Seroprotection for hepatitis B in children with nephrotic syndrome

Mantan, Mukta; Pandharikar, Nagaraj; Yadav, Sangeeta; Chakravarti, Anita; Sethi, Gulshan Rai

doi:10.1007/s00467-013-2538-0

Cited by 20 publications

(20 citation statements)

References 12 publications

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“…Similar results were found in a study by Mantan M, et al who observed more anti-HBS titre with double dose (20µg) of vaccine than with normal dose (10µg) of vaccine in SSNS 11 . In our study, the mean HB vaccine titre was significantly higher in children receiving 20µg HB vaccine compared to those receiving 10µg.…”

Section: Discussionsupporting

confidence: 90%

“…In the study by Mantan M, et al, only 37% children with NS on non-steroid immunosuppression had seroprotective titres after HB vaccine in comparison with 76% only on steroids 11 . A four-dose schedule (0, 1, 2, 12 months) or double the normal dose at the routine intervals can overcome this 11,12 .…”

Section: Discussionmentioning

confidence: 92%

“…A four-dose schedule (0, 1, 2, 12 months) or double the normal dose at the routine intervals can overcome this 11,12 . Steroid treatment inhibits CD4 cell activity and helps to reduce antibody titres 13,14 .…”

Section: Discussionmentioning

confidence: 99%

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Seroconversion following hepatitis B vaccination in childhood steroid sensitive nephrotic syndrome

Jesmin

Hanif

Anjum

et al. 2017

Sri Lanka J Child Health

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Background:The commonest factor associated with frequent relapse in minimal change nephrotic syndrome is infection, either bacterial sepsis or viral infection. Among the viral infections, hepatitis B virus (HBV) has a prominent role. Steroid sensitive nephrotic syndrome (SSNS) patients are immunocompromised because of the disease itself as well its treatment with a steroid. Thus, their seroprotection will not be enough with conventional dose as that of a healthy person.Objective: To evaluate the seroresponse among SSNS with hepatitis B (HB) vaccination when they were in remission, to compare the antibody titre between single and double dose and to find out whether there were any complications following HB vaccination.Method: A prospective study was conducted among thirty SSNS children from July 2012 to June 2013; children were randomly assigned to be given either 10μg (Group-A) or 20μg (Group-B) of HBV vaccine.The vaccine was administered intramuscularly according to 0, 1, 2 months protocol. After one month of the last dose of vaccine, seroprotection rate was measured. Results: Mean vaccine titres of Group-A and Group-B were 25.60 ±19.97 mIU/ml and 617.47 ± 292.11 mIU/ml respectively. Mean vaccine titre difference between the 2 groups was statistically significant. Conclusion:Seroconversion was better observed by double dose (1ml) of HB vaccine in comparison to the single dose (0.5 ml) in children with SSNS during the remission period. There were no complications following HB vaccine during the study period.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 92%

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Seroconversion following hepatitis B vaccination in childhood steroid sensitive nephrotic syndrome

Jesmin

Hanif

Anjum

et al. 2017

Sri Lanka J Child Health

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“…In contrast, a cross-sectional study that examined protection against HBV in 33 children with SSNS found that only 63.6 % patients had protective antibody levels [22]. Patients who had received the vaccine as part of their routine childhood vaccination schedule had higher antibody titers than those who received the vaccine after onset of NS, despite the latter group receiving a double dose [22].…”

Section: Patients Receiving Steroidsmentioning

confidence: 88%

“…Patients who had received the vaccine as part of their routine childhood vaccination schedule had higher antibody titers than those who received the vaccine after onset of NS, despite the latter group receiving a double dose [22]. Two other studies have shown that the response to vaccination with HBV is lower in children with SSNS (63-67 % seroconversion after 3 doses) than in healthy children, particularly in those on 2 mg/kg/day of prednisolone, even if the vaccine is administered in remission [23,24].…”

Section: Patients Receiving Steroidsmentioning

confidence: 91%

Vaccinations in children on immunosuppressive medications for renal disease

2015

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Renal diseases are often treated with immunosuppressive medications, placing patients at risk of infections, some of which are vaccine-preventable. However, in such patients vaccinations may be delayed or disregarded due to complications of the underlying disease process and challenges in its management. The decision to administer vaccines to immunosuppressed children is a risk-benefit balance as such children may have a qualitatively diminished immunological response or develop diseases caused by the vaccine pathogen. Vaccination may cause a flare-up of disease activity or provocation of graft rejection in renal transplant recipients. Moreover, it cannot be assumed that a given antibody level provides the same protection in immunosupressed children as in healthy ones. We have evaluated the safety and efficacy of licensed vaccines in children on immunosuppressive therapy and in renal transplant recipients. The limited evidence available suggests that vaccines are most effective if given early, ideally before the requirement for immunosuppressive therapy, which may require administration of accelerated vaccine courses. Once treatment with immunosuppressive drugs is started, inactivated vaccines are usually considered to be safe when the disease is quiescent, but supplemental doses may be required. In the majority of cases, live vaccines are to be avoided. All vaccines are generally contraindicated within 3-6 months of a renal transplant.

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