Title: Hepatitis B Vaccine Response in Selected Immunocompromised Population
Authors: Dr Nasha Kollathodi, Dr Anitha Poduvail Moorkoth, Dr Ajithkumar Vellani Thamunni, Dr Melemadathil Sreelatha
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.152
Abstract
Background: Prevention of hepatitis B is highly essential insusceptible population including immunocompromised individuals like patients with leukemia on chemotherapy and CKD patients on hemodialysis. Immune response is generally lower among these individuals. However, if protective antibody levels are attained, it confers protection on subsequent exposures to HBV.
Aim: To evaluate the immune response to hepatitis B vaccine in immunocompromised.
Methods: A cross sectional study conducted on 100 patients at a tertiary care center in northern Kerala for a period of 1 year. The study population divided into category I- Children with leukemia on chemotherapy and category II- CKD patients on hemodialysis, immunized within past 10 years were tested for anti-HBs by quantitative ELISA. Those who had inadequate response were tested for HBsAg and additional doses administered.
Results: 76%showed adequate anti-HBs levels (Category I- 70% and category II- 82%). 7 subjects detected to be HBsAg positive were children with leukemia not immunized routinely but at the time of chemotherapy. In category I, 87.5% response was detected in those immunized as part of routine primary immunization and 53.8% in those immunized at the time of chemotherapy (p =0.009). In category II, 81.3% response seen with 0-1-2-6 regimen and 100% with 0-1-2-12(p =0.499).On giving additional doses the remaining subjects also responded.
Conclusion: Protective immune response was achieved in all subjects after additional doses in indicated individuals. Immunization during chemotherapy was seen to be less effective in children with leukemia. This study emphasizes the importance of routine primary immunization.
Keywords: hepatitis b vaccine, anti-HBs, vaccine response.
