Immunization against Viral Hepatitis A and B in Children with Autoimmune Hepatitis
Chlíbek R.1, Beran J.1,4, Dědek P.2, Štěpánová V.3, Špliňo M.1, Pozler O.2
Vakcinační centrum, Katedra epidemiologie, Vojenská lékařská akademie J. E. Purkyně, Hradec Králové,1 vedoucí prof. MUDr. M. Špliňo, DrSc. Dětská klinika, Fakultní nemocnice, Hradec Králové,2 přednostka doc. MUDr. E. Pařízková, CSc. Ústav klinické mikrobiologie, Fakultní nemocnice, Hradec Králové,3 přednosta prof. MUDr. J. Horáček, CSc. Klinika infekčních nemocí, Fakultní nemocnice, Hradec Králové,4 přednosta doc. MUDr. V. Dostál |
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Summary:
Prevention of infectious hepatitis type A and B in patients with autoimmune hepatitis is important with regard
to possible course deterioration of the basic disease after a history of infectious hepatitis. The most effective
possibility is immunisation with a combined vaccine against both types of viral hepatitis. The objective of the
presented study implemented in 2000 - 2001 was to assess the safety and immunogenicity of vaccination incl. the
influence on the clinical course of autoimmune hepatitis in patients vaccinated with the combined vaccine Twinrix.
In the immunogenicity no significant difference was recorded in the post-vaccination titres of anti-HAV antibodies
between the patients and healthy subjects in similar clinical studies. Child patients (6 subjects,mean age 12.8 years)
as well as patients older than 16 years (4 subjects, mean age 19.8 years) achieved significantly lower anti-HBs
antibody values than their healthy peers. In all investigated patients a 100% anti-HAV seroconversion was found
one month after the completed basic immunization with 3 doses of vaccine (pattern: month 0, 1, 6). Two patients
(age 19 and 21 years) did not respond to the antigen of the hepatitis B virus in the vaccine and were described as
non-responders. Anti-HBs seroprotection was only 50% in group older than 16 years.Vaccination did not influence
in a significant way the clinical course of the disease and the vaccine was well tolerated.
Key words:
autoimmune hepatitis, vaccination, immunogenicity, safety
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