Rapid decline of antibodies after hepatitis A immunization in liver and renal transplant recipients

Background. Hepatitis A vaccine is safe and achieves good seroconversion ra tes in liver (LTX) and renal (RTX) transplant recipients. Methods. A study was performed to determine the anti-hepatitis A virus (HAV) antibody declin e in LTX and RTX patients, and in healthy controls who have been immunized with two doses of hepatitis A vaccine. Results. LTX and RTX patients had a satisfactory seroconversion rate after complete immunisation. However, 2 years later they had experienced a much m ore rapid antibody decline than controls, and only 59% of LTX and 26% of RT X seroconverters showed titres above the cut-off level defined as protectiv e. Conclusions. Patients on immunosuppressive therapy may not be adequately pr otected against hepatitis A a few years after vaccination and alternative v accination schemes may have to be considered.