ORIGINAL PAPER
Assessment of anti-HBs antibody concentration in children with juvenile idiopathic arthritis treated with biological drugs, vaccinated against viral type B hepatitis in infancy
1
Clinic of Developmental Age Rheumatology, National Institute of Geriatric, Rheumatology and Rehabilitation, Warsaw, Poland
Submission date: 2019-11-20
Final revision date: 2020-02-18
Acceptance date: 2020-02-20
Online publication date: 2020-02-28
Publication date: 2020-02-28
Reumatologia 2020;58(1):15-20
KEYWORDS
TOPICS
ABSTRACT
Objectives:
The introduction of vaccinations against viral hepatitis B in the years 1994–1996 in Poland significantly improved the epidemiological situation of hepatitis B virus (HBV) infections in our country. According to the report of the National Institute of Public Health – National Institute of Hygiene in 2018, 40 cases of acute hepatitis B were noted while still in the 1980s between 10 and 20 thousand new cases were reported annually. The aim of the study was to determine whether in children treated with biological drugs (adalimumab, etanercept, infliximab) due to juvenile idiopathic arthritis (JIA), vaccinated against hepatitis B in infancy, a protective concentration of anti-HBs antibodies persists. In patients, the value ≥ 10 mIU/ml is regarded as a protective concentration of antibodies, determined at least four weeks after administration of the last vaccine dose. Among healthy individuals, presence of anti-HBs antibodies in any concentration means seroprotection. No booster vaccinations are recommended in basically vaccinated healthy individuals.
Material and methods:
The concentrations of anti-HBs antibodies were determined in 56 children with JIA (38 girls – 67.9% and 18 boys – 32.1%) aged from 2 years and 4 months to 17.5 years, treated for at least three months with biological drugs. The diagnosis of JIA was made based on the International League of Associations for Rheumatology (ILAR) criteria. All studied patients were at the stable stage of the disease and received a full course of hepatitis B vaccination during infancy (in accordance with 0,1,6 months injection scheme).
Results:
In the studied children a protective anti-HBs antibody concentration was found in 34 cases (60.7%), and 22 children (39.3%) had anti-HBs antibody concentration < 10 mIU/ml (in these children no seroprotection was found).
Conclusions:
The post-vaccination antibody concentration should be determined in children with JIA, treated with biological drugs and, in case of absence of a protective concentration, revaccination should be started.
The introduction of vaccinations against viral hepatitis B in the years 1994–1996 in Poland significantly improved the epidemiological situation of hepatitis B virus (HBV) infections in our country. According to the report of the National Institute of Public Health – National Institute of Hygiene in 2018, 40 cases of acute hepatitis B were noted while still in the 1980s between 10 and 20 thousand new cases were reported annually. The aim of the study was to determine whether in children treated with biological drugs (adalimumab, etanercept, infliximab) due to juvenile idiopathic arthritis (JIA), vaccinated against hepatitis B in infancy, a protective concentration of anti-HBs antibodies persists. In patients, the value ≥ 10 mIU/ml is regarded as a protective concentration of antibodies, determined at least four weeks after administration of the last vaccine dose. Among healthy individuals, presence of anti-HBs antibodies in any concentration means seroprotection. No booster vaccinations are recommended in basically vaccinated healthy individuals.
Material and methods:
The concentrations of anti-HBs antibodies were determined in 56 children with JIA (38 girls – 67.9% and 18 boys – 32.1%) aged from 2 years and 4 months to 17.5 years, treated for at least three months with biological drugs. The diagnosis of JIA was made based on the International League of Associations for Rheumatology (ILAR) criteria. All studied patients were at the stable stage of the disease and received a full course of hepatitis B vaccination during infancy (in accordance with 0,1,6 months injection scheme).
Results:
In the studied children a protective anti-HBs antibody concentration was found in 34 cases (60.7%), and 22 children (39.3%) had anti-HBs antibody concentration < 10 mIU/ml (in these children no seroprotection was found).
Conclusions:
The post-vaccination antibody concentration should be determined in children with JIA, treated with biological drugs and, in case of absence of a protective concentration, revaccination should be started.
REFERENCES (22)
1.
Komiya Y, Katayama K, Yugi H, et al. Minimum infectious dose of hepatitis B virus in chimpanzees and difference in the dynamics of viremia between genotype A and genotype C. Transfusion 2008; 48: 286-294, DOI: 10.1111/j.1537-2995.2007.01522.x.
2.
Kuchar E, Mrukowicz J, Stryczyńska-Kozubal J, et al. Szczepienia przeciwko wirusowemu zapaleniu wątroby typu B. Szczepienia 2017; 4: 88-91.
3.
World Health Organization Newletter. Hepatitis B Key facts.Lipiec, 2015. http://www.who.int/mediacentre... (access: 19.11.2019).
