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Effects of Adjuvants (Granulocyte-Macrophage Colony-Stimulating Factor, Levamisole, Adjuvant System 04, Adjuvant System 02B) on Enhancing Immune Response to Hepatitis B Vaccine: A Systematic Review and Meta-Analysis Publisher



Zangi M1 ; Alemohammad SY2 ; Kohandel K3 ; Binaei S4 ; Tavasol A5 ; Fathi M5 ; Madani MM6 ; Omidan N7 ; Mohammadi J8 ; Maleki F9
Authors
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Authors Affiliations
  1. 1. Shahid Beheshti University of Medical Science, Tehran, Iran
  2. 2. Robert Stempel Collage of Public Health and Social Work, Florida International University, Miami, FL, United States
  3. 3. Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Medical School, Islamic Azad University, Zahedan Branch, Zahedan, Iran
  5. 5. School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran
  6. 6. School of Medicine, Mashhad University of Medical Sciences, Iran
  7. 7. School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
  8. 8. School of Medicine, Ilam University of Medical Science, Iran
  9. 9. Noncommunicable Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran

Source: Reviews and Research in Medical Microbiology Published:2024


Abstract

Background and objective:Hepatitis B virus (HBV) is known as one of the prevalent infectious diseases considered a public health problem in numerous countries. At present, the only safe prevention strategy is vaccination, but it cannot provide complete immunity. We aimed to evaluate the effect of granulocyte-macrophage colony-stimulating factor (GM-CSF), levamisole, adjuvant system 04 (AS04), and adjuvant system 02B (AS02B) as adjuvants in HBV vaccination.Methods:The databases of ScienceDirect, MEDLIB-ED, PubMed, and Embase were systematically searched using valid keywords. Controlled clinical trial studies, which evaluated the response rate of the population to the HBV vaccine alone (control group) compared with the HBV vaccine combined with adjuvants (study group) were included in this review. The data were analyzed through a random-effects meta-analysis model using R programming language and Stata (version 11.2).Results:A total of 36 article including 4805 participants were included in this review. The findings revealed that the response rate to HBV vaccination for levamisole in the study group was 46.1% (95% confidence interval (CI) [38-51]), and that was 43.8% (95% CI [36-51]) in the control group. These values were also 56.8% (95% CI [53-60]) and 43.3% (95% CI [40-46.7]) for GM-CSF in the study group and the control group, respectively. Considering AS04, the response rate in the study group was 50.8% (95% CI [40-61]), and that was 45.8% (95% CI [37-54]) in the control group. Moreover, these values were 86.3% (95% CI [75-95]) and 47.6% (95% CI [31-63]) for AS02B in the study group and the control group, respectively.Conclusion:The results of this meta-analysis demonstrated the significant benefit of using GM-CSF, levamisole, AS04, and AS02B as adjuvants to boost the immunogenicity of the HBV vaccine. © 2024 Wolters Kluwer Health, Inc. All rights reserved.
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