Clinical

Children with idiopathic arthritis respond to hepatitis B vaccine

Last Updated: 2004-09-02 13:42:55 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Hepatitis B vaccination can generate an adequate immune response in children with juvenile idiopathic arthritis (JIA) and this response is unaffected by immunosuppressive therapy, new research suggests.

These findings have important implications for developing countries where hepatitis B virus (HBV) infection is endemic, lead author Dr. Ozgur Kasapcopur and colleagues, from Istanbul University in Turkey, note.

Initially, researchers thought that hepatitis B vaccination might worsen chronic rheumatologic diseases in adults. However, it was later show that this was not the case and, in fact, an effective immune response was observed. Still, the matter has not been resolved in children.

To address this issue, Dr. Kasapcopur's team evaluated the safety and efficacy of hepatitis B vaccination in 39 children with JIA and in 41 healthy controls. All of the JIA patients were in remission and tested negative for hepatitis B surface antigen. The subjects received the vaccine at 0, 1, and 3 months or at 0, 1, and 6 months.

The researchers' findings appear in the Annals of the Rheumatic Diseases for September.

With the exception of one JIA patient, all of the subjects displayed an anti-HBV antibody response. Antibody levels were significantly lower in the JIA group than in controls, but were still considered adequate for protection. Treatment with methotrexate or prednisolone did not influence antibody levels in the JIA group.

The vaccination schedule used did not affect antibody levels in the control group. In contrast, in the JIA group, there was a trend toward a better response with the 0, 1, and 6-month schedule (p < 0.07).

Hepatitis B vaccination appeared safe in the JIA group with none of the subjects experiencing a disease flare-up or clinical deterioration linked to vaccination.

"Further studies are needed with larger numbers of patients to confirm these findings," the authors state.

Ann Rheum Dis 2004;63:1128-1130.