Efficacy of HBV vaccination in children with thalassemia major

Hepatitis B is a major problem occurred in patients with thalassemia major due to repeated blood transfusion. Regarding its acute and chronic complications (Fulminant hepatitis, Cirrhosis, Hepatic neoplasm), vaccination could be helpful in thalassemia patients. Immune suppression due to frequent blood transfusion iron blood persistent hemolytic, decreased anti-HBS-Ab level after HBV vaccination.

This descriptive study was performed in South Khorasan in 2007 on 38 patients with major thalassemia. All patients have received Hepatitis B vaccine. A questionnaire containing some questions about demographic characteristics was filed for all patients including: age, sex, frequency of blood transfusion in year. The blood samples of patients were tested to detect serum markers including HBS Ag, anti-HBS with ELISA method. The results were analyzed by using SPSS.

Of 38 patients with major thalassemia, 20 (52.6 %) were male and 18 (47.4 %) were female. Average age of patients was 9.2±4.6. 37 patients (97.4 %) have transfusion >12 time in year. All of patients were negative for HBS Ag and anti-HBC. 16 patients (42.1 %) was anti-HBS Ab positive and 22 patients (57.9 %) was anti-HBS-Ab negative. Based on the Serum levels of anti HBS-Ab, subjects were categorized as: Good responder (anti HBS> 100 IU/lit) (34.2 %) Low responder (anti-HBS 10-100 IU/lit) (23.7 %) Non responder (anti-HBS < 10 IU/lit) (42.1 %). 34/2 % of patients that over 5 years lapsed since last vaccine injection were responders. Statistical analysis has not shown significant relationship between age, sex and anti-HBS-Ab (p> 0.05) and time lapsed since last vaccination in two groups (p> 0.05).

Immune response in children with thalassemia major lower than normal children and we recommended determining the antibody level after the last vaccination and if necessary, booster dose gives them.