title: Hepatitis B virus vaccination in children with steroid sensitive nephrotic syndrome: immunogenicity and safety?
abstract: We investigated the efficacy and safety of Hepatitis B vaccine (HBVac) in steroid sensitive nephrotic syndrome (SSNS) children. 41 patients with SSNS and 30 controls were vaccinated with HBVac(Engerix B(®)). Patients were divided into 3 subgroups:full dose steroid users, alternate-day steroid users and steroid non-users. Seroconversion rate was lower in steroid users than non-users at the 6th(p=0.015) and 12th(p=0.036) months. Antibody to Hepatitis B surface antigen(HBsAb) titers were significantly different between subgroups and controls at the 15th month. However, HBsAb and response rates were not different between subgroups at the 12th and 15th months (p>0.05). Five patients were unresponsive to HBVac. Relapse rates after the vaccination were higher than those in the prevaccination period (p=0.002). HBVac is less effective in producing immune response in SSNS children with steroid therapy. HBVac may trigger relapse in some patients. We recommend HBVac to SSNS children with low dose steroid therapy or after steroids are discontinued.
authors.affiliation: Istanbul University, Cerrahpaşa Medical Faculty, Department of Pediatric Nephrology, Cerrahpaşa, Istanbul, Turkey. nurdan.yildiz@marmara.edu.tr
authors.forename: N
authors.initials: N
authors.lastname: Yıldız
authors.forename: Lale
authors.initials: L
authors.lastname: Sever
authors.forename: Ö
authors.initials: Ö
authors.lastname: Kasapçopur
authors.forename: F
authors.initials: F
authors.lastname: Çullu
authors.forename: Nil
authors.initials: N
authors.lastname: Arısoy
authors.forename: S
authors.initials: S
authors.lastname: Çalışkan
mesh_terms: D000917:Antibody Formation / Q000187:drug effects*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006509:Hepatitis B / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D017325:Hepatitis B Vaccines / Q000276:immunology / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy / Q000276:immunology*; D012008:Recurrence; D013256:Steroids / Q000009:adverse effects* / Q000627:therapeutic use; D014611:Vaccination
chemical_list: C075654:Engerix-B; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D013256:Steroids
keywords: Children; Hepatitis B vaccination; Immune response; Nephrotic syndrome; Steroid therapy