Are Boys at Risk of Low Immune Response to Recombinant Hepatitis B Virus Vaccine in Steroid Sensitive Nephrotic Syndrome?
Journal of Pediatric Nephrology,
Vol. 5 No. 2 (2017),
1 January 2018
,
Page 1-6
https://doi.org/10.22037/jpn.v5i2.17167
Abstract
Introduction: This study was conducted to evaluate the immune response following vaccination with different doses and to compare the antigen specific antibody response to Hepatitis B Vaccine (HBVac) in Steroid Sensitive Nephrotic Syndrome (SSNS) patients between boys and girls.
Materials and Methods: This prospective study was conducted in 30 SSNS children at Bangladesh Institute of Child Health, Dhaka, Bangladesh from July 2012 to June 2013.Thirty patients who had all features of Minimal Change Nephrotic Syndrome (MCNS) according to International Study for Kidney Diseases for Children (ISKDC) and received oral prednisolone every alternate day and were HBsAg negative were enrolled in the study. The patients were randomly assigned to one of the two treatment group to receive either 0.5 ml (10μg) or double dose 1ml (20μg) of HB vaccine in a 0-1-2month schedule. After excluding hepatitis B virus infection, the vaccine was administered at a standard dose in group-A (0.5 ml or 10 microgram) and at a double dose (1 ml or 20 microgram) in group-B. After one month of the last dose, the seroprotection rate was measured and compared among sexes.
Results: The mean age of the participants in group-A was 5.81 ± 1.73 years with a boy to girl ratio of 9:6 and the mean age of the subjects in group-B was 5.65 ± 1.68 years with a boy to girl ratio of 8:7. The mean vaccine titer was 25.60 ±19.97 mIU/ml in group-A and 617.47 ±292.11 mIU/mlin group-B, with a significant difference (p<0.05) between the two groups. Irrespective of the dose, the mean vaccine titer was higher in girls (37.33 ± 19.45 mIU/ml) compared to boys (16.22 ± 14.81mIU/ml) and the difference was statistically significant in group-A. It was also observed that the mean vaccine titer was significantly higher in girls (743.00±252.34mIU/ml) compared to boys (394.88±246.63 mIU/ml) in group-B (p<0.05,t-test).
Conclusions: The results of our study showed a reduced response to HB Vaccine boys with SSNS in comparison to girls. As the study size was small, single center study and time limited follow-up, we cannot draw any valid conclusions.
Keywords: Immune deficiency; Sex differences; Steroid Sensitive Nephrotic Syndrome; Seroconversion.How to Cite
References
Sabra L, Klein1 and Katie L. Flanagan Sex differences in immune responses. NATURE.2009.
Ruggieri A, Anticoli S, Ambrosio AD, Giordani L, Viora M. The influence of sex and gender on immunity, infection and vaccination. Ann Ist Super Sanità. 2016. 52:198-204.
Wang C, Tang J, Song W, Lobashevsky E, Wilson CM, Kaslow RA. HLA and cytokine gene polymorphisms are independently associated with responses to hepatitis B vaccination. Hepatology. 2004. 38:978-988.
Madalinski K. Persistence of immunity following vaccination against hepatitis B. PrzeglEpidemiol. 2002. 56:605-613.
Keating GM, Noble S. Recombinant hepatitis B vaccine (Engerix-B): a review of its immunogenicity and protective efficacy against hepatitis B. Drugs. 2003. 63: 1021-1051.
Desombere I, Willems A, Lerous-Roels G. Response to hepatitis B vaccine: multiple HLA gens are involved. Tissue Antigens. 1998. 51:593-604.
Yucesoy B, Johnson VJ, Fluharty K et al. Influence of cytokine gene variations on immunization to child vaccines. Vaccione. 2009. 27:6991-6997.
Yildiz N, Sever L, Kasapcopur O, Cullu F, Arisoy N, Caliskan S. Hepatitis B virus vaccination in children with steroid sensitive nephrotic syndrome: immunogenicity and safety? Vaccine. 2013.31:3309-3312.
Szajner- Milart I, Zajaczkowska M. Efficacy of vaccination against vital hepatitis type B in children with NS. Ann University Mariae Curiae, Sklodowska (Med). 2003. 58 (1): 402-8.
Baytan B, Gunes AM, Gunay U. Efficacy of primary hepatitis B immunization in children with acute lymphoblastic leukemia. Indian Pediatr. 2008. 45:265–270.
Mantan M, Pandharikar N, Yadav S, Chakravarti A, Sethi GR. Seroprotection for hepatitis B in children with nephrotic syndrome. PediatrNephrol. 2013; 28:2125–2130.
Cook, I. F. Sexual dimorphism of humoral immunity with human vaccines. Vaccine. 2008. 26:3551–3555.
Klein SL, Jedlicka A, Pekosz A. The Xs and Y of immune responses to viral vaccines. Lancet Infect Dis. 2010. 10:338-49.
Giefing-Kroll C, Berger P. Lepperdinger G. Grubeck-Loebenstein B. How sex and age affect immune responses, susceptibility to infections, and response to vaccination. Aging Cell. 2015. 14:309–321.
La Manna A, Politico. Reduced response to Hepatitis B virus vaccination in males with SSNS. PaediatrNepthrol. 1992. 6:251-253.
LerousRoelsG, kurz P. Hepatocyte International Hepatitis update special Features-Variable response to Hepatitis B vaccine influencing factor. Adis Inter. Ltd. 1993. 61:293-295.
Schnaper HW. The immune system in minimal change nephrotic syndrome. PediatrNephrol. 1989. 3:101-110.
O’Regan E, O’Callaghan V, Dundon S. HLA antigens and steroid responsive nephrotic syndrome of childhood. Tissue Antigens. 1980. 16:147-151.
Alper CA, Kruskall MS, Marcus-Bagley D. Genetic prediction of non-response to hepatitis B vaccine. N Engl J Med. 1989. 321:708-712.
Lagueruela CC, Buettner TL, Cole BR, Kissane JM, Robson SM. HLA extended haplotypes in syeroid-sensitive nephrotic syndromes in childhood. Kidney Int. 1990. 38: 145-150.
Blumberg BS, Sutnik AI, London WT, Melartin L. Sex distribution of Australia antigen. Arch Intern Med. 1972. 130:227-231.
Chiaramonte M, Floreani A, Giani G. Sex differences in HBsAg and anti HBs distribution.hepatogastroenterology. 1982. 29:13.
Kleinknecht C, Gubler MD.vNeohrose. In: Royer P, Habib R, Mathieu H, Nroyer M (eds) Nephrogenic pediatrique. 3rd edn. Flammarion. Paris. 1983. p 274-293.
Klein SL, Jedlicka A, Pekosz A. The Xs and Y of immune responses to viral vaccines. Lancet Infect. 2010. 10:338–349.
Giefing-Kroll C, Berger P,Lepperdinger G, Grubeck-Loebenstein B. How sex and age affect immune responses, susceptibility to infections, and response to vaccination. Aging Cell. 2015. 14:309–321.
Abeyagunawardena AS, Goldblatt D, Andrews N, Trompeter RS. Risk of relapse after meningococcal C conjugate vaccine in nephrotic syndrome. Lancet. 2003. 362:449–450.
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