Hepatitis B Clinical Trial
Official title:
Immunogenicity of Booster Hepatitis B Vaccines in Children After Liver Transplantation
Aim/Background: This study aims to investigate the necessity and efficacy of a hepatitis B
virus (HBV) vaccine booster in children after liver transplantation. A universal mass
vaccination program of HBV was launched for 20 years in Taiwan. The coverage rate is high
and the effect is great. The carrier rate of the population under vaccine coverage decreased
from 10-15% to < 1%. In Taiwan, most children who receive organ transplantation were
vaccinated with HBV vaccine in infancy and well before the transplantation procedure. This
vaccination background information on Taiwanese children is quite unique and not similar to
the other countries in the world. The antibody generated by the vaccine usually wanes after
a certain period even in normal subjects, let alone in subjects who receive organ
transplantation and immunosuppressive agents after transplantation. At present, Taiwan is
still an HBV hyperendemic area and the risk of exposure to HBV cannot be overlooked. Should
children be given a booster dose of HBV vaccine after transplantation? And how about the
immunogenicity of this booster dose in these immunocompromised hosts? If these children
cannot obtain an adequate antibody titer, will the risk of HBV infection increase? This
study is designed to answer these questions. As a pediatric hepatologist, the author's
routine work is to take care of children who underwent liver transplantation. To take
advantage of this, the investigators decided to study the efficacy and necessity of HBV
booster vaccine in these patients. However, the results of this study should be able to be
applied to any kind of solid organ transplanted patients.
Method: The anti-hepatitis B surface antigen (HBs) titer will be checked in patients who
received liver transplantation > 1 year ago. If the titer is < 10 IU/L, a booster dose will
be administered. The humoral (anti-HBs) and cellular immunity (by ELISPOT to assay T and B
cell specific proliferation) and cytokine assay will be done in these patients before and
after the booster dose. A three-year follow-up will be performed to monitor the HBV
infection in these patients.
Expected Results: The investigators expect for those who survive one year more after liver
transplantation to yield a relatively good response to HBV booster under adequate
immunosuppression.
The anti-HBs titer will be checked in the patients who received liver transplantation for > 1 year. If the titer is < 10 IU/L, a booster dose will be administered. The humoral (anti-HBs) and cellular immunity (by ELISPOT to assay T and B cell specific proliferation) and cytokine assay will be done in these patients before and after the booster dose. A three-year follow-up will be performed to monitor the HBV infection in these patients. ;
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic
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