Accelerated schedule of hepatitis B vaccination in patients with hemophilia

E. Santagostino, P. M. Mannucci, A. Gringeri, M. G. Rumi, D. Rafanelli, A. Rocino, M. Schiavoni, A. Chistolini, E. Di Bona, G. Muleo

Research output: Contribution to journalArticlepeer-review


Early development of immunity after hepatitis B vaccination is particularly important for patients such as hemophiliacs, at high risk for acquiring hepatitis B from potentially infectious plasma-derived concentrates. The purpose of this study was to evaluate whether or not predictive antibody titers could be achieved quickly and maintaine in hemophiliacs by an accelerated vaccination schedule. A yeast-recombinant hepatitis B vaccine (Engerix B, SKF Ritt) was given subcutaneously in the deltoid region and repeated 2 and 6 weeks later to 85 hemophiliacs negative for hepatitis B virus (HBV) markers. After the first 22 patients had been enrolled, a modification of the schedule involving a fourth booster dose 24 weeks after the first dose of vaccine was applied to the next 63 consecutive vaccinees. Fifty-three percent of vaccinees had antibody titers to hepatitis B surface antigen (anti-HBs ≥10 mIU/ml) by week 6, even though the mean titers of anti-HBs were somewhat lower than those achieved historically in normal individuals. The protection rate had increased to 87% by week 10, one month after the third dose of vaccine, and to 93% by week 24. One year after starting vaccination, the rate for the vaccinees who did not receive the fourth booster dose was 71%, and 96% for those who did receive the fourth dose, with only 2 patients not responding despite the booster dose. It is concluded that even though the accelerated schedule of immunization produced rapidly high rates of protective antibody titers, a booster dose is required to obtain higher titers and provide more persistent immunity.

Original languageEnglish
Pages (from-to)95-98
Number of pages4
JournalJournal of Medical Virology
Issue number2
Publication statusPublished - 1993


  • HBV
  • Hemophiliacs
  • Protection
  • Vaccine

ASJC Scopus subject areas

  • Virology


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