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Meta-Analysis
. 2015 Jul 21;10(7):e0133464.
doi: 10.1371/journal.pone.0133464. eCollection 2015.

Comparison of Accelerated and Standard Hepatitis B Vaccination Schedules in High-Risk Healthy Adults: A Meta-Analysis of Randomized Controlled Trials

Hui Jin  1 , Zhaoying Tan  2 , Xuefeng Zhang  2 , Bei Wang  1 , Yueyuan Zhao  1 , Pei Liu  1
Affiliations
Meta-Analysis

Comparison of Accelerated and Standard Hepatitis B Vaccination Schedules in High-Risk Healthy Adults: A Meta-Analysis of Randomized Controlled Trials

Hui Jin et al. PLoS One. .

Abstract

Background: Selecting the most efficient vaccination schedule is an important issue.

Objective: To assess the beneficial and harmful effects of accelerated hepatitis B vaccination schedules in high-risk healthy adults.

Methods: We searched controlled trial registers of The Cochrane Library as well as MEDLINE, EMBASE, VIP Database for Chinese Technical Periodicals, and the Chinese National Knowledge Infrastructure databases for randomized controlled trials published up to December 2013 that compared accelerated hepatitis B vaccine schedules to the standard schedule in adults. The results were presented as relative risk with 95% confidence intervals. Fixed or random effect models were used for analysis.

Results: We identified 10 randomized trials, all with one or more methodological weaknesses. Compared to the standard schedule, most accelerated schedules resulted in higher proportions of healthy vaccines more rapidly reaching anti-hepatitis B antibody levels >10 IU/L (P<0.05) initially and maintaining similar seroprotection rates after 6 months (P>0.05). Although accelerated schedules produced anti-hepatitis B levels higher than the standard schedule for the first month after the initial vaccine dose, they were significantly lower than the standard schedule after 6 months, except for an accelerated schedule that called for a fourth booster injection 12 months after the initial dose. Subjects administered accelerated vaccine schedules had similar compliance rate as those administered the standard schedule over the first 6 months of vaccination (relative risk = 1.00, 95% confidence interval: 0.84-1.21).

Conclusion: For rapid seroconversion and almost immediate short-term protection, accelerated vaccination schedules could be useful for at-risk groups. However, additional studies on the long-term protection and effectiveness of the primary doses of accelerated schedules are necessary.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of included studies.
Fig 2
Fig 2. Forest plots showing protective rate comparisons between accelerated and standard schedules for intention-to-treat analysis at 1 month after initial dose.
Fig 3
Fig 3. Forest plots showing protective rate comparisons between accelerated and standard schedules for intention-to-treat analysis at 3 month after initial dose.
Fig 4
Fig 4. Forest plots showing protective rate comparisons between accelerated and standard schedules for intention-to-treat analysis at 7 month after initial dose.
Fig 5
Fig 5. Forest plots showing protective rate comparisons between accelerated and standard schedules for intention-to-treat analysis at 12 month after initial dose.
Fig 6
Fig 6. Forest plots showing protective rate comparisons between accelerated and standard schedules for intention-to-treat analysis at 22 month after initial dose.
Fig 7
Fig 7. Seroprotection rate changes for different vaccination schedules according to months after initial dose.
Fig 8
Fig 8. Log10 antibody titer changes for different vaccination schedules according to months after initial dose.
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References

    1. Perz JF, Armstrong GL, Farrington LA, Hutin YJ, Bell BP. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. 2006. J Hepatol; 45(4):529–38. - PubMed
    1. Rich JD, Ching CG, Lally MA, Gaitanis MM, Schwartzapfel B, Charuvastra A, et al. A review of the case for hepatitis B vaccination of high-risk adults. Am J Med. 2003; 114(4):316–8. - PubMed
    1. Goldstein ST, Alter MJ, Williams IT, Moyer LA, Judson FN, Mottram K, et al. Incidence and risk factors for acute hepatitis B in the United States, 1982–1998: implications for vaccination programs. J Infect Dis. 2002; 185(6):713–9. - PubMed
    1. Asli AA, Moghadami M, Zamiri N, Tolide-Ei HR, Heydari ST, Alavian SM, et al. Vaccination against hepatitis B among prisoners in Iran: accelerated vs. classic vaccination. Health Policy. 2011; 100(2–3):297–304. 10.1016/j.healthpol.2010.12.007 - DOI - PubMed
    1. Wahl M, Hermodsson S, Iwarson S. Hepatitis B vaccination with short dose intervals—a possible alternative for post-exposure prophylaxis? Infection. 1988; 16(4):229–32. - PubMed

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