Immunogenicity and safety of hepatitis A vaccine in liver and renal transplant recipients

Organ transplant recipients with chronic hepatitis B or hepatitis C virus i nfection may be at increased risk of fulminant hepatitis A. Liver transplan t (LTX) recipients, renal transplant (RTX) recipients, and healthy controls received 2 doses of hepatitis A vaccine 6 months apart. Anti-hepatitis A v irus (anti-HAV) seroconversion after the primary dose occurred in 41% of th e LTX patients, 24% of the RTX patients, and 90% of the controls. After the booster dose, the respective rates were 97%, 72%, and 100% (P<.001). RTX: patients also had significantly lower geometric mean titers (GMTs) of anti- HAV than LTE: patients and controls. In the RTX group, the seroconversion r ate and GMT were inversely associated with the number of immunosuppressive drugs received by the patients. The vaccine was well tolerated. Hepatitis A vaccine can be recommended to LTX and RTX patients, but the patients shoul d receive a full course of 2 doses before imminent exposure.