Hepatitis B Seroprotection in Pediatric Nephrotic Syndrome

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.