Safety and efficacy of hepatitis A vaccine in children with chronic liver disease.
OBJECTIVE
To study the safety and efficacy of hepatitis A vaccine (HAV) in children with chronic liver disease of various etiologies.


METHODS
Eleven children with chronic liver disease and thirteen age- and sex-matched controls negative for HAV antibodies were vaccinated against hepatitis A after they gave their informed consent. Children with uncontrolled coagulopathy or signs of hepatic decompensation were excluded. The vaccine (Havrix: 720 ELISA units in 0.5 mL, from GlaxoSmithKline Biologicals) was given intramuscularly in the deltoid in 2 doses 6 mo apart. Children were tested for HAV antibodies one and six months after the 1st dose and one month after the 2nd dose. Total serum bilirubin, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were determined immediately before and after one month of the 1st dose of the vaccine.


RESULTS
Only 7 out of the 11 patients were positive for HAV antibodies after the 1st dose of the vaccine, as compared to 100% of the controls. One month after the 2nd dose, all patients tested were positive for HAV antibodies. No deterioration in liver functions of patients was noted after vaccination. No adverse events, immediate or late, were reported by the mothers after each dose of the vaccine.


CONCLUSIONS
Hepatitis A vaccine is both safe and effective in this small studied group of children with chronic liver disease. Given the high seroconversion rate, post-vaccination testing for HAV antibodies is not needed.
El-Karaksy
Hanaa-Mostafa
HM
Department of Pediatrics, Cairo University, 44 Mohei El-Deen Abu El-Ezz Street, Dokki, Cairo 12311, Egypt. hanaakaraksy@yahoo.com
El-Hawary
Manal-Ismail
MI
El-Koofy
Nehal-Mohammad
NM
El-Sayed
Rokaya
R
El-Raziky
Mona-Al-Saeed
MA
Mansour
Samah-Asaad
SA
Taha
Gamal-Mohammad
GM
El-Mougy
Fatma
F
D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D000917:Antibody Formation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006506:Hepatitis A / Q000276:immunology; D035922:Hepatitis A Antibodies / Q000097:blood; D022362:Hepatitis A Vaccines / Q000592:standards* / Q000627:therapeutic use*; D006801:Humans; D008107:Liver Diseases / Q000276:immunology*; D008111:Liver Function Tests; D008297:Male; D018579:Patient Selection; D012449:Safety
D035922:Hepatitis A Antibodies; D022362:Hepatitis A Vaccines; D000410:Alanine Transaminase