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Thromb Haemost 1994; 72(04): 508-510
DOI: 10.1055/s-0038-1648904
Original Article
Schattauer GmbH Stuttgart

Patterns of Immunogenicity of an Inactivated Hepatitis A Vaccine in Anti-HIV Positive and Negative Hemophilic Patients

E Santagostino
1   Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Institute of Internal Medicine IRCCS, Maggiore Hospital and University of Milan, Italy
,
A Gringeri
1   Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Institute of Internal Medicine IRCCS, Maggiore Hospital and University of Milan, Italy
,
A Rocino
2   Hematology Department, Nuovo Pellegrini Hospital, Napoli, Italy
,
A Zanetti
3   Virology Institute, University of Milan, Italy
,
R de Biasi
2   Hematology Department, Nuovo Pellegrini Hospital, Napoli, Italy
,
P M Mannucci
1   Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Institute of Internal Medicine IRCCS, Maggiore Hospital and University of Milan, Italy
› Author Affiliations
Further Information

Publication History

Received: 18 April 1994

Accepted after revision23 June 1994

Publication Date:
06 July 2018 (online)

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Summary

Hepatitis A vaccination has been recommended to patients with hemophilia since they are exposed to potentially infectious clotting factor concentrates. Aim of this study was to assess the immunogenicity of vaccination in hemophiliacs, infected or not with the human immunodeficiency virus (HIV). A formalin-inactivated hepatitis A vaccine was injected subcutaneously to 113 susceptible adults and children and repeated after 1 and 6 months. 47 vaccinees were anti-HIV positive (28 asymptomatic, 15 with CD4 cell counts of less than 200/pl and 4 with symptomatic disease). The first dose of vaccine induced seroconversion, with antibody titers of at least 20 mlU/ml, in 89% of the 66 anti-HIV negative patients, 100% of them responding after the second injection. In anti-HIV positive hemophiliacs seroconversion rates and antibody titers were significantly lower than in non-infected patients. After 12 months, only 76% of anti-HIV positive vaccinees and 40% of those with signs of HIV disease progression maintained the antibody, whereas all anti-HIV negative patients had titers of 20 mlU/ml or more. Our results indicate that there is an association between defective response to hepatitis A vaccine and stage of progression of HIV disease.

 

  • References

  • 1 Mannucci PM. Outbreak of hepatitis A among Italian patients with hemophilia. Lancet 1992; 339: 819
    PubMedGoogle Scholar
  • 2 Gerritzen A, Schneweis KE, Brackmann HH, Oldenburg J, Hanfland P, Gerlich WH, Caspari G. Acute hepatitis A in hemophiliacs. Lancet 1992; 340: 1231-1232
    PubMedGoogle Scholar
  • 2 Temperley IJ, Cotter KP, Walsh TJ, Power J, Hillary IB. Clotting factors and hepatitis A. Lancet 1992; 340: 1466
    CrossrefPubMedGoogle Scholar
  • 4 Peerlinck K, Vermylen J. Acute hepatitis A in patients with hemophilia A. Lancet 1993; 341: 179
    PubMedGoogle Scholar
  • 5 Horowitz B, Wiebe M, Lippin A, Strycker MH. Inactivation of viruses in labile blood derivates. Disruption of lipid-enveloped viruses by tri(n-butyl)phosphate detergent combinations. Transfusion 1985; 25: 516-522
    PubMedGoogle Scholar
  • 6 Mannucci PM, Gdovin S, Gringeri A, Colombo M, Mele A, Schinaia N, Ciavarella N, Emerson SU, Purcell RH. Transmission of hepatitis A to patients with hemophilia by factor VIII concentrates treated with organic solvent and detergent to inactivate viruses. Ann Intern Med 1994; 119: 1-7
    PubMedGoogle Scholar
  • 7 Tilzey AT, Palmer SJ, Barrow S, Perry KR, Tyrrell H, Safary A, Banatvala JE. Clinical trial with inactivated hepatitis A vaccine and recommendations for its use. Br Med J 1992; 304: 1272-1276
    CrossrefPubMedGoogle Scholar
  • 8 Davidson M, Krugman S, Sandman LA. Inactivated hepatitis A vaccine: a safety and immunogenicity study in health professionals. Vaccine 1992; 10 (Suppl. 01) 119-120
    CrossrefPubMedGoogle Scholar
  • 9 Papaevangelou G, Totos GR, Roumeliotou A, Safary A, Hepatitis A. vaccination in Greek military recruits. J Med Virol 1993; 40: 1-4
    CrossrefPubMedGoogle Scholar
  • 10 Zanetti AR, Mannucci PM, Tanzi E, Moroni GA, De Paschale M, Morfini M, Carnelli V, Tirindelli MC, De Biasi R, Ciavarella N, De Rosa V, Rodeghiero F, Colombo M. Hepatitis B vaccination of 113 hemophiliacs: lower antibody response in anti-LAV/HTLV-III-positive patients. Am J Hematol 1986; 23: 339-345
    CrossrefPubMedGoogle Scholar
  • 11 Mannucci PM, Zanetti AR, Gringeri A, Tanzi E, Morfini M, Messori A, Tirindelli MC, De Biasi R, Ciavarella N, Colombo M. Long-term immunogenicity of a plasma-derived hepatitis B vaccine in HIV seropositive and HIV seronegative hemophiliacs. Arch Intern Med 1989; 149: 1333-1337
    CrossrefPubMedGoogle Scholar
  • 12 Andre FE, Hepburn A, D’Hondt E. Inactivated candidate vaccines for hepatitis A. In: Progress in Medical Virology Melnick JL. (ed) Basel; Karger: 1990. 37 72-95
  • 13 Hadler SC. Hepatitis B prevention and human immunodeficiency virus (HIV) infection. Ann Intern Med 1988; 109: 92-94
    CrossrefPubMedGoogle Scholar
  • 14 Rumi MG, Colombo M, Romeo R, Boschini A, Zanetti AR, Gringeri A, Mannucci PM. Suboptimal response to hepatitis B vaccine in drug users. Arch Intern Med 1991; 151: 574-578
    CrossrefPubMedGoogle Scholar
  • 15 Mueller R, Chriske H, Deinhardt F, Jilg J, Theilmann L, Hess C, Hofmann F, Hopf U, Stickl H, Maiwald H, Bienzle U, Scoefeld C, Zimmermann H, Dietrich M, May B, Bock HL, Clemens R, Bogaerts H. Hepatitis A vaccination: schedule for accelerated immunization. Vaccine 1992; 10 (Suppl. 01) 124-125
    CrossrefPubMedGoogle Scholar
  • 16 Jilg W, Bittner R, Bock HL, Clemens R, Schaetzl H, Schmidt M, Andre FE, Deinhardt F. Vaccination against hepatitis A: comparison of different shortterm immunization schedules. Vaccine 1992; 10 (Suppl. 01) 126-128
    CrossrefPubMedGoogle Scholar