Abstract
Objectives
To study the prevalence of Hepatitis B seroprotection in children (>1 y) with nephrotic syndrome vaccinated against Hepatitis B vaccine as per the Universal Immunization Program schedule (0,6,10,14 wk); to compare the Hepatitis B seroprotection rates and anti-HBs titers among different phenotypes of nephrotic syndrome; to evaluate the association between Hepatitis B seroprotection status and the immunosuppressive agents; and to study the correlation between anti-HBs titres and proteinuria.
Methods
Hepatitis B serology and anti-HBs titers were analyzed in 100 children (age-1-18 y) with different clinical phenotypes of nephrotic syndrome (cases) and 100 healthy controls.
Results
The proportion of seroprotected children among the cases and controls was 37% (n=37) and 61% (n=61), respectively (P<0.04). The median (IQR) anti- HBs antibodies titers among the cases was 75 (62.5, 81) mIU/mL and 112 (56, 367) mIU/mL among the controls (P=0.001). The proportion of seroprotected children among the steroid sensitive nephrotic syndrome, steroid-resistant nephrotic syndrome and controls was 40% (n=28), 30% (n=9) and 61% (n=61), respectively (P<0.01). No differences in the anti-HBs titers between children receiving steroids versus steroids along with other immunosuppressants were found. Weak negative correlation was noted between proteinuria and protective titers (r = −0.155; P=0.039).
Conclusion
Children with nephrotic syndrome, in general, and steroid-resistant nephrotic syndrome in particular, show poor seroprotection with Hepatitis B vaccination.
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NN: collected the data, reviewed the literature and drafted the first version of the manuscript; SK: conceptualized the study, designed the study protocol, reviewed the literature and revised the manuscript; BJ: participated in protocol preparations and critically reviewed the manuscript; RD: participated in protocol preparations, supervised the laboratory tests and critically reviewed the manuscript. All authors approved the final version of the manuscript, and are willing to be accountable for all aspects of the study. SK: shall act as guarantor of the paper.
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Intramural funding from JIPMER, Puducherry.
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None stated.
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Neupane, N., Krishnamurthy, S., Jagadisan, B. et al. Hepatitis B Seroprotection in Pediatric Nephrotic Syndrome. Indian Pediatr 56, 659–662 (2019). https://doi.org/10.1007/s13312-019-1589-0
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DOI: https://doi.org/10.1007/s13312-019-1589-0