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Evaluation of immune status against hepatitis B in children with thalassemia major in Egypt: A single center study

Year 2012, Volume: 2 Issue: 02, 44 - 49, 01.06.2012
https://doi.org/10.5799/jmid.123149

Abstract

Objectives: Thalassemic children with repeated blood transfusion are at higher risk of suffering transfusion related infections including hepatitis B virus (HBV). HBV vaccine immunogenicity in several studies showed variable response rates. The aim of this study is to evaluate the immunogenic effect of hepatitis B vaccine in thalassemic children at different age groups. Materials and methods: After ethical approval and informed parent consent, 125 diagnosed thalassemic patients were recruited from the Hematology/Oncology Unit, Pediatric Department, Tanta University Hospital. Patient&#39;s transfusion, and vaccination history, clinical data, and blood samples were obtained. Patient&#39;s sera were stored at -20&deg;C till tested for Anti-hepatitis B surface (anti-HBs) by ELISA. Patients with titers <10 IU were tested for HBs-Ag. Results: Although none of our cases had hepatitis B virus infection, only 20.8% had a protective anti-HBs titer (>10 IU/L). Significantly higher percentage of protected patients (40.1%) were younger than 3 years of age, while age groups above 3years showed a significant trend towards having non protective titers (p=0.003). Anti-HBs titers weren&#39;t correlated to age, ferritin, liver enzymes, and duration of transfusion or number of transfused packs. Conclusion: Protective Anti-HBs titer was reduced after age of 3 years in our patients. So, we recommend screening of thalassemic patients at age of 3 years to evaluate the need of a booster dose.

References

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  • El-Beshlawy A, Kaddah N, Moustafa A, et al. Screening for ß-thalassemia carriers in Egypt: Significance of the osmotic fragility test. East Mediterr Health J 2007; 13:224-230.
  • Rund D, Rachmilewitz E. ß-Thalassemia. N Engl J Med 2005; 353:1135-1146.
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  • Hauri A, Armstrong G, Hutin Y. The global burden of disease attributable to contaminated injections given in health care settings. Int J STD AIDS 2004; 15: 7-16.
  • Davis AR, Rosenthal P. Hepatitis B in children. Pediatr Rev 2008; 29:111-120
  • Elisofon SA, Jonas MM. Hepatitis B and C in children: current treatment and future strategies. Clin Liver Dis 2006; 10:133- 148.
  • El-Gilany AH, El-Fedawy S. Bloodborne infections among stu- dent voluntary blood donors in Mansoura University, Egypt. East Mediterr Health J 2006; 12:742-748.
  • Kao JH; Chen DS. Global control of hepatitis B virus infection, Lancet Infect Dis 2002; 2:395-403.
  • Kirk GD. Hepatitis B vaccination and liver cancer. In: Stew- art BW, Kleihues P (Eds).World Cancer Report. Lyon: IARC Press, 2003, 144-147.
  • Bonanni P, Pesavento G, Bechini A, et al. Impact of universal vaccination programs on the epidemiology of hepatitis B: 10 years of experience in Italy. Vaccine 2003; 21: 685-691.
  • Fitzsimons D, François G, Hall A, et al. Long-term efficacy of hepatitis B vaccine, booster policy, and impact of hepatitis B mutants. Vaccine 2005; 23:4158-4166.
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  • Rivkina A, Pharm D, Rybalov S. Chronic hepatitis B: Cur- rent and future treatment options. Pharmacotherapy 2002; 22: 721-737.
  • But DY, Lai CL, Lim WL, Fung J, Wong DK, Yuen MF. Twen- ty-two years follow-up of a prospective randomized trial of hepatitis B vaccines without booster dose in children: Final report. Vaccine 2008; 2; 26:6587-6591.
  • Saberifiroozi M, Gholamzadeh S, Serati AR. The long-term immunity among health care workers vaccinated against hepatitis B virus in a large referral hospital in southern Iran. Arch Iran Med.2006; 9:204-207.
  • Saraswat S, Banerjee K, Chaudhury N, et al. Post transfu- sion hepatitis type B following multiple transfusions of HBsAg negative blood. J Hepatol 1996; 25:639-643.
  • Chang MH. Impact of hepatitis B vaccination on hepatitis B disease and nucleic acid testing in high-prevalence popula- tions. J Clin Virol 2006; 36: 45-50.
  • Dentico P, Buongiorno A, Volpe A, Zavoianni D, De Mattia D, Sabato V. Long term persistence of anti-HBs after hepa- titis B immunization in thalassemic patients. Infection 1992; 20:276-278.
  • Wu JS, Hwang LY, Goodman KJ, Beasley RP. Hepatitis B vaccination in high-risk infants: 10 year follow-up. J Infect Dis. 1999; 179:1319-1325.
  • Peces R, Laures AS. Persistence of immunologic memory in long-term hemodialysis and healthcare workers given hepa- titis B vaccine: Role of a booster dose on antibody response. Nephron 2001; 89: 172-176.
  • Azarkeivan A, Karimi G, Shaiegan M, Maghsudlu M, Tab- baroki A. Antibody titration and immune response of Iranian beta-thalassemic patients to hepatitis B virus vaccine (boost- er effect). Pediatr Hematol Oncol 2009;26:195-201.
  • Vahidi AA, VaresVazirian M, Shamsadini A, et al. Determina- tion of hepatitis B surface antibody titer in vaccinated chil- dren with major thalassemia in Kerman, Iran. Iran J Immunol 2006; 3:30-34.
  • Sharifi Z, Milani S, Shooshtari M. Study on efficacy of hepa- titis B immunization in vaccinated beta thalassemia children in Tehran. Iran J Pediatric 2010; 20: 211-215.
  • Mokhles M, El Ashry R, Sedky M , et al. Long Term Efficacy of Hepatitis B Vaccine among High Risk Multiple Blood Transfu- sion Children in Egypt J Appl Sci Res. 2009; 5:2504-2510
  • Li H, Li RC, Liao SS, Yang JY, Zeng XJ, Wang SS. Persis- tence of hepatitis B vaccine immune protection and response to hepatitis B booster immunization. World J Gastroenterol 1998;4: 493-496.
  • Samandari T, Fiore A, Negus S, et al. Differences in response to a hepatitis B vaccine booster dose among Alaskan chil- dren and adolescents vaccinated during infancy. Pediatrics 2007; 120: e373-e381
  • El Ghandour S, El Sayed H, Abdel Hamid A, Gad S. Effective- ness of Hepatitis B Vaccination in Egyptian infants in Ismailia Governorate. Suez Canal University Med J 1998; 1:123-130.
  • Ocak S, Kaya H, Cetin M, Gali E, Ozturk M. Seroprevalence of hepatitis B and hepatitis C in patients with thalassemia and sickle cell anemia in a long-term follow-up. Arch Med Res 2006; 37:895-898
  • El Gawhary S, Omar N, Abdel Rahman L, Mahmoud M. He- patic viruses screening in multitransfused Egyptian thalas- semia patients. J Arab Child 2009;20:193-202.

Evaluation of immune status against hepatitis B in children with thalassemia major in Egypt: A single center study

Year 2012, Volume: 2 Issue: 02, 44 - 49, 01.06.2012
https://doi.org/10.5799/jmid.123149

Abstract

References

  • Sexana A, Phadke SR. Feasibility of thalassemia control by extended family screening in Indian context. J Health Popul Nutr 2002; 20:31-35.
  • El-Beshlawy A, Kaddah N, Moustafa A, et al. Screening for ß-thalassemia carriers in Egypt: Significance of the osmotic fragility test. East Mediterr Health J 2007; 13:224-230.
  • Rund D, Rachmilewitz E. ß-Thalassemia. N Engl J Med 2005; 353:1135-1146.
  • Bassily S, Hyams K, Fouad R, Samfaan M, and Hibbs R. A high risk of hepatitis C infection among Egyptian blood do- nors: The role of parenteral drug abuse. Am J Trop Med Hyg 52; 1995: 503-505.
  • Hauri A, Armstrong G, Hutin Y. The global burden of disease attributable to contaminated injections given in health care settings. Int J STD AIDS 2004; 15: 7-16.
  • Davis AR, Rosenthal P. Hepatitis B in children. Pediatr Rev 2008; 29:111-120
  • Elisofon SA, Jonas MM. Hepatitis B and C in children: current treatment and future strategies. Clin Liver Dis 2006; 10:133- 148.
  • El-Gilany AH, El-Fedawy S. Bloodborne infections among stu- dent voluntary blood donors in Mansoura University, Egypt. East Mediterr Health J 2006; 12:742-748.
  • Kao JH; Chen DS. Global control of hepatitis B virus infection, Lancet Infect Dis 2002; 2:395-403.
  • Kirk GD. Hepatitis B vaccination and liver cancer. In: Stew- art BW, Kleihues P (Eds).World Cancer Report. Lyon: IARC Press, 2003, 144-147.
  • Bonanni P, Pesavento G, Bechini A, et al. Impact of universal vaccination programs on the epidemiology of hepatitis B: 10 years of experience in Italy. Vaccine 2003; 21: 685-691.
  • Fitzsimons D, François G, Hall A, et al. Long-term efficacy of hepatitis B vaccine, booster policy, and impact of hepatitis B mutants. Vaccine 2005; 23:4158-4166.
  • World Health Organization. Last update: 3 October 2011, Immunization Profile-Egypt, WHO Vaccine Preventable Dis- eases Monitoring System web site, http://apps.who.int/im- munization_monitoring/en/globalsummary/countryprofilere- sult.cfm?C=egy [accessed Oct 5, 2011]
  • Rivkina A, Pharm D, Rybalov S. Chronic hepatitis B: Cur- rent and future treatment options. Pharmacotherapy 2002; 22: 721-737.
  • But DY, Lai CL, Lim WL, Fung J, Wong DK, Yuen MF. Twen- ty-two years follow-up of a prospective randomized trial of hepatitis B vaccines without booster dose in children: Final report. Vaccine 2008; 2; 26:6587-6591.
  • Saberifiroozi M, Gholamzadeh S, Serati AR. The long-term immunity among health care workers vaccinated against hepatitis B virus in a large referral hospital in southern Iran. Arch Iran Med.2006; 9:204-207.
  • Saraswat S, Banerjee K, Chaudhury N, et al. Post transfu- sion hepatitis type B following multiple transfusions of HBsAg negative blood. J Hepatol 1996; 25:639-643.
  • Chang MH. Impact of hepatitis B vaccination on hepatitis B disease and nucleic acid testing in high-prevalence popula- tions. J Clin Virol 2006; 36: 45-50.
  • Dentico P, Buongiorno A, Volpe A, Zavoianni D, De Mattia D, Sabato V. Long term persistence of anti-HBs after hepa- titis B immunization in thalassemic patients. Infection 1992; 20:276-278.
  • Wu JS, Hwang LY, Goodman KJ, Beasley RP. Hepatitis B vaccination in high-risk infants: 10 year follow-up. J Infect Dis. 1999; 179:1319-1325.
  • Peces R, Laures AS. Persistence of immunologic memory in long-term hemodialysis and healthcare workers given hepa- titis B vaccine: Role of a booster dose on antibody response. Nephron 2001; 89: 172-176.
  • Azarkeivan A, Karimi G, Shaiegan M, Maghsudlu M, Tab- baroki A. Antibody titration and immune response of Iranian beta-thalassemic patients to hepatitis B virus vaccine (boost- er effect). Pediatr Hematol Oncol 2009;26:195-201.
  • Vahidi AA, VaresVazirian M, Shamsadini A, et al. Determina- tion of hepatitis B surface antibody titer in vaccinated chil- dren with major thalassemia in Kerman, Iran. Iran J Immunol 2006; 3:30-34.
  • Sharifi Z, Milani S, Shooshtari M. Study on efficacy of hepa- titis B immunization in vaccinated beta thalassemia children in Tehran. Iran J Pediatric 2010; 20: 211-215.
  • Mokhles M, El Ashry R, Sedky M , et al. Long Term Efficacy of Hepatitis B Vaccine among High Risk Multiple Blood Transfu- sion Children in Egypt J Appl Sci Res. 2009; 5:2504-2510
  • Li H, Li RC, Liao SS, Yang JY, Zeng XJ, Wang SS. Persis- tence of hepatitis B vaccine immune protection and response to hepatitis B booster immunization. World J Gastroenterol 1998;4: 493-496.
  • Samandari T, Fiore A, Negus S, et al. Differences in response to a hepatitis B vaccine booster dose among Alaskan chil- dren and adolescents vaccinated during infancy. Pediatrics 2007; 120: e373-e381
  • El Ghandour S, El Sayed H, Abdel Hamid A, Gad S. Effective- ness of Hepatitis B Vaccination in Egyptian infants in Ismailia Governorate. Suez Canal University Med J 1998; 1:123-130.
  • Ocak S, Kaya H, Cetin M, Gali E, Ozturk M. Seroprevalence of hepatitis B and hepatitis C in patients with thalassemia and sickle cell anemia in a long-term follow-up. Arch Med Res 2006; 37:895-898
  • El Gawhary S, Omar N, Abdel Rahman L, Mahmoud M. He- patic viruses screening in multitransfused Egyptian thalas- semia patients. J Arab Child 2009;20:193-202.
There are 30 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section ART
Authors

Hanan H. Soliman This is me

Ibrahim Kabbash A. This is me

Mohamed R. El-shanshory This is me

Hala M. Nagy This is me

Said H. Abdou This is me

Publication Date June 1, 2012
Published in Issue Year 2012 Volume: 2 Issue: 02

Cite

APA Soliman, H. H., A., I. K., El-shanshory, M. R., Nagy, H. M., et al. (2012). Evaluation of immune status against hepatitis B in children with thalassemia major in Egypt: A single center study. Journal of Microbiology and Infectious Diseases, 2(02), 44-49. https://doi.org/10.5799/jmid.123149
AMA Soliman HH, A. IK, El-shanshory MR, Nagy HM, Abdou SH. Evaluation of immune status against hepatitis B in children with thalassemia major in Egypt: A single center study. J Microbil Infect Dis. June 2012;2(02):44-49. doi:10.5799/jmid.123149
Chicago Soliman, Hanan H., Ibrahim Kabbash A., Mohamed R. El-shanshory, Hala M. Nagy, and Said H. Abdou. “Evaluation of Immune Status Against Hepatitis B in Children With Thalassemia Major in Egypt: A Single Center Study”. Journal of Microbiology and Infectious Diseases 2, no. 02 (June 2012): 44-49. https://doi.org/10.5799/jmid.123149.
EndNote Soliman HH, A. IK, El-shanshory MR, Nagy HM, Abdou SH (June 1, 2012) Evaluation of immune status against hepatitis B in children with thalassemia major in Egypt: A single center study. Journal of Microbiology and Infectious Diseases 2 02 44–49.
IEEE H. H. Soliman, I. K. A., M. R. El-shanshory, H. M. Nagy, and S. H. Abdou, “Evaluation of immune status against hepatitis B in children with thalassemia major in Egypt: A single center study”, J Microbil Infect Dis, vol. 2, no. 02, pp. 44–49, 2012, doi: 10.5799/jmid.123149.
ISNAD Soliman, Hanan H. et al. “Evaluation of Immune Status Against Hepatitis B in Children With Thalassemia Major in Egypt: A Single Center Study”. Journal of Microbiology and Infectious Diseases 2/02 (June 2012), 44-49. https://doi.org/10.5799/jmid.123149.
JAMA Soliman HH, A. IK, El-shanshory MR, Nagy HM, Abdou SH. Evaluation of immune status against hepatitis B in children with thalassemia major in Egypt: A single center study. J Microbil Infect Dis. 2012;2:44–49.
MLA Soliman, Hanan H. et al. “Evaluation of Immune Status Against Hepatitis B in Children With Thalassemia Major in Egypt: A Single Center Study”. Journal of Microbiology and Infectious Diseases, vol. 2, no. 02, 2012, pp. 44-49, doi:10.5799/jmid.123149.
Vancouver Soliman HH, A. IK, El-shanshory MR, Nagy HM, Abdou SH. Evaluation of immune status against hepatitis B in children with thalassemia major in Egypt: A single center study. J Microbil Infect Dis. 2012;2(02):44-9.