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Lack of Response to Recombinant Hepatitis B Vaccine in Nonresponders to the Plasma Vaccine

Joy Y. Weissman, MD; Mark M. Tsuchiyose, MD; Myron J. Tong, PhD, MD; Ruth Co, RN; Kenneth Chin, MD; Robert B. Ettenger, MD
JAMA. 1988;260(12):1734-1738. doi:10.1001/jama.1988.03410120080031.
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Yeast recombinant hepatitis B vaccine was administered to 25 nonresponders to the plasma-derived hepatitis B vaccine. After three 10-μg doses, nine subjects (36%) produced levels of antibodies to hepatitis B surface antigen (antiHBs) of less than 2.1 sample ratio units (SRU) (nonresponders), and five (20%) developed anti-HBs of 2.1 to 9.9 SRU (hyporesponders); anti-HBs levels of 10 SRU or greater were detected at least once in 11 vaccinees (44%), but by the sixth and 12th months after the last vaccination, only three and one of these "responders," respectively, still maintained anti-HBs values of 10 SRU or greater. In these 25 subjects HLA subtyping showed a high prevalence of DR7, B8, and the combinations of DR3 and DR7 and DR4 and DR7. Our findings indicate that the yeast recombinant hepatitis B vaccine was not effective in eliciting a sustained anti-HBs response in nonresponders to the plasma hepatitis B vaccine.

(JAMA 1988;260:1734-1738)


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