Hepatitis B vaccine improves survival for patients with chronic liver disease Latest news from doctors, nurses and pharmacists

A study presented at AASLD 2023 shows that a hepatitis B virus (HBV) vaccine significantly improves survival in patients with different types of chronic liver disease.

“Our results show that when the use of a hepatitis B surface antigen vaccine is validated, the survival rates of vaccinated patients with different types of chronic liver disease are often significantly improved,” said researchers led by Andreas Teufel of the Medical School of the University of Heidelberg Mannheim in Germany. improve.” .

“Hepatitis B vaccines have proven highly successful in preventing HBV infection and reducing the consequent hepatitis B-related disease burden in countries where vaccination has been implemented. However, few studies have reported on hepatitis B Impact of vaccination on overall survival, particularly in patients with chronic liver disease other than chronic hepatitis B,” they noted.

Teufel and colleagues evaluated a total of 57,306 patients with chronic liver disease between 2000 and 2020 through the Observational Health Data Science and Informatics (OHDSI) consortium to examine the efficacy of the hepatitis B vaccine in this group.

Among patients with chronic liver disease, 1,601 (2.79%) had received hepatitis B vaccine. Survival rates were significantly improved among vaccinated patients (p=0.000), as were those with cirrhosis (p=0.000). (AASLD 2023, Abstract 1341-C)

Subgroup analysis confirmed a significant benefit from hepatitis B vaccination (p=0.0001), particularly in patients with chronic hepatitis C (p=0.000), chronic non-alcoholic liver disease (p=0.0001) or alcoholic and non-alcoholic cirrhosis (p=0.0001 for both). No differences were observed in these benefits between genders.

“However, as 97.21% (55,706/57,306) of the population did not report immunity, further efforts must be made to improve the quality and comprehensiveness of medical records for patients with chronic liver disease,” the researchers said.

Cirrhosis

An early study of patients with cirrhosis reported low seroprotection rates even after completion of the hepatitis B vaccination series. The authors identified 11 studies after a Medline search. Overall, 961 participants were evaluated, and changes in vaccine doses and vaccination schedules were noted. (Journal of Medical Virology 2017;doi:10.1002/rmv.1942)

In patients with cirrhosis, response rates to HBV vaccination ranged from as low as 16% to as high as 87%, regardless of vaccine number and dose. Those who received the standard dose vaccine achieved seroprotection rates of 16% to 79% (mean response rate 38%), while those who received the double dose vaccine achieved better seroprotection, ranging from 26% to 87% % (average response rate 53%) ). Overall, the average response rate to hepatitis B vaccination was 47%. (Journal of Medical Virology

2017;doi:10.1002/rmv.1942)

“There are several strategies that attempt to improve immunogenicity,” the authors said. “(H)ower, additional research is strongly needed to further explore the immune response associated with confounders of adverse vaccination responses, novel strategies to improve immunogenicity, and the immune mechanisms underlying differences in hepatitis B vaccination response rates,” the author said.