Maritsi Despoina N, Coffin Susan E, Argyri Ioanna, Vartzelis George, Spyridis Nick, Tsolia Maria N
Second Department of Paediatrics, P. & A. Kyriakou Children's Hospital, University of Athens, Greece.
Division of Infectious Diseases, Centre for Paediatric Clinical Effectiveness, and Department of Infection Prevention, Children's Hospital of Philadelphia, PA, USA.
Clin Exp Rheumatol. 2017 Jul-Aug;35(4):711-715. Epub 2017 Jul 13.
To describe the immunogenicity and side effects of immunisation against hepatitis A virus (HAV) in JIA patients on methotrexate treatment, who have not been previously exposed to HAV.
Case-control study performed in JIA patients and healthy controls matched on age and gender. The subjects received two doses of inactivated anti-HAV vaccine (720 mIU/ml) intramuscularly at 0 and 6 months. Seroconversion, seroprotection rates and anti-HAV-IgG titres were measured at 1, 7 and 18 months. Children were monitored for adverse events.
83 JIA patients and 76 controls were enrolled in the study. At one month, seroprotection rates were lower in children with, as compared to those without JIA (48.2% vs. 65%; p=0.05). At 7 and 18 months, rates of seroprotection rose significantly and were similar in both groups. The titre of anti-HAV-IgG was lower in children with JIA than healthy children at all time points (p<0.001). Vaccines were well tolerated.
Two doses of inactivated HAV vaccine were well tolerated and immunogenic in most immunosuppressed children with JIA; however, a single dose of HAV vaccine was insufficient to induce seroprotection in half of the patients. Further studies are required to analyse the long-term immunity against HAV in this population and optimal HAV immunisation regimen.
描述甲氨蝶呤治疗的幼年特发性关节炎（JIA）患者（此前未接触过甲型肝炎病毒（HAV））接种HAV疫苗后的免疫原性和副作用。
在年龄和性别匹配的JIA患者和健康对照中进行病例对照研究。受试者在0个月和6个月时肌肉注射两剂灭活抗HAV疫苗（720 mIU/ml）。在1、7和18个月时测量血清转化、血清保护率和抗HAV-IgG滴度。对儿童进行不良事件监测。
83例JIA患者和76例对照纳入研究。1个月时，与无JIA的儿童相比，JIA儿童的血清保护率较低（48.2%对65%；p=0.05）。在7个月和18个月时，血清保护率显著上升，两组相似。在所有时间点，JIA儿童的抗HAV-IgG滴度均低于健康儿童（p<0.001）。疫苗耐受性良好。
两剂灭活HAV疫苗在大多数免疫抑制的JIA儿童中耐受性良好且具有免疫原性；然而，单剂HAV疫苗不足以使一半患者产生血清保护。需要进一步研究分析该人群对HAV的长期免疫力以及最佳HAV免疫方案。
