Inactivated hepatitis A vaccine in Chinese patients with chronic hepatitis B infection

Background : Hepatitis B (HBV)‐infected patients have a higher morbidity and mortality when super‐infected by hepatitis A (HAV). Aim : To evaluate the immunogenicity and safety of a commercial inactivated HAV vaccine in Chinese patients with chronic HBV infection. Methods : Sixty‐five HBV‐infected patients (30 carriers, 22 chronic hepatitis, 13 cirrhosis), who were seronegative for HAV, received a dose of 1440 ELISA units of HAV vaccine at weeks 0 and 24. Twenty‐eight healthy individuals aged 18–57 years, who were seronegative for both HBV and HAV infection, also received the same vaccination regimen. Seroconversion was defined as an anti‐HAV titre ≥ 33 mIU/mL. Results : The seroconversion rates for the HBV‐infected patients at weeks 2, 4 and 24 were 72, 91 and 80%, respectively. The corresponding geometric mean titres (GMTs) were 103, 311 and 123 mIU/mL. In the healthy control group the seroconversion rates were 86, 93 and 89% at weeks 2, 4 and 24. The corresponding GMTs were 112, 158 and 250 mIU/mL. There was no difference in the seroconversion rates between the two groups, but healthy controls had a significantly higher GMT at week 24 (P=0.04). Side‐effects were more common in HBV patients. Conclusion : The HAV vaccine is equally efficacious in patients with chronic HBV infection.