title: Reduced immune response to hepatitis B vaccine in children with insulin dependent diabetes.
abstract: Twenty-four patients with moderately controlled insulin dependent diabetes with a duration of diabetes ranging from 2 to 10 years as well as 17 control subjects were vaccinated against hepatitis B virus using Gen Hevac B vaccine. The vaccine was injected 0.5 mL intramuscularly into the deltoid region on three separate occasions at intervals of 1 month. If subjects were still negative for anti-hepatitis B surface antigen (HBs) or had inadequate antibody after the third injection, a fourth administration of vaccine was given 3 months later. The mean anti-HBs titer was 243.3 +/- 97.2 mi.u./mL in control subjects and 39.8 +/- 53.2 in diabetic patients (P < 0.001). In the control group optimal protection was obtained in 100% of subjects, whereas 11 diabetic patients (45.8%) had low anti-HBs titer (< 10 mi.u./mL). All of 11 diabetic patients showed adequate (> 10 mi.u./mL) anti-HBs titer after the fourth dose of vaccine. In diabetic patients the most striking feature was the reduced CD4/CD8 ratio which was significantly lower (P < 0.001) than that of the control group. We conclude that diabetic children have an impaired immune response to hepatitis B vaccine. It is suggested that diabetic children should be vaccinated against hepatitis B virus with four injections instead of three.
authors.affiliation: Department of Pediatrics, University of Istanbul, Turkey.
authors.forename: C
authors.initials: C
authors.lastname: Fiçicioğlu
authors.forename: S
authors.initials: S
authors.lastname: Mikla
authors.forename: K
authors.initials: K
authors.lastname: Midilli
authors.forename: A
authors.initials: A
authors.lastname: Aydin
authors.forename: H
authors.initials: H
authors.lastname: Cam
authors.forename: S
authors.initials: S
authors.lastname: Erğin
mesh_terms: D000293:Adolescent; D000917:Antibody Formation; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology*; D005260:Female; D006509:Hepatitis B / Q000517:prevention & control*; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D017325:Hepatitis B Vaccines / Q000276:immunology*; D006801:Humans; D008297:Male
chemical_list: D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines