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Reuters Health Information (2004-09-02): Children with idiopathic arthritis respond to hepatitis B vaccine 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.
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