Immunogenicity of Hepatitis B vaccine in multi-transfused Thalassemic patients with and without Hepatitis C infection: A comparative study with healthy controls
Hepatitis C virus (HCV) infection is highly prevalent in thalassemic patients, and this may decrease the serum antibody response to hepatitis B virus (HBV) vaccine. There is also some alteration of the immune system in multi-transfused thalassemic patients, as a consequence of iron overload. We investigated whether HCV infection may reduce the effectiveness of HBV vaccine in multi - transfused thalassemic patients. Subjects were cited and studied prospectively in three groups: group 1: 125 multi-transfused thalassemic patients with negative serum HCV antibody; group 2: 96 multi-transfused thalassemic patients with positive serum HCV antibody (ELISA II), in at least 2 different occasions; group 3: 100 healthy subjects. Matching was performed between three groups in sex, age and body mass index and subjects in all groups had negative serum HBsAg, anti-HBc and anti-HBs and received three 20 µgr/dose injections of recombinant HBV vaccine (Heberbiovac HB) in months 0, 1, 6. Anti-HBs titer was obtained one month after the last dose of vaccine and it was considered seroprotective if it was 2: 10 IU/L. Seroprