Hepatitis B virus vaccination in children with steroid sensitive nephrotic syndrome: Immunogenicity and safety?
Hepatitis B virus vaccination in children with steroid sensitive nephrotic syndrome: Immunogenicity and safety?
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DOI：
10.1016/j.vaccine.2013.05.004
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发表时间：
2013-07-18
期刊：
影响因子：
5.5
通讯作者：
Caliskan, S.
中科院分区：
文献类型：
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作者：
Yildiz, N.;Sever, Lale;Caliskan, S.
为探讨乙肝疫苗(HBVac)治疗激素敏感型肾病综合征(SSNS)的有效性和安全性，对41例SSNS患者和30例对照儿童接种了HBVac(Engerix B(R))。患者被分成3个亚组：全量使用类固醇、隔日使用类固醇和不使用类固醇。在第6个月(p=0.015)和第12个月(p=0.036)，使用类固醇的患者血清转换率低于未使用的患者。15个月时，亚组与对照组之间的乙肝表面抗原抗体滴度差异有统计学意义。然而，在12个月和15个月时，不同亚组之间的乙肝表面抗体和应答率没有差异(p>；0.05)。5名患者对HBVac无反应。接种后复发率高于接种前(p=0.002)。HBVac对激素治疗的SSNS儿童产生免疫应答的效果较差。HBVac在某些患者中可能会引发复发。我们建议使用小剂量激素治疗或停用激素后的SSNS儿童使用HBVac。(C)2013爱思唯尔有限公司。保留所有权利。
We investigated the efficacy and safety of Hepatitis B vaccine (HBVac) in steroid sensitive nephrotic syndrome (SSNS) children.41 patients with SSNS and 30 controls were vaccinated with HBVac(Engerix B (R)). Patients were divided into 3 subgroups:full dose steroid users, alternate-day steroid users and steroid non-users. Seroconversion rate was lower in steroid users than non-users at the 6th(p = 0.015) and 12th(p = 0.036) months. Antibody to Hepatitis B surface antigen(HBsAb) titers were significantly different between subgroups and controls at the 15th month. However, HBsAb and response rates were not different between subgroups at the 12th and 15th months (p>0.05). Five patients were unresponsive to HBVac. Relapse rates after the vaccination were higher than those in the prevaccination period (p = 0.002).HBVac is less effective in producing immune response in SSNS children with steroid therapy. HBVac may trigger relapse in some patients. We recommend HBVac to SSNS children with low dose steroid therapy or after steroids are discontinued. (C) 2013 Elsevier Ltd. All rights reserved.