Hepatitis B vaccine seroprotection in children with liver transplant and response to the booster dose

Abstract

Introduction: Vaccine-preventable infections cause complications in children who have undergone liver transplants, notably the hepatitis B virus (HBV). Vaccine-induced protection against HBV may decrease after a liver transplant.

Objective: To determine the proportion of liver transplant recipients who maintain seroprotection following HBV vaccination and their response to the booster dose.

Materials and Methods: Demographic, clinical, and immunization data, as well as titers of antibodies to hepatitis B surface antigen (anti‑HBs), were retrospectively assessed for patients aged under 18 years who underwent liver transplants between 1 January 2013, and 31 December 2022. An antibody level greater than 10 IU/L was considered protective.

Results: 48 patients with liver transplants were analyzed; all had received at least three doses of the HBV vaccine prior to the transplant.  The percentage of anti-HBs levels in the protective range was 6.2% (three patients); in five cases, a booster dose was administered.

Conclusions: Seroprotection from HBV vaccination is lost in a high proportion of patients after receiving a liver transplant.  It can be improved with a booster dose, and it is important to continue serological monitoring of these patients.