Background and Aims: In Egypt, compulsory vaccination against
hepatitis B virus (HBV) infection started in 1992. Patients with
chronic hepatitis C (CHC) should be vaccinated against HBV. The
aim was to assess the response to HBV vaccine in CHC patients
treated with direct acting antivirals (DDAs) in comparison to
treatment-naive patients and healthy subjects. Method: This
retrospective-prospective study was carried out on 360 consecutive
adult subjects subdivided into 3 groups. Group I included 150 CHC
patients who vaccinated after getting sustained virologic response
(SVR) following treatment with DAAs. Group II comprised 110
CHC treatment- naive patients while the control group comprised
100 healthy subjects. Three intramuscular 20 µg doses (at 0, 1 & 6
months) of HBV-vaccine (rDNA) were administered; HBs Ab titres
were evaluated 6 – 8 weeks after the 3rd dose. Results: CHC
patients (treated or treatment-naïve) had highly significant lower
mean HBs Ab titre than controls. Twelve patients in group I (8%)
had no response to HBV vaccine in comparison to 4.5% in group II
and 1% controls. About 83.3%in group I compared to 85.5% in
group II and 98% controls had a good response. In CHC treated
patients, HBsAb titre was negatively associated with FIB-4 score, fibrosis stage and ALT levels
while positively associated with platelet count. The fibrosis stage was the most significant
predictor of weak response. Conclusion: CHC Patients demonstrate a significantly weak
response to HBV vaccine. Concomitant DAAs treatment does not influence response.
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