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治疗初治的幼年特发性关节炎患者的乙型肝炎疫苗接种反应。

Hepatitis B vaccination response of treatment-naive patients with juvenile idiopathic arthritis.

机构信息

Department of Pediatric Rheumatology, Istanbul University Medical School, Istanbul University Istanbul Faculty of Medicine, Fatih, Istanbul, Turkey.

Department of Pediatric Rheumatology, Zeynep Kamil Women and Children's Diseases Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.

出版信息

Rheumatol Int. 2022 Jul;42(7):1199-1205. doi: 10.1007/s00296-021-04833-3. Epub 2021 Mar 18.

Abstract

To evaluate the vaccine response of treatment-naive juvenile idiopathic arthritis (JIA) patients who were fully vaccinated against Hepatitis B Virus (HBV) and then compare their antibody status with healthy controls. In this multicenter study, initial visit hepatitis B surface antigen (HbsAg) and anti-hepatitis B surface antibody (anti-Hbs) titers of 262 treatment-naive JIA patients who were followed up regularly between May 2015 and October 2019 were evaluated retrospectively from patients' medical records and compared with 276 healthy peers. Both HbsAg and anti-Hbs antibody titers were tested by the ELISA technique. Anti-HBs titers ≥ 10 IU/L were considered as reactive indicating seroprotection against HBV. In the JIA group, seropositivity rate was 59.1% while 72.9% of the control group were immune against HBV (p = 0.002). The median titer for anti-Hbs was 14 (range: 0-1000) IU/L in the patient group and 43.3 (range: 0-1000) IU/L in the control group (p = 0.01). Neither JIA patients nor healthy controls were positive for HbsAg. Patients with JIA vaccinated according to the national vaccination schedule were evaluated at their first visit in pediatric rheumatology outpatient clinics for anti-Hbs presence and it was found that they have lesser seroprotectivity than their age and sex-matched routinely vaccinated, healthy peers. So, to complete missing vaccines and booster vaccine doses, assessing the immune status of the patients at the time of diagnosis against HBV should be in the check-list of physicians dealing with pediatric rheumatic diseases.

摘要

评估已全程接种乙型肝炎病毒 (HBV) 疫苗的初治幼年特发性关节炎 (JIA) 患者的疫苗反应,并将其抗体状态与健康对照进行比较。在这项多中心研究中,回顾性分析了 2015 年 5 月至 2019 年 10 月期间定期随访的 262 例初治 JIA 患者的病历,评估了他们的初始就诊乙型肝炎表面抗原 (HbsAg) 和抗乙型肝炎表面抗体 (anti-Hbs) 滴度,并与 276 名健康同龄人进行了比较。HbsAg 和抗-HBs 抗体滴度均采用 ELISA 技术检测。anti-HBs 滴度≥10IU/L 被认为是对 HBV 具有反应性,表明具有血清保护作用。在 JIA 组中,血清阳性率为 59.1%,而对照组中有 72.9%的人对 HBV 具有免疫力 (p=0.002)。患者组的 anti-Hbs 中位数为 14(范围:0-1000)IU/L,对照组为 43.3(范围:0-1000)IU/L(p=0.01)。JIA 患者和健康对照者均未检测到 HbsAg 阳性。根据国家疫苗接种计划接种疫苗的 JIA 患者在儿科风湿病门诊就诊时评估 anti-Hbs 存在情况,发现他们的血清保护作用低于年龄和性别匹配的常规接种、健康同龄人。因此,为了完成缺失的疫苗和加强疫苗剂量,在诊断时评估患者针对 HBV 的免疫状态应成为处理儿科风湿病医生的检查清单的一部分。

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