The authors wrote, “Hepatitis B virus (HBV) vaccination is recommended for solid organ transplant (SOT) candidates. However, there is a lack of data on the HBV vaccine compliance, serologic response, and durability of HBV seroprotection in thoracic organ transplantation recipients.”
This retrospective study cohort included adult heart and lung transplant candidates who obtained hepatitis B vaccinations at Mayo Clinic sites in Minnesota, Arizona, and Florida from January 2018 to August 2023.
The primary objective was to describe the clinical characteristics and vaccine adherence of SOT candidates needing HBV vaccination and identify vaccine-induced hepatitis B surface antibody seroprotection pretransplantation predictors. The secondary objective was to evaluate the incidence and risk factors for loss of HBV seroprotection 30 days posttransplantation (D30).
Conventional recombinant hepatitis B vaccine was utilized before 2020, and Heplisav-B was the preferred HBV vaccine after 2020.
The authors wrote, “HBV seroprotection was defined as hepatitis B surface antibody (HBsAb) ≥10 IU/L. Furthermore, we compared characteristics between recipients who maintained HBV seroprotection and those who lost HBV seroprotection (HBsAb <10 IU/L) at 30 days posttransplantation (D30).”
The results revealed that among 922 candidates who were eligible for HBV vaccination, 430 (47%) completed the HBV vaccine series. Completion rates were higher for the two-dose Heplisav-B vaccine (81%) compared with the three-dose HBV vaccine (60%; P <.001). Seroprotection rates were also higher with the two-dose series Heplisav-B (75%) compared with the conventional recombinant three-dose series HBV vaccine (64%; P = .023).
Additionally, multivariate logistic regression analysis identified receiving Heplisav-B as an independent predictor for HBV seroprotection (adjusted odds ratio [aOR] 1.723; 95% CI, 1.056-2.810; P = .029).
The authors indicated that 145 thoracic organ transplant recipients attained HBV seroprotection at the date of transplantation, and loss of HBV seroprotection transpired in 38 patients (26%) patients at D30.
The authors wrote, “Multivariate logistic regression analysis identified two predictors for HBV seroprotection loss at D30: age ≥ 60 years (aOR, 2.503; 95% CI, 1.026-6.107; P = .044) and pretransplant HBsAb level between 10 and 100 IU/L (aOR, 18.575; 95% CI, 5.211-66.209; P <.001).”
Based on their findings, the authors noted, “Heplisav-B vaccine demonstrates superior compliance and higher seroprotection than the conventional three-dose series of hepatitis B vaccines in thoracic organ transplant candidates. Heplisav-B should be the preferred Hepatitis B vaccine in the pretransplant setting for this population.”
The authors stressed that clinicians should be aware of the augmented loss of HBV seroprotection in thoracic organ transplant recipients who are aged 60 years or older and have pretransplant HBsAb levels between 10 and 100 IU/L and also highlighted the significance of assessing seroprotection after HBV vaccination during the pretransplant period.
The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.
