title: Hepatitis B vaccination failure in children with diabetes mellitus? The debate continues.
abstract: BACKGROUND
  The aim of our study was to evaluate the presence of specific antibodies against HBsAg in diabetic children (IDDM) previously vaccinated against hepatitis B virus.
  
  
  METHODS
  110 diabetic children were retrospectively studied and 100 healthy controls were recruited. In all patients surface antigen, HBV core IgG, antibodies against HBV "e" antigen and quantitative HBV surface antibodies were detected. In 45 patients molecular typing of HLA alleles was performed. Metabolic control was evaluated as mean glycated hemoglobin (HbA1c) and all patients were compliant to insulin therapy.
  
  
  RESULTS
  46 of 110 diabetic children (41.8%) and 16 of 100 healthy controls (16%) were found to have not anti-HBs antibodies (p < 0.0001). The mean antibody titer was found significantly-lower (p < 0.0001) in IDDM children than healthy controls. No correlation was found between antibody titer, age, duration of disease and HbA1c. We did not find any difference of gender, age, years of onset of the disease and metabolic control, between diabetics with anti-HBs antibodies and those without.
  
  
  CONCLUSIONS
  Our data confirm the reduced seroprotection rate for HBV vaccination in diabetics. However it remains poorly clarify the real clinical significance of this result. In our study no diabetic children showed markers of HBV infection.
authors.affiliation: University of Catania, Department of Pediatrics, Catania, Italy. leonardi@unict.it
authors.forename: Salvatore
authors.initials: S
authors.lastname: Leonardi
authors.forename: Giovanna
authors.initials: G
authors.lastname: Vitaliti
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Garozzo
authors.forename: Michele
authors.initials: M
authors.lastname: Miraglia del Giudice
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Marseglia
authors.forename: Mario
authors.initials: M
authors.lastname: La Rosa
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus / Q000276:immunology*; D005260:Female; D006510:Hepatitis B Antibodies / Q000097:blood*; D006512:Hepatitis B Core Antigens / Q000097:blood / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000097:blood / Q000276:immunology; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines