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Response to hepatitis A and B vaccination in patients with chronic hepatitis C: 8-year follow-up
Derya Kalyoncu1, Nafiye Urganci
1Department of Paediatrics, Sisli Etfal Training and Research Hospital, Istanbul, Turkey. deryakaly@hotmail.com
Insights
Children with chronic hepatitis C (CHC) show adequate response to hepatitis A vaccine (HAV) but a lower seroconversion rate to hepatitis B vaccine (HBV) compared to healthy children. Antibody levels remained stable over 8 years.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Vaccinology
Background:
- Superinfection with hepatitis A (HAV) or B (HBV) in chronic hepatitis C (CHC) patients increases morbidity and mortality.
- Vaccine seroconversion rates may be lower in CHC patients than in healthy individuals.
Purpose of the Study:
- To assess the immune response to HAV and HBV vaccination in pediatric CHC patients.
- To compare vaccination response rates between CHC children and healthy controls.
Main Methods:
- Thirty CHC patients (7.3-18 years) and 50 healthy controls were vaccinated.
- Serological evaluation occurred post-primary vaccination, post-booster, and annually for 8 years.
Main Results:
- Hepatitis A vaccine response was 95.4% in CHC patients versus 100% in controls.
- Hepatitis B vaccine response was 80% in CHC patients versus 90% in controls.
- Overall seroprotection was 86% in CHC patients and 96% in controls, with sustained antibody levels over 8 years.
Conclusions:
- Pediatric CHC patients demonstrate an adequate response to HAV vaccination.
- A reduced seroconversion rate to HBV vaccination was observed in CHC patients compared to healthy controls.
- Vaccination response remained stable in both groups over an 8-year follow-up period.
Background:
In patients with chronic hepatitis C (CHC), superinfection with hepatitis A (HAV) or B (HAB) viruses is associated with increased morbidity and mortality. The seroconversion rate of these patients following vaccination is considered to be lower than in healthy subjects.
Aim:
To evaluate the response to HAV and HBV vaccination in children with CHC.
Methods:
Thirty patients with CHC aged from 7.3 to 18 years were compared with 50 healthy age-, gender- and body-mass-index-matched controls. Post-vaccination serological evaluation was performed 1 month after the last dose of primary vaccination, 1 month after the booster dose and once a year during follow-up.
Results:
Twenty-two patients received hepatitis A vaccine and response rate was 95.4%. Thirty patients received hepatitis B vaccine and 80% responded (hepatitis Bs titres ≥10 mIU/ml). Thirty-five controls received hepatitis A vaccine and protective anti-HAV antibodies developed in all. All of the controls were vaccinated against hepatitis B virus and 90% responded. After the whole vaccination series, overall seroprotection rates were 86% in patients and 96% in controls. No significant reduction in antibody response was observed in patients or controls during 8-years follow-up.
Conclusions:
The rate of seroconversion to the HBV vaccine is lower in patients with CHC than in healthy controls but response to HAV is adequate.
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