Failure of passively administered antibody to hepatitis B surface antigen to augment the immune response of a low-responder population to hepatitis B vaccination.
Sixteen renal dialysis patients with documented failure to respond to hepatitis B vaccination in the past were administered passive antibody to hepatitis B surface antigen (anti-HBs) 2 weeks prior to revaccination in an attempt to augment their response to the vaccine. Although 15/16 patients were seropositive for anti-HBs at 1, 3, and/or 6 months following vaccine boost, only 2/13 (15%) remained positive at 12 months, suggesting that the positive findings in the remaining individuals were a result of either passively acquired anti-HBs and/or an active but transient response to the vaccine. As response rates of approximately 5-30% have been reported previously in this population with a vaccine boost in the absence of pre-vaccine passive immunoprophylaxis, these results do not support the use of combined passive/active immunoprophylaxis to augment the immune response to HBV vaccine in low-responder groups.