title: Immunogenicity of hepatitis B vaccine in multi-transfused thalassemic patients with and without hepatitis C infection: a comparative study with healthy controls.
abstract: BACKGROUND
  Hepatitis C virus (HCV) infection is highly prevalent in thalassemic patients. This may decrease serum antibody response to hepatitis B virus (HBV) vaccine. There is also some alteration in the immune system of multi-transfused thalassemic patients as a consequence of iron overload. We deduced that HCV infection may reduce the effectiveness of HBV vaccine in multi-transfused thalassemic patients.
  
  
  METHODS
  Subjects were cited and studied prospectively in three groups. Group 1:125 multi-transfused thalassemic patients with negative serum HCV antibody, Group 2:96 multi-transfused thalassemic patients with positive serum HCV antibody on at least 2 different occasions, and Group3:100 healthy subjects. Subjects in all groups had negative serum HBsAg, anti-HBc, and anti-HBs, and they received three 20-microg doses of recombinant HBV vaccine in months 0,1, and 6. The anti-HBs titer was obtained one month after the last dose of vaccine and was considered seroprotective if > or =10 IU/l.
  
  
  RESULTS
  The seroprotection rate was 83.2% in Group 1 and 80.2% in Group 2 (P = 0.74). It was 86% in healthy subjects, which didn't significantly differ from HCV-positive and -negative thalassemics (P = 0.56). Moreover, the mean values of ALT among the responder and non-responder thalassemic patients were 55.5 +/- 41.9 and 57.4 +/- 48.5 U/l, respectively (p = 0.802). During the vaccination periods, patients in all 3 groups did not show any significant adverse reactions.
  
  
  CONCLUSIONS
  Our study shows that three standard doses of HBV vaccine are immunogenic and safe in multi-transfused thalassemic patients with or without HCV infection.
authors.affiliation: Digestive Diseases Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Froutan-Pishbijari
authors.forename: Hadi
authors.initials: H
authors.lastname: Ghofrani
authors.forename: Shahram
authors.initials: S
authors.lastname: Mirmomenm
authors.forename: Siamak
authors.initials: S
authors.lastname: Kazemi-Asl
authors.forename: Mohsen
authors.initials: M
authors.lastname: Nassiri-Toosi
authors.forename: Mohammad-Jafar
authors.initials: MJ
authors.lastname: Farahvash
authors.forename: Hossein Hashemi
authors.initials: HH
authors.lastname: Toroghi
authors.forename: Keyvan
authors.initials: K
authors.lastname: Aminian
authors.forename: Fariborz
authors.initials: F
authors.lastname: Mansour-Ghanaei
authors.forename: Amir-Hossein
authors.initials: AH
authors.lastname: Bagherzadeh
mesh_terms: D000293:Adolescent; D000328:Adult; D001803:Blood Transfusion; D002648:Child; D015331:Cohort Studies; D005260:Female; D006508:Hepatitis Antibodies / Q000097:blood*; D006509:Hepatitis B / Q000097:blood / Q000150:complications / Q000517:prevention & control; D006510:Hepatitis B Antibodies / Q000097:blood; D017325:Hepatitis B Vaccines / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use; D006515:Hepatitis B virus / Q000276:immunology; D006526:Hepatitis C / Q000150:complications; D018937:Hepatitis C Antibodies / Q000008:administration & dosage* / Q000097:blood; D006801:Humans; D007115:Immunization Schedule; D008297:Male; D013789:Thalassemia / Q000150:complications / Q000276:immunology*
chemical_list: D006508:Hepatitis Antibodies; D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines; D018937:Hepatitis C Antibodies