Immune response of patients with congenital coagulation disorders to hepatitis b vaccine: Suboptimal response and human immunodeficiency virus infection

Seventy‐eight patients with congenital coagulation disorders were treated with hepatitis B vaccine either subcutaneously or intradermally. All the children (eight vaccinated subcutaneously and eight vaccinated intradermally) responded. Seventeen of 19 (90%) anti‐HIV‐negative adults vaccinated subcutaneously and 14/25 (56%) anti‐HIV‐negative adults vaccinated intradermally showed an immune response. At 24 months, the anti‐HBs level was > 10 IU/I in all children vaccinated subcutaneously, 83% of children vaccinated intradermally, 77% of adults vaccinated subcutaneously, and 55% of adults vaccinated intradermally. Eight of 15 (53%) adult patients who were anti‐HIV positive were also anti‐HBc positive before vaccination and 6/8 (75%) failed to produce an amnestic response to vaccine. Subcutaneous vaccination with regular monitoring of anti‐HBs levels and appropriate boosting is recommended.