LAUSR

We have carefully read the study published by Rodríguez-Tajes et al. (1) , which reports on the implementation of a second cycle of three double-doses of HBV vaccine (at 0-1-2 months) for non-responders to an identical initial round of treatment. Current clinical practice guidelines recommend double-doses at 0-1-2 months, followed by an additional booster dose, generally at the sixth month (2) . However, responses to the standard regimen are poor and highly sensitive to impaired liver function. The study followed a large series of cirrhotic patients, covering the whole spectrum of disease severity, with a high rate of unprotected subjects, similar to that observed previously in Spain (3) .