title: Evaluation of immune response to hepatitis A vaccination and vaccine safety in juvenile idiopathic arthritis.
abstract: BACKGROUND
  Autoimmune mechanisms and drugs used in treatment increase the risk of liver disease in patients with juvenile idiopathic arthritis (JIA) and hepatitis A virus (HAV) vaccination is important, especially in intermediate-endemicity areas like Turkey. In our study, we aimed to evaluate the immune response to hepatitis A vaccine and vaccine safety in children with JIA.
  
  
  METHODS
  This study was carried out in our hospital's Pediatric Rheumatology outpatient clinic and Healthy Child clinic between the years 2003 and 2008. The study group consisted of 47 children with JIA (23 male and 24 female) diagnosed according to International League of Associations for Rheumatology diagnostic criteria. The control group consisted of 67 healthy children (31 female, 36 male) who did not have a history of hepatitis A infection or vaccination. Both groups were vaccinated with two doses of hepatitis A vaccine at 6-month intervals. Anti-HAV IgG >80 MIU was accepted as positive response.
  
  
  RESULTS
  There was no significant difference between the groups in terms of age and sex. None of the patients with JIA had fever, clinical worsening, or disease activation after vaccination. Anti-HAV IgG positivity rate was significantly higher in the control group (p < 0.05). Anti-HAV IgG was negative in only four cases, and they were all male patients with systemic JIA who had active disease under anti-tumor necrosis factor treatment.
  
  
  CONCLUSIONS
  Hepatitis A vaccine was safe in patients with JIA, and response to vaccine did not differ between healthy children and patients with JIA except for children with active systemic JIA receiving anti-tumor necrosis factor alpha drugs.
authors.affiliation: Department of Pediatrics, Ministry of Health, Goztepe Training and Research Hospital, Istanbul, Turkey. muferete@yahoo.com
authors.forename: Muferet
authors.initials: M
authors.lastname: Erguven
authors.forename: Bulent
authors.initials: B
authors.lastname: Kaya
authors.forename: Oznur Yilmaz
authors.initials: OY
authors.lastname: Hamzah
authors.forename: Fatma
authors.initials: F
authors.lastname: Tufan
mesh_terms: D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood; D001171:Arthritis, Juvenile / Q000188:drug therapy / Q000276:immunology*; D002648:Child; D005260:Female; D022362:Hepatitis A Vaccines / Q000009:adverse effects / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014611:Vaccination
chemical_list: D000914:Antibodies, Viral; D022362:Hepatitis A Vaccines; D007074:Immunoglobulin G; D014409:Tumor Necrosis Factor-alpha