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An extra priming dose of hepatitis A vaccine to adult patients with rheumatoid arthritis and drug induced immunosuppression: A prospective, open-label, multi-center study
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2018 (English)In: Travel Medicine and Infectious Disease, ISSN 1477-8939, E-ISSN 1873-0442, Vol. 21, p. 43-50Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Previous studies have indicated that a pre-travel single dose of hepatitis A vaccine is not sufficient as protection against hepatitis A in immunocompromised travelers. We evaluated if an extra dose of hepatitis A vaccine given shortly prior to traveling ensures seroconversion.

METHOD:

Patients with rheumatoid arthritis (n = 69, median age = 55 years) treated with Tumor Necrosis Factor inhibitor(TNFi) and/or Methotrexate (MTX) were immunized with two doses of hepatitis A vaccine, either as double dose or four weeks apart, followed by a booster dose at six months. Furthermore, 48 healthy individuals, median age = 60 years were immunized with two doses, six months apart. Anti-hepatitis A antibodies were measured at 0, 1, 2, 6, 7 and 12 months.

RESULTS:

Two months after the initial vaccination, 84% of the RA patients had protective antibodies, compared to 85% of the healthy individuals. There was no significant difference between the two vaccine schedules. At twelve months, 99% of RA patients and 100% of healthy individuals had seroprotective antibodies.

CONCLUSION:

An extra priming dos of hepatitis A vaccine prior to traveling offered an acceptable protection in individuals treated with TNFi and/or MTX. This constitutes an attractive pre-travel solution to this vulnerable group of patients.

Place, publisher, year, edition, pages
2018. Vol. 21, p. 43-50
Keywords [en]
Hepatitis A, Immunosuppression, Methotrexate, Rheumatoid arthritis, TNF-Inhibitors, Vaccine
National Category
Infectious Medicine
Identifiers
URN: urn:nbn:se:uu:diva-342510DOI: 10.1016/j.tmaid.2017.12.004ISI: 000426614600006PubMedID: 29229311OAI: oai:DiVA.org:uu-342510DiVA, id: diva2:1184523
Available from: 2018-02-21 Created: 2018-02-21 Last updated: 2018-05-16Bibliographically approved

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Rombo, Lars

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Centrum för klinisk forskning i Sörmland (CKFD)
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