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Reduced immune response to hepatitis B vaccine in children with insulin dependent diabetes
Author(s) -
FIÇICIOǦLU CAN,
MIKLA SHARARE,
MIDILLI KENAN,
AYDIN AHMET,
ÇAM HALIT,
ERǦIN SEVGI
Publication year - 1995
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.1995.tb03404.x
Subject(s) - medicine , hepatitis b vaccine , immune system , diabetes mellitus , insulin , hepatitis a vaccine , virology , immunology , immunization , endocrinology , hepatitis b virus , virus , hbsag
Twenty‐four patients with moderately controlled insulin dependent diabetes with a duration of diabetes ranging from 2 to 10 years as well as 17 control subjects were vaccinated against hepatitis B virus using Gen Hevac B vaccine. The vaccine was injected 0.5 mL intramuscularly into the deltoid region on three separate occasions at intervals of 1 month. If subjects were still negative for anti‐hepatitis B surface antigen (HBs) or had inadequate antibody after the third injection, a fourth administration of vaccine was given 3 months later. The mean anti‐HBs titer was 243.3 ± 97.2 mi.u./mL in control subjects and 39.8 ± 53.2 in diabetic patients ( P < 0.001). In the control group optimal protection was obtained in 100% of subjects, whereas 11 diabetic patients (45.8%) had low anti‐HBs titer (< 10 mi.u./mL). All of 11 diabetic patients showed adequate (> 10 mi.u./mL) anti‐HBs titer after the fourth dose of vaccine. In diabetic patients the most striking feature was the reduced CD4/CD8 ratio which was significantly lower ( P < 0.001) than that of the control group. We conclude that diabetic children have an impaired immune response to hepatitis B vaccine. It is suggested that diabetic children should be vaccinated against hepatitis B virus with four injections instead of three.