Rosa Mariana Nogueira de Paula, Hessel Gabriel, Alves De Tommaso Adriana María
Departamento de Pediatria, Faculdade de Ciências Médicas, UNICAMP, Ciudad de Campinas, Sao Paulo, Brazil.
Acta Gastroenterol Latinoam. 2008 Sep;38(3):187-93.
In Brazil, approximately 130 new cases of hepatitis A per 100,000 inhabitants occur annually and 15% of the population has been in contact with hepatitis B virus. Portal hypertension causes hypersplenism and reduces T cell production, which may lead to less effective response to hepatitis vaccination. The objective of the study was to evaluate the response to hepatitis A and B vaccination in patients with portal hypertension secondary to chronic liver disease or portal vein thrombosis. Twenty-three patients (2 to 18 years) with portal hypertension seen at the Pediatric Hepatology Service of Hospital das Clínicas, Universidade Estadual de Campinas, between 1994 and 2006 were studied. Hepatitis A and B serology was tested in all patients. Patients who had not been vaccinated before their visits received the vaccines during the study period. Patients who had been vaccinated before but had negative anti-HB antibodies received a booster dose, and their serology was repeated Blood counts were performed in each patient to assess for immunosuppression. Eighteen patients received hepatitis A vaccine and all became positive for anti-HAV antibodies. All patients had received hepatitis B vaccine and 17 (73.9%) were anti-HBs positive at the time of the study The other 6 received a booster dose and became anti-HBs positive afterward. The anti-HBs-positive and -negative patients did not differ significantly in age, leukocytes, lymphocytes, or duration between the vaccination and positive serology. In this study, hepatitis A vaccines elicited a 100% response and hepatitis B vaccine conferred protection and induced an anamnestic response in pediatric patients with portal hypertension.
在巴西，每年每10万居民中约有130例甲型肝炎新发病例，15%的人口曾接触过乙型肝炎病毒。门静脉高压会导致脾功能亢进并减少T细胞生成，这可能会导致对肝炎疫苗的反应效果降低。本研究的目的是评估慢性肝病或门静脉血栓形成继发门静脉高压患者对甲型和乙型肝炎疫苗的反应。对1994年至2006年期间在坎皮纳斯州立大学临床医院儿科肝病科就诊的23例（2至18岁）门静脉高压患者进行了研究。对所有患者进行了甲型和乙型肝炎血清学检测。就诊前未接种疫苗的患者在研究期间接种了疫苗。之前接种过疫苗但抗-HB抗体呈阴性的患者接受了加强剂量接种，并再次进行血清学检测。对每位患者进行血细胞计数以评估免疫抑制情况。18例患者接种了甲型肝炎疫苗，所有患者抗-HAV抗体均转为阳性。所有患者均接种了乙型肝炎疫苗，研究时17例（73.9%）抗-HBs呈阳性。另外6例接受了加强剂量接种，之后抗-HBs转为阳性。抗-HBs阳性和阴性患者在年龄、白细胞、淋巴细胞或接种疫苗至血清学阳性之间的时间间隔方面无显著差异。在本研究中，甲型肝炎疫苗引发了100%的反应率，乙型肝炎疫苗在门静脉高压儿科患者中提供了保护并诱导了回忆反应。