4.
Kowalska M, Kalinowski P, Bojakowska U, Krauze M. Epidemiology of hepatitis B in Poland in 2010-2014. J Education, Health and Sport. 2017; 7: 414-426, DOI: 10.5281/zenodo.344961.
5.
Magdzik W, Czarkowski M. Sytuacja epidemiologiczna wirusowego zapalenia wątroby typu B w Polsce w latach 1979–2004. [Epidemiological situation of hepatitis B in Poland in the years 1979–2004]. Prz Epidemiol 2006; 60: 471-480.
6.
Woynarowski M. Polski dziecięcy program interferonowy leczenia przewlekłego zapalenia wątroby typu B. Koncepcja, realizacja i efekty. Rozprawa habilitacyjna, Warszawa 2005.
7.
Informacje o zachorowaniach na choroby zakaźne i zatruciach w Polsce w 2018 roku. NIPZ-PZH Warszawa, 2019. http://wwwold.pzh.gov.pl/oldpa... (access: 19.11.2019).
8.
Pokorska-Lis M, Marczyńska M. Czy nastolatki szczepione w wieku niemowlęcym mają odporność przeciwko WZW typu B? Prz Lek 2010; 67: 13-17.
9.
Kuchar E, Załęski A, Kozłowska-Jałowska A. Profilaktyka poekspozycyjna chorób zakaźnych. Szczepienia 2018; 2: 76-81.
10.
Petty RE, Southwood TR, Manners P, et al. International League of Association for Rheumatology Classification of Juvenile Idiopathic Arthritis: second revision, Edmonton, 2001. J Rheumatol 2004; 31: 390-392.
11.
Stępień M. Rośnie liczba przewlekłych przypadków WZW B w krajach UE/EEA. https://szczepienia.pzh.gov.pl... (access: 19.11.2019).
12.
Szczygielska I, Hernik E, Kwiatkowska M, et al. Ocena stężenia poszczepiennych przeciwciał anty-HBs u dzieci z zapalnymi układowymi chorobami tkanki łącznej leczonych immunosupresyjnie. [Assessment of the level of vaccine-induced anti-HBs antibodies in children with inflammatory systemic connective tissue diseases treated with immunosuppression]. Reumatologia 2015; 53: 56-60, DOI: 10.5114/reum.2015.51503.
13.
Maritsi D, Vartzelis G, Soldatou A, et al. Markedly decreased antibody titers against hepatitis B in previously immunised children presenting with juvenile idiopathic arthritis. Clin Exp Rheumatol 2013; 31: 969-973.
14.
Furer V, Rondaan Ch, Hejistek MW, et al. 2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases. Ann Rheum Dis 2020; 79: 39-52, DOI: 10.1136/annrheumdis-2019-215882.
15.
Heijstek MW, Ott de Briun LM, Bijl M, et al. EULAR recommendations for vaccination in peadiatric with rheumatic diseases. Ann Rheum Dis 2011; 70: 1704-1712, DOI: 10.1136/ard.2011.150193.
16.
Kasapçopur Ö, Çullu F, Kamburoðlu-Goksel A, et al. Hepatitis B vaccination in children with juvenile idiopathic arthritis. Ann Rheum Dis 2004; 63: 1128-1130.
17.
Nerome Y, Akaike H, Nonaka Y, et al. The safety and effectiveness of HBV vaccination in patients with juvenile idiopathic arthritis controlled by treatment. Mod Rheumatol 2016; 26: 368-371, DOI: 10.3109/14397595.2015.1085608.
18.
Toplak N, Avčin T. Long-term safety and efficacy of varicella vaccination in children with juvenile idiopathic arthritis treated with biologic therapy. Vaccine 2015; 33: 4056-4059, DOI: 10.1016/j.vaccine.2015.06.086.
19.
Groot N, Pileggi G, Sandoval CB, et al. Varicella vaccination elicits a humoral and cellular response in children with rheumatic diseases using immune suppressive treatment. Vaccine 2017; 35: 2818-2822, DOI: 10.1016/j.vaccine.2017.
20.
Silva CA, Terreri MT, Aikawa NE, et al. Vaccination practice in children with rheumatic disease. Rev Bras Reumatol 2010; 50: 351-361.
21.
Haykir Solay A, Eser F. High dose hepatitis B vaccine is not effective in patients using immunomodulatory drugs: a pilot study. Hum Vaccin Immunother 2019; 15: 1177-1182, DOI: 10.1080/21645515.2019.1574151.
22.
Rywczak I, Ściubisz M. Program szczepień ochronnych w Polsce na 2019 rok. Szczepienia 2019; 1: 37-49.
Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
| eISSN: | 2084-9834 |
| ISSN: | 0034-6233 |
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