Rapid hepatitis B (HB) surface antibody (anti-HBs) loss is prevalent after liver transplantation (LT). Herein, we evaluated anti-HBs persistence after HB vaccination using two regimens in LT children. We recruited 66 previously immunized LT children with anti-HBs level of < 100 mIU/mL. Participants were randomly reimmunized with standard-three-dose (SD) and double-three-dose (DD) intramuscular HB vaccination at 0, 1, and 6 months. Anti-HBs were assessed at every outpatient visit. Antibody loss defined as anti-HBs levels < 100 mIU/mL after three-dose vaccination. After three-dose vaccination, 81.8% and 78.7% of participants in the SD and DD groups, had anti-HBs levels > 100 mIU/mL, with a geometric mean titer (GMT) of 601.68 and 668.01 mIU/mL (P = 0.983). After a mean follow-up of 2.31 years, the anti-HBs GMT was 209.81 and 212.61 mIU/mL in the SD and DD groups (P = 0.969). The number of immunosuppressants used and an anti-HBs level < 1 mIU/mL at baseline were independently associated with anti-HB loss. The DD regimen strongly increased the risk of anti-HBs loss (adjusted hazard ratio, 2.97 [1.21–7.31]; P = 0.018). The SD HB reimmunization regimen effectively maintained protective anti-HBs levels in children undergoing LT, making it the preferred regimen for such children with anti-HB loss.

Trial registration: TCTR20180723002.

肝移植 (LT) 后，乙型肝炎 (HB) 表面抗体（抗 HBs）迅速丧失是普遍现象。在此，我们评估了 LT 儿童使用两种方案接种 HB 疫苗后抗 HBs 的持续性。我们招募了 66 名先前免疫过的 LT 儿童，其抗 HBs 水平 < 100 mIU/mL。参与者在 0、1 和 6 个月时随机接受标准三剂量 (SD) 和双三剂量 (DD) 肌内 HB 疫苗接种。每次门诊就诊时都会评估抗-HBs。抗体损失定义为三剂疫苗接种后抗 HBs 水平 < 100 mIU/mL。三剂疫苗接种后，SD 组和 DD 组中 81.8% 和 78.7% 的参与者抗 HBs 水平 > 100 mIU/mL，几何平均滴度 (GMT) 分别为 601.68 和 668.01 mIU/mL ( P = 0.983 ）。平均随访 2.31 年后，SD 组和 DD 组的抗 HBs GMT 分别为 209.81 和 212.61 mIU/mL（ P = 0.969）。使用的免疫抑制剂数量和基线时抗 HBs 水平 < 1 mIU/mL 与抗 HB 损失独立相关。 DD 方案大大增加了抗 HBs 丢失的风险（调整后的风险比为 2.97 [1.21–7.31]； P = 0.018）。 SD HB 再免疫方案有效维持了接受 LT 的儿童的保护性抗 HBs 水平，使其成为此类抗 HB 丧失儿童的首选方案。

试用注册：TCTR20180723002。