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Hepatitis B Seroprotection in Pediatric Nephrotic Syndrome

Nischal Neupane1, Sriram Krishnamurthy2, Barath Jagadisan1

  • 1Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Indian Pediatrics
|September 4, 2019
PubMed

Insights

Children with nephrotic syndrome have lower Hepatitis B seroprotection rates after vaccination. Steroid-resistant nephrotic syndrome is particularly associated with poor immune response to the Hepatitis B vaccine.

Area of Science:

  • Pediatric Nephrology
  • Immunology
  • Vaccinology

Background:

  • Nephrotic syndrome is a kidney disorder affecting children, often requiring immunosuppressive therapy.
  • Hepatitis B vaccination is crucial for protection, but immune response can be affected by underlying conditions and treatments.

Purpose of the Study:

  • To determine Hepatitis B seroprotection prevalence in vaccinated children with nephrotic syndrome.
  • To compare seroprotection rates and antibody titers among nephrotic syndrome phenotypes.
  • To assess the impact of immunosuppressive agents and proteinuria on Hepatitis B vaccine response.

Main Methods:

  • Analyzed Hepatitis B serology and anti-HBs titers in 100 children with nephrotic syndrome (cases) and 100 healthy controls.
  • Vaccination followed the Universal Immunization Program schedule.
  • Compared seroprotection across different nephrotic syndrome phenotypes (steroid-sensitive, steroid-resistant) and controls.

Main Results:

  • Seroprotection rates were significantly lower in children with nephrotic syndrome (37%) compared to controls (61%).
  • Steroid-resistant nephrotic syndrome showed the lowest seroprotection rate (30%) compared to steroid-sensitive (40%) and controls (61%).
  • A weak negative correlation was observed between proteinuria and protective anti-HBs titers.

Conclusions:

  • Children with nephrotic syndrome exhibit diminished seroprotection following Hepatitis B vaccination.
  • Steroid-resistant nephrotic syndrome is linked to a particularly inadequate immune response to the Hepatitis B vaccine.
  • Proteinuria may play a role in reduced vaccine efficacy in this population.
Abstract

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