Hepatitis B virus serologic markers and anti-hepatitis B vaccination in patients with diabetes.
BACKGROUND
In Poland HBV infections are mainly the result of nosocomial infections or risky behavior. Active prevention plays a crucial role in limiting such infections. Patients suffering from insulin-dependent diabetes (type 1) incur high risk of infection with hepatotropic viruses because of frequent hospitalization and blood tests. The aim of our study was to determine the frequency of occurrence of serological markers of HBV infection among patients with diabetes type 1, to evaluate the humoral response to HBV vaccine depending on dosage, and to evaluate the influence of past HBV infections on vaccination response.


METHODS
299 diabetic patients were vaccinated against hepatitis B with Engerix B in two doses (20 mg or 40 mg), on a 0-1-6 month schedule. The humoral response to the vaccination was evaluated in the 5th and 8th months after the first dose of vaccine according to sex, dose and previous detection of anti-HBc in serum. Serologic markers of HBV infection were detected with the immunoenzymatic-fluorescent ELFA method, with bioMerieux tests using the VIDAS system.


RESULTS
98.7% of patients achieved protective anti-HBs titer after vaccination. Women responded better than men. There were no differences in mean anti-HBs concentration by vaccine dose. Patients with previous serum anti-HBc achieved anti-HBs titers (p<0.00001).


CONCLUSIONS
The frequency of anti-HBc among patients with diabetes confirms the widespread risk of HBV infection in the Polish population. Diabetics should be vaccinated against hepatitis B with standard doses. Diabetics with anti-HBc in serum can be vaccinated with a single dose.
Halota
Waldemar
W
Department of Infectious Diseases The L. Rydygier Medical University, Bydgoszcz, Poland. wszoz@logonet.com.pl
Muszyńska
Mirosława
M
Pawłowska
Małgorzata
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000276:immunology* / Q000821:virology; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology*; D006515:Hepatitis B virus / Q000276:immunology*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D014611:Vaccination
D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D018937:Hepatitis C Antibodies