Immunogenicity of hepatitis B vaccine in multi-transfused thalassemic patients with and without hepatitis C infection: a comparative study with healthy controls.
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.
Froutan-Pishbijari
Hossein
H
Digestive Diseases Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Ghofrani
Hadi
H
Mirmomenm
Shahram
S
Kazemi-Asl
Siamak
S
Nassiri-Toosi
Mohsen
M
Farahvash
Mohammad-Jafar
MJ
Toroghi
Hossein Hashemi
HH
Aminian
Keyvan
K
Mansour-Ghanaei
Fariborz
F
Bagherzadeh
Amir-Hossein
AH
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*
D006508:Hepatitis Antibodies; D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines; D018937:Hepatitis C Antibodies