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Efficacy of primary hepatitis B immunization in children with acute lymphoblastic leukemia
Birol Baytan1, Adalet Meral Gunes, Unsal Gunay
1Department of Pediatric Hematology, Uludag University, Medical Faculty, bursa, Turkey. baytanbirol@yahoo.com
Insights
Routine hepatitis B vaccination significantly reduces hepatitis B virus infection in children with acute lymphoblastic leukemia. Prior vaccination offers crucial protection against chronic HBV infection in this high-risk pediatric group.
Area of Science:
- Pediatric Oncology
- Immunology
- Infectious Diseases
Background:
- Children with acute lymphoblastic leukemia (ALL) face a heightened risk of hepatitis B virus (HBV) infection.
- The study investigates the protective effect of routine hepatitis B vaccination against HBV in these vulnerable children.
Purpose of the Study:
- To evaluate the efficacy of the national immunization program's hepatitis B vaccine in preventing HBV infection among children with ALL.
- To assess the impact of prior vaccination status on HBV seroconversion and chronic infection rates in pediatric ALL patients.
Main Methods:
- Ninety-six children with ALL were screened for HBV infection.
- Participants were categorized into three groups based on vaccination and serological status.
- A subset of children received a three-dose hepatitis B vaccination course during maintenance therapy.
Main Results:
- Hepatitis B vaccine seroconversion rates varied by prior vaccination status, with previously vaccinated children showing higher response rates.
- Overall, 11.5% of children tested positive for HBsAg, developing chronic hepatitis B.
- Significantly fewer previously vaccinated children (Group I) developed chronic HBV infection compared to unvaccinated children (Group II) (P<0.04).
Conclusions:
- Routine hepatitis B vaccination is crucial for reducing HBV infection incidence in children with ALL.
- Prior vaccination within the national immunization program provides substantial protection against chronic hepatitis B in this high-risk pediatric population.
Background:
Children with acute lymphoblastic leukemia (ALL) carry a high risk of hepatitis B virus (HIV) infection. The present study was conducted to see if prior routine hepatitis B vaccine received as a part of national immunization program could prevent HBV infection in these children.
Methodology:
Ninety-six children with ALL were screened for HBV. Children were divided into three groups according to their initial HBV serology; previously vaccinated children (Group I) (n=34) previously unvaccinated and seronegative children (Group II) (n=56),and unvaccinated but HBsAg negative and anti-HBs positive children (group III) (n=6). Sixty-seven of 96 (69.7%) children received vaccination. The schedule was initiated during the third month of maintenance therapy and each course consisted of three doses given at one month interval.
Results:
Anti-HBs seroconversion following the first course of three doses of hepatitis B vaccination in group I, II and III was 57%, 33% and 100%, respectively. It increased to 97% in Group I, 62.5% in Group II, 100% in Group III. HBsAg positivity was found in 11 children (11.5%) and all of them developed chronic hepatitis B. Ten of them were in Group II whereas only one child was in Group I (P<0.04).
Conclusion:
This data reveals that routine HBV vaccination within the national immunization program plays an important role in decreasing subsequent hepatitis B infection in children with ALL.