Tags

Type your tag names separated by a space and hit enter

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.
Travel Med Infect Dis. 2018 Jan - Feb; 21:43-50.TM

Abstract

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, 88% 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.

Authors+Show Affiliations

School of Medical Sciences, Örebro University, SE 701 82 Örebro, Sweden; Dept. of Infectious Diseases, Örebro University Hospital, SE 701 85 Örebro, Sweden. Electronic address: anja.rosdahl@regionorebrolan.se.Swiss Tropical and Public Health Institute, CH 4051 Basel, Switzerland; University of Basel, CH 4001 Basel, Switzerland. Electronic address: herzog.ch47@gmail.com.Institute of Virology, Technical University of Munich / Helmholtz Zentrum München, 81675 Munich, Germany. Electronic address: gfrosner@gmx.net.School of Medical Sciences, Örebro University, SE 701 82 Örebro, Sweden; Dept. of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, SE 701 85 Örebro, Sweden. Electronic address: torbjorn.noren@regionorebolan.se.Centre for Clinical Research, Sörmland, Uppsala University, SE 631 88 Eskilstuna, Sweden. Electronic address: lars.rombo@gmail.com.Karolinska Institutet, Dept. of Medicine/Solna, Unit for Infectious Diseases, SE 171 76 Stockholm, Sweden; Dept. of Communicable Diseases Control and Prevention, Sörmland, SE 631 88 Eskilstuna, Sweden. Electronic address: helena.hervius.askling@ki.se.

Pub Type(s)

Clinical Study
Journal Article

Language

eng

PubMed ID

29229311

Citation

Rosdahl, Anja, et al. "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." Travel Medicine and Infectious Disease, vol. 21, 2018, pp. 43-50.
Rosdahl A, Herzog C, Frösner G, et al. 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. Travel Med Infect Dis. 2018;21:43-50.
Rosdahl, A., Herzog, C., Frösner, G., Norén, T., Rombo, L., & Askling, H. H. (2018). 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. Travel Medicine and Infectious Disease, 21, 43-50. https://doi.org/10.1016/j.tmaid.2017.12.004
Rosdahl A, et al. 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. Travel Med Infect Dis. 2018 Jan - Feb;21:43-50. PubMed PMID: 29229311.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Rosdahl,Anja, AU - Herzog,Christian, AU - Frösner,Gert, AU - Norén,Torbjörn, AU - Rombo,Lars, AU - Askling,Helena H, Y1 - 2017/12/08/ PY - 2017/08/29/received PY - 2017/12/04/revised PY - 2017/12/07/accepted PY - 2017/12/13/pubmed PY - 2018/5/26/medline PY - 2017/12/13/entrez KW - Hepatitis A KW - Immunosuppression KW - Methotrexate KW - Rheumatoid arthritis KW - TNF-Inhibitors KW - Vaccine SP - 43 EP - 50 JF - Travel medicine and infectious disease JO - Travel Med Infect Dis VL - 21 N2 - 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, 88% 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. SN - 1873-0442 UR - https://www.unboundmedicine.com/medline/citation/29229311/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_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1477-8939(17)30221-1 DB - PRIME DP - Unbound Medicine ER -