The comparison of antibody titers secondary to intramuscularly, subcutaneous or intradermal application of low dose Hepatitis B vaccine

Abstract

Objectives: There are approximately 300 million HBV carriers where 25-30% of them had deceased due to cirrhosis or PHK. Universal vaccination is suggested worldwide against HBV because it is proven that vaccinating only the risk group is useless to reduce or eradicate the HB. However, the high costs limit its extensive usage. One way to reduce high costs is vaccinating in low dose. The purpose of this study is to determine the dependable, effective and low-cost dose as the result of evaluating the antibody titers against recombinant HB vaccine in three routes. Materials and methods: Antibody titers against three times intramuscularly (IM), subcutaneous (SC) and intradermal (ID) in different doses like 4µg, 10µg or 20µg were detected. Results: Totally, 96 newborn were chosen from HBsAg negative mothers and greater than 2500 gram in birth weight. They were randomly distributed into 7 groups. The recombinant HB vaccine (20 µg/0.5 ml. Gen-Hevac B. Pasteur Merieux) is applied as IM 20 µg (IM20) to 15, IM 10 µg (IM10) to 18, IM4µg (IM4) to 12, SC 20 µg to 12, SC 10 µg to 14, SC 4 µg to 10 and finally IM 4 µg to 15 babies after birth, at first month and sixth month. Six month after the third dose, the protective antibody titers gathered from the first four groups (100%, 93.4%, 91.6%, and 88.9% respectively) are accepted as sufficient. Conclusion: The application of low dose (4 pg) Hepatitis-B Vaccine via intradermal resulted in desired immunization level without reducing immune response and by reducing the cost five times.

Keywords

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Düşük doz hepatit B aşısının kas içi, deri altı veya deri içi uygulaması sonucu gelişen anti-HBs antikor titrelerinin karşılaştırılması

Öz

Amaç: Dünya'da 300 milyon Hepatit B virusu (HBV) taşıyıcısı olduğu ve bunların %25-30'unun Siroz veya Primer Hepatosellüler Karsinoma (PHK) nedeniyle kaybedildiği kabul edilmektedir. Bundan dolayı HBV'ne karşı tüm dünyada universal aşılama önerilmektedir. Ancak aşı maliyetinin yüksek olması yaygın kullanımını kısıtlamaktadır. Yüksek maliyeti azaltma yollarından biri de düşük dozlarda aşı uygulamasıdır. Bu çalışmanın amacı düşük doz Hepatit B aşısını üç değişik yolan uygulayarak elde edilen Anti-HBs antikor titrelerini karşılaştırmaktır. Gereç ve yöntem: Bu çalışmada, rekombinant HB aşısının intramuskuler (IM), subkutan (SK) veya intradermal (ID) değişik dozlarda (4.10 veya 20 µg) 3 kez uygulanması ile oluşan antikor titrelerinin değerlendirildi. Bulgular: HBsAg negatif anneden doğan, ağırlığı >2500 gram olan 96 yenidoğan bebek rastgele 7 gruba ayrıldı. İntramüsküler 20 µg (IM20) 15, IM 10 µg (IM10) 18, IM 4 µg (IM4) 12, SK 20 µg 12, SK 10 µg 14, SK 4 µg 10 ve ID 4 µg 15 bebeğe 0, 1 ve 6. aylarda rekombinant HB aşısı (20 µg /0.5 ml. Gen-Hevac B. Pasteur Merieux) uygulandı. Üçüncü dozdan 6 ay sonra ilk dört gurupta elde edilen koruyucu antikor titreleri (sırasıyla %100, %93.4, %91.6 ve %88.9) bulundu ve yeterli kabul edildi. Sonuç: Sonuç olarak ID yoldan düşük doz (4 µg) HB aşısı uygulamasının immün yanıtı azaltmadan maliyeti 5 kat azaltarak istenilen bağışıklama düzeyleri sağladığını söyleyebiliriz.

Anahtar Kelimeler

• Hepatit B, düşük doz aşı, antikor yanıtı, kasiçi, derialti, deriiçi

Kaynakça

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