standard doses of vaccine under the accelerated mode in most of the cases does not provide effective and sustained immunodefence and does not prevent development of graft HBV-infection de novo.

вакцинациягепатит Вde novoтрансплантация печениvaccinationhepatitis Bde novotransplantation of the liverReferencesBarcena R., Moraleda G., Moreno J. et al. Prevention of de novo HBV infection by the presence of anti-HBs in transplanted patients receiving core antibody-positive livers // World J. Gastroenterol. – 2006. – Vol. 12, N 13. – P. 2070–2074.Barcena R., Moraleda G., Moreno J. et al. Prevention of de novo HBV infection by the presence of anti-HBs in transplanted patients receiving core antibody-positive livers // World J. Gastroenterol. – 2006. – Vol. 12, N 13. – P. 2070–2074.Dickson R.C., Everhart J.E., Lake J.R. et al. Transmission of hepatitis B by transplantation of livers from donors positive for antibody to hepatitis B core antigen. The National Institute of Diabetes and Digestive and Kidney Diseases Liver Transplantation Database // Gastroenterology. – 1997. – Vol. 113, N 5. – P. 1668–1674.Dickson R.C., Everhart J.E., Lake J.R. et al. Transmission of hepatitis B by transplantation of livers from donors positive for antibody to hepatitis B core antigen. The National Institute of Diabetes and Digestive and Kidney Diseases Liver Transplantation Database // Gastroenterology. – 1997. – Vol. 113, N 5. – P. 1668–1674.Douglas D.D., Rakela J., Wright T.L. et al. The clinical course of transplantation-associated de novo hepatitis B infection in the liver transplant recipient // Liver Transplant. – 1997. – Vol. 3, N 2. – P. 105–111.Douglas D.D., Rakela J., Wright T.L. et al. The clinical course of transplantation-associated de novo hepatitis B infection in the liver transplant recipient // Liver Transplant. – 1997. – Vol. 3, N 2. – P. 105–111.Engler S.H., Sauer P.W., Golling M. et al. Immunogenicity of two accelerated hepatitis B vaccination protocols in liver transplant candidates // Eur. J. Gastroenterol. Hepatol. – 2001. – Vol. 13, N 4. – P. 363–367.Engler S.H., Sauer P.W., Golling M. et al. Immunogenicity of two accelerated hepatitis B vaccination protocols in liver transplant candidates // Eur. J. Gastroenterol. Hepatol. – 2001. – Vol. 13, N 4. – P. 363–367.Fabia R., Levy M.F., Crippin J. et al. De novo hepatitis B infection after liver transplantation: sources of disease, incidence and impact // Liver Transplant. – 1998. – Vol. 4, N 1. – P. 119–127.Fabia R., Levy M.F., Crippin J. et al. De novo hepatitis B infection after liver transplantation: sources of disease, incidence and impact // Liver Transplant. – 1998. – Vol. 4, N 1. – P. 119–127.Horlander J.C., Boyle N., Manam R. et al. Vaccination against hepatitis B in patients with chronic liver disease awaiting liver transplantation // Am. J. Med. Sci. – 1999. – Vol. 318, N 5. – P. 304–307.Horlander J.C., Boyle N., Manam R. et al. Vaccination against hepatitis B in patients with chronic liver disease awaiting liver transplantation // Am. J. Med. Sci. – 1999. – Vol. 318, N 5. – P. 304–307.Idilman R., Colantoni A., De Maria N. et al. Impaired antibody response rates after high dose short interval hepatitis B virus vaccination of immunosuppressed individuals // Hepatogastroenterology. – 2003. – Vol. 50, N 49. – P. 217–221.Idilman R., Colantoni A., De Maria N. et al. Impaired antibody response rates after high dose short interval hepatitis B virus vaccination of immunosuppressed individuals // Hepatogastroenterology. – 2003. – Vol. 50, N 49. – P. 217–221.Kallinowski B., Benz C., Bucholz L. et al. Accelerated schedule of hepatitis B vaccination in liver transplant candidates // Transplant. Proc. – 1998. – Vol. 30, N 3. – P. 797–799Kallinowski B., Benz C., Bucholz L. et al. Accelerated schedule of hepatitis B vaccination in liver transplant candidates // Transplant. Proc. – 1998. – Vol. 30, N 3. – P. 797–799Mattos A.A., Gomes E.B., Tovo C.V. et al. Hepatitis B vaccine efficacy in patients with chronic liver disease by hepatitis C virus // Gastroenterology. – 2004. – Vol. 41, N 3. – P. 180–184Mattos A.A., Gomes E.B., Tovo C.V. et al. Hepatitis B vaccine efficacy in patients with chronic liver disease by hepatitis C virus // Gastroenterology. – 2004. – Vol. 41, N 3. – P. 180–184Pascasio J.M., Aoufi S., Gash A. Response to a vaccination schedule with 4 doses of 40 microg against hepatitis B virus in cirrhotic patients evaluated for liver transplantation // Transplant. Proc. – 2008. – Vol. 40, N 9. – P. 2943–2945Pascasio J.M., Aoufi S., Gash A. Response to a vaccination schedule with 4 doses of 40 microg against hepatitis B virus in cirrhotic patients evaluated for liver transplantation // Transplant. Proc. – 2008. – Vol. 40, N 9. – P. 2943–2945Prieto M., Gomez M., Berenguer M. et al. De novo hepatitis B after liver transplantation from hepatitis B core antibody–positive donors in an area with high prevalence of anti-HBc positivity in the donor population // Liver Transplant. – 2001. – Vol. 7, N 1. – P. 51–58.Prieto M., Gomez M., Berenguer M. et al. De novo hepatitis B after liver transplantation from hepatitis B core antibody–positive donors in an area with high prevalence of anti-HBc positivity in the donor population // Liver Transplant. – 2001. – Vol. 7, N 1. – P. 51–58.Roche B., Samuel D., Gigou M. et al. De novo and apparent de novo hepatitis B virus infection after liver transplantation // J. Hepatol. – 1997. – Vol. 26, N 3. – P. 517–526.Roche B., Samuel D., Gigou M. et al. De novo and apparent de novo hepatitis B virus infection after liver transplantation // J. Hepatol. – 1997. – Vol. 26, N 3. – P. 517–526.Roque-Afonso A.M., Feray C., Samuel D. et al. Antibodies to hepatitis B surface antigen prevent viral reactivation in recipients of liver grafts from anti-HBC positive donors // Gut. – 2002. – Vol. 50, N 1. – P. 95–99.Roque-Afonso A.M., Feray C., Samuel D. et al. Antibodies to hepatitis B surface antigen prevent viral reactivation in recipients of liver grafts from anti-HBC positive donors // Gut. – 2002. – Vol. 50, N 1. – P. 95–99.Su W.J., Ho M.C., Ni Y.H. et al. High-titer antibody to hepatitis B surface antigen before liver transplantation can prevent de novo hepatitis B infection // J. Pediatr. Gastroenterol. Nutr. – 2009. – Vol. 48, N 2. – P. 203–208.Su W.J., Ho M.C., Ni Y.H. et al. High-titer antibody to hepatitis B surface antigen before liver transplantation can prevent de novo hepatitis B infection // J. Pediatr. Gastroenterol. Nutr. – 2009. – Vol. 48, N 2. – P. 203–208.

The authors declare that there are no conflicts of interest present.