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Hepatitis B vaccine response before and after transplantation in 55 extrahepatic biliary atresia children
1Department of Paediatrics, Université Catholique de Louvain, Cliniques St. Luc, Brussels, Belgium.
Insights
Hepatitis B vaccination effectively induces immunity in most children with cholestatic cirrhosis. While some immunity wanes post-transplant under immunosuppression, vaccination before surgery offers better protection than post-transplant vaccination.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Hepatology
Background:
- Extrahepatic biliary atresia is a serious condition leading to cholestatic cirrhosis in children.
- Hepatitis B vaccination is crucial for preventing hepatitis B virus infection, especially in at-risk populations.
- Assessing vaccine efficacy in immunocompromised patients, such as post-liver transplant recipients, is vital.
Purpose of the Study:
- To evaluate the efficacy of hepatitis B vaccination in children with cholestatic cirrhosis.
- To compare antibody levels before and after liver transplantation in vaccinated children.
- To determine the long-term protection conferred by hepatitis B vaccination in this cohort.
Main Methods:
- A cohort of 55 children with cholestatic cirrhosis due to extrahepatic biliary atresia received hepatitis B vaccination (plasma-derived or recombinant).
- Antibody levels (anti-HBs) were measured before and after liver transplantation in 30 patients, and post-transplantation only in 25 others.
- Immune response and protective antibody levels were assessed.
Main Results:
- Pre-transplantation, 73.3% of children showed protective hepatitis B antibody levels.
- One to 15 months post-transplantation, 54.6% of all studied children maintained protective anti-HBs levels.
- Hepatitis B vaccination demonstrated efficiency in inducing immunity in the majority of these pediatric patients.
Conclusions:
- Hepatitis B vaccination is effective in generating immunity in most children with cholestatic cirrhosis.
- Immunosuppression post-liver transplantation can lead to a decrease in protective antibody levels.
- Pre-transplant vaccination offers a higher protection rate compared to vaccination after liver transplantation.
Abstract:
Fifty-five children with cholestatic cirrhosis due to extrahepatic biliary atresia received a course of hepatitis B vaccine. Forty-seven received a plasma-derived vaccine and eight a recombinant vaccine. Antibody determination was evaluated before and after liver transplantation in 30 patients. Twenty-five additional patients had antibody determination after transplantation only. Protection against hepatitis B was observed in 73.3% of the children evaluated prior to transplantation. One to 15 months after transplantation, 54.6% of all children studied showed protective levels of anti HBs. We conclude that hepatitis B vaccination is efficient in inducing immunity in the majority of children with cholestatic cirrhosis. Some patients will loose immunity under immunosuppression, but the protection rate remains higher than reported for patients vaccinated after transplantation.
