One-year vaccination against hepatitis B virus with a MPL-vaccine in liver transplant patients for HBV-related cirrhosis

Transpl Int. 2010 Nov;23(11):1105-12. doi: 10.1111/j.1432-2277.2010.01104.x. Epub 2010 Aug 19.


Conflicting results have been reported on vaccination against hepatitis B virus (HBV) as a prophylaxis against viral recurrence after liver transplantation. We investigated the efficacy of 1-year, monthly vaccination using an adjuvant 3-deacylated monophosphoryl-lipid-A (MPL) recombinant S vaccine initially administered together with hepatitis B immunoglobulins (HBIg) in 18 patients transplanted for HBV-related cirrhosis. All received 12 vaccine doses (HBsAg, 20 mcg plus MPL, 50 mcg): the initial six doses (phase I) were administered within 7days after intravenous HBIg (2000IU), while the last 6 (phase II) following HBIg withdrawal. All patients received lamivudine during the study. Anti-HBs titers were determined before each dose and then for 1year after vaccination. After phase I anti-HBs titers were greater than 100IU/l in all patients and in three (16.6%) were greater than 500IU/l. After phase II 10 patients (55.5%) achieved anti-HBs titers greater than 100IU/l and five (27.7%) greater than 500IU/l. One year after vaccination eight patients (44.4%) maintained anti-HBs titers greater than 100IU/l, with a median titer of 234IU/l (102-1205), and 2 (11.1%) greater than 500IU/l. One-year extended monthly vaccination with a MPL-adjuvant recombinant vaccine induces a sustained protective anti-HBs response in approximately half of transplant recipients.

MeSH terms

  • Adult
  • Female
  • Fibrosis / prevention & control*
  • Fibrosis / virology*
  • Hepatitis B / complications*
  • Hepatitis B / prevention & control*
  • Hepatitis B Vaccines / therapeutic use*
  • Hepatitis B virus / chemistry
  • Hepatitis B virus / immunology*
  • Humans
  • Immunoglobulins / chemistry
  • Lipid A / analogs & derivatives
  • Lipid A / chemistry
  • Liver Transplantation / methods*
  • Male
  • Middle Aged
  • Time Factors
  • Treatment Outcome
  • Vaccines, Synthetic / chemistry


  • Hepatitis B Vaccines
  • Immunoglobulins
  • Lipid A
  • Vaccines, Synthetic
  • monophosphoryl lipid A