Abstract

Background: It is estimated that 10 of people receiving hepatitis B (HB) vaccination fail to produce a protective level of hepatitis B surface antibody (HBsAb). Various methods such as administration of immune-enhancing medications, increasing the dose of vaccine, or changing injection route are implemented to overcome this issue. Objectives: In this regard, to the current study aimed at assessing the efficacy of atorvastatin treatment in subjects not responding to HB vaccination and evaluating the possible molecular pathways included in the process. Methods: In the current clinical trial, healthy subjects with HBsAb titers of less than 10 IU/mL after a complete course of HB vaccination were included. Participants were randomly assigned into two groups of case and control. Subjects in the case group received daily atorvastatin (40 mg) tablets for 10 days, while the controls were given identical placebo tablets. On the 5th day all subjects received 1.0 mL intramuscular HB vaccine. Four to eight weeks after vaccination, blood samples were drawn from the participants for laboratory assessments including enzyme-linked immunosorbent assay (ELISA) to measure the level of HBsAb, interleukin (IL)-4, IL-17, interferon (IFN)-gamma and transforming growth factor (TGF)-beta cytokines, and real-time polymerase chain reaction (PCR) was also used to evaluate the expression of their corresponding genes; T-Bet, RORc, and GATA3. Results: A total of 30 subjects (five females and 25 males) were included, with 15 participants in each group. There was no significant difference between the two groups considering baseline characteristics of the participants. Final laboratory assessment of HBsAb levels revealed that 12 (80) subjects from the case and 5 (33.3) from the control groups produced a protective level of antibodies (P = 0.025). No significant difference was observed in the concentration of IL-4, IL-17, IFN-gamma, and TGF-beta, and the expression of their corresponding genes between the two groups. Conclusions: The study showed that short-term atorvastatin administration was associated with an increased level of HBsAb to that of protective levels against HB, but this response was not induced through the assessed immune pathways. Further investigations are required to identify the exact mechanism for this effect of atorvastatin.