Assessment of anti-HBs antibody concentration in children with juvenile idiopathic arthritis treated with biological drugs, vaccinated against viral type B hepatitis in infancy

Abstract

Objectives: The introduction of vaccinations against viral hepatitis B in the years 1994-1996 in Poland significantly improved the epidemiological situation of hepatitis B virus (HBV) infections in our country. According to the report of the National Institute of Public Health-National Institute of Hygiene in 2018, 40 cases of acute hepatitis B were noted while still in the 1980s between 10 and 20 thousand new cases were reported annually. The aim of the study was to determine whether in children treated with biological drugs (adalimumab, etanercept, infliximab) due to juvenile idiopathic arthritis (JIA), vaccinated against hepatitis B in infancy, a protective concentration of anti-HBs antibodies persists. In patients, the value ≥ 10 mIU/ml is regarded as a protective concentration of antibodies, determined at least four weeks after administration of the last vaccine dose. Among healthy individuals, presence of anti-HBs antibodies in any concentration means seroprotection. No booster vaccinations are recommended in basically vaccinated healthy individuals. Material and methods: The concentrations of anti-HBs antibodies were determined in 56 children with JIA (38 girls-67.9% and 18 boys-32.1%) aged from 2 years and 4 months to 17.5 years, treated for at least three months with biological drugs. The diagnosis of JIA was made based on the International League of Associations for Rheumatology (ILAR) criteria. All studied patients were at the stable stage of the disease and received a full course of hepatitis B vaccination during infancy (in accordance with 0,1,6 months injection scheme). Results: In the studied children a protective anti-HBs antibody concentration was found in 34 cases (60.7%), and 22 children (39.3%) had anti-HBs antibody concentration < 10 mIU/ml (in these children no seroprotection was found). Conclusions: The post-vaccination antibody concentration should be determined in children with JIA, treated with biological drugs and, in case of absence of a protective concentration, revaccination should be started.

The Vaccine Coverage and Vaccine Immunity Status and Risk Factors of Non-Protective Levels of Antibodies Against Vaccines in Children with Juvenile Idiopathic Arthritis: Russian Tertiary Centre Study.

“…In previous studies, methotrexate and corticosteroids' negative effect on the antibodies against measles, mumps, rubella, diphtheria, and tetanus was not shown [21,27,28,46,47]. However, other studies have shown the opposite data [31,33,48].…”

“…In the Polish study, 60.7% of JIA patients with similar ages had protective levels of antibodies against hepatitis B. Girls, and patients with polyarticular JIA had the lowest levels of antibodies [33]. Only half of the patients with different PRD receiving immunosuppressive treatment had a protective anti-HBs level compare to controls -4% [33].…”

“…Girls, and patients with polyarticular JIA had the lowest levels of antibodies [33]. Only half of the patients with different PRD receiving immunosuppressive treatment had a protective anti-HBs level compare to controls -4% [33]. In Maritsi D. et al in 89 patients with a different JIA form, only 55% had a protective level of anti-HBs antibodies and 92% in healthy controls [34].…”

COVID‐19 vaccination in patients receiving allergen immunotherapy (AIT) or biologicals—EAACI recommendations

“…However, a significant percentage of patients on this treatment can mount protective vaccine titres. 148 , 149 , 150 Data on certolizumab suggest that pneumococcal and influenza vaccine responses were not impaired when applied during therapy initiation. 151 A systematic review on biologicals on vaccine responses in the context of autoimmune inflammatory rheumatic diseases concluded that vaccine responses to influenza and pneumococcal vaccine are adequate under anti‐TNF‐α drugs, tocilizumab (anti‐IL‐6) and belimumab (anti‐B‐cell activating factor (BAFF); data only for the pneumococcal vaccine).…”

Effectiveness and Safety of Vaccination in Patients with Juvenile Idiopathic Arthritis

“…У 34 детей (60,7%) обнаружена защитная концентрация антител к гепатиту В, у 22 детей (39,3%) -концентрация anti-HBs менее 10 мМЕ/мл (что свидетельствует об отсутствии иммунитета к инфекции). В конце статьи авторы делают вывод о том, что детям с ЮИА, получавшим лечение БМАРП, следует определять уровень антител и в случае отсутствия защитной концентрации проводить ревакцинацию [37].…”