TY - JOUR
T1 - Hepatitis A vaccine for immunosuppressed patients with rheumatoid arthritis: A prospective, open-label, multi-centre study
AU - Askling, Helena H.
AU - Rombo, Lars
AU - van Vollenhoven, Ronald
AU - Hallén, Ingemar
AU - Thörner, Åke
AU - Nordin, Margareta
AU - Herzog, Christian
AU - Kantele, Anu
PY - 2014
Y1 - 2014
N2 - Background: Hepatitis A vaccine is the most frequently used travel vaccine, yet data are scarce about its ability to induce protection in patients with concurrent immunosuppressive treatment. We assessed the immunogenicity of this vaccine in rheumatoid arthritis (RA) patients treated with tumour necrosis factor-inhibitors (TNFi) and/or methotrexate (MIX). Methods: Hepatitis A vaccine was administered to non-immune RA patients at 0 and 6 months. Hepatitis A virus (HAV) antibodies were assessed at 0, 1, 6, 7, 12, and 24 months with a quantitative Chemiluminescent Microparticle Immuno Assay (CMIA) for HAV-IgG. Samples from month 1, 6, and 7 were, in addition, analysed with a microparticle EIA (MEIA) for anti-HAV IgM + IgG. Results: The final study population consisted of 53 patients treated with TNFi (n = 15), TNFi + MIX (n = 21) or MIX (n = 17). One and six months after the first dose, 10% and 33% of the patients had attained seroprotection. One and six months after the second dose 83% and 72% were seroprotected. At month 24, 86% of the vaccinees showed protective levels. Conclusions: Two doses of hepatitis A vaccine at a 6-month interval provided protection for most immunosuppressed RA patients. A single dose does not seem to afford sufficient protection to this group of patients. (C) 2014 The Authors. Published by Elsevier Ltd
AB - Background: Hepatitis A vaccine is the most frequently used travel vaccine, yet data are scarce about its ability to induce protection in patients with concurrent immunosuppressive treatment. We assessed the immunogenicity of this vaccine in rheumatoid arthritis (RA) patients treated with tumour necrosis factor-inhibitors (TNFi) and/or methotrexate (MIX). Methods: Hepatitis A vaccine was administered to non-immune RA patients at 0 and 6 months. Hepatitis A virus (HAV) antibodies were assessed at 0, 1, 6, 7, 12, and 24 months with a quantitative Chemiluminescent Microparticle Immuno Assay (CMIA) for HAV-IgG. Samples from month 1, 6, and 7 were, in addition, analysed with a microparticle EIA (MEIA) for anti-HAV IgM + IgG. Results: The final study population consisted of 53 patients treated with TNFi (n = 15), TNFi + MIX (n = 21) or MIX (n = 17). One and six months after the first dose, 10% and 33% of the patients had attained seroprotection. One and six months after the second dose 83% and 72% were seroprotected. At month 24, 86% of the vaccinees showed protective levels. Conclusions: Two doses of hepatitis A vaccine at a 6-month interval provided protection for most immunosuppressed RA patients. A single dose does not seem to afford sufficient protection to this group of patients. (C) 2014 The Authors. Published by Elsevier Ltd
U2 - https://doi.org/10.1016/j.tmaid.2014.01.005
DO - https://doi.org/10.1016/j.tmaid.2014.01.005
M3 - Article
C2 - 24529746
SN - 1477-8939
VL - 12
SP - 134
EP - 142
JO - Travel medicine and infectious disease
JF - Travel medicine and infectious disease
IS - 2
ER -