Kamath Nivedita, Vasudevan Anil, Iyengar Arpana
Department of Pediatric Nephrology, St. John's Medical College Hospital, Bengaluru, Karnataka, India.
Saudi J Kidney Dis Transpl. 2019 Mar-Apr;30(2):334-338. doi: 10.4103/1319-2442.256840.
Seroconversion following hepatitis B vaccination is low in children with chronic kidney disease (CKD). This study aimed to assess the seroconversion and persistence of protective immunity following hepatitis B vaccination in children with CKD. This prospective observational study was conducted in a tertiary pediatric nephrology centre to assess the seroconversion and maintenance of antibody titers (>10 mIU/mL) at one year following hepatitis B vaccination (10 μg at 0, 1, and 2 months) in children with CKD Stages II to V. Those who did not seroconvert after the schedule were re-vaccinated, and antibody titers were checked. Categorical data were expressed as proportions and analyzed using the Chi-square test. Pearson's correlation test was used to determine the correlation of antibody titers with other continuous variables. Seroconversion was observed in 72% (n = 26/36) after vaccination. Only 60% (n = 6/10) had seroconversion after the second course of vaccination. Only 60% of children (n = 12/20) who seroconverted had protective antibody titers at one year. Seroconversion following three doses of hepatitis B vaccine is low in children with CKD. Antibody titers should be monitored periodically as the protective immunity wanes rapidly.
慢性肾脏病(CKD)患儿接种乙肝疫苗后的血清学转换率较低。本研究旨在评估CKD患儿接种乙肝疫苗后保护性免疫的血清学转换情况及持久性。这项前瞻性观察性研究在一家三级儿科肾脏病中心进行,以评估CKDⅡ至Ⅴ期患儿在接种乙肝疫苗(0、1和2个月时各接种10μg)后一年时抗体滴度(>10 mIU/mL)的血清学转换及维持情况。按接种程序接种后未发生血清学转换的患儿进行再次接种,并检查抗体滴度。分类数据以比例表示,并采用卡方检验进行分析。采用Pearson相关检验确定抗体滴度与其他连续变量之间的相关性。接种疫苗后72%(n = 26/36)观察到血清学转换。在第二剂疫苗接种后,只有60%(n = 6/10)发生血清学转换。在发生血清学转换的儿童中,只有60%(n = {12/20})在一年时具有保护性抗体滴度。CKD患儿接种三剂乙肝疫苗后的血清学转换率较低。由于保护性免疫迅速减弱,应定期监测抗体滴度。