Immunogenicity of hepatitis B vaccine in multi-transfused thalassemic patients with and without hepatitis C infection: A comparative study with healthy controls
Hossein Froutan-Pishbijari, Hadi Ghofrani, Shahram Mirmomen, Siamak Kazemi -Asl, Mohsen Nassiri-Toosi, Mohammad-Jafar Farahvash, Hossein Hashemi Toroghi, Keyvan Aminian, Fariborz Mansour-Ghanaei, Amir-Hossein Bagherzadeh
Med Sci Monit 2004; 10(12): CR679-683
Available online: 2004-12-01
Background:Hepatitis C virus (HCV) infection is highly prevalent in thalassemic patients. This may decrease serum antibody response to hepatitis B virus (HBV) vaccine. There is also some alteration in the immune system of multi-transfused thalassemic patients as a consequence of iron overload. We deduced that HCV infection may reduce the effectiveness of HBV vaccine in multi-transfused thalassemic patients.Material/Methods:Subjects were cited and studied prospectively in three groups. Group 1:125 multi-transfused thalassemic patients with negative serum HCV antibody, Group 2:96 multi-transfused thalassemic patients with positive serum HCV antibody on at least 2 different occasions, and Group3:100 healthy subjects. Subjects in all groups had negative serum HBsAg, anti-HBc, and anti-HBs, and they received three 20-µg doses of recombinant HBV vaccine in months 0,1, and 6. The anti-HBs titer was obtained one month after the last dose of vaccine and was considered seroprotective if ł10 IU/l.Results:The seroprotection rate was 83.2% in Group 1 and 80.2% in Group 2 (P=0.74). It was 86% in healthy subjects, which didn’t significantly differ from HCV-positive and -negative thalassemics (P=0.56). Moreover, the mean values of ALT among the responder and non-responder thalassemic patients were 55.5±41.9 and 57.4±48.5 U/l, respectively (p=0.802). During the vaccination periods, patients in all 3 groups did not show any significant adverse reactions.Conclusions:Our study shows that three standard doses of HBV vaccine are immunogenic and safe in multi-transfused thalassemic patients with or without HCV infection.
Keywords: Hepatitis B Vaccines - adverse effects, Hepatitis C Antibodies - administration & dosage, Thalassemia - complications, Thalassemia - immunology, Adolescent, Adult, Blood Transfusion, Child, Cohort Studies, Hepatitis Antibodies - blood, Hepatitis B - prevention & control, Hepatitis B Antibodies - blood, Hepatitis B Vaccines - therapeutic use, Hepatitis B virus - immunology, Hepatitis C - complications, Hepatitis C Antibodies - blood, Immunization Schedule, Thalassemia - immunology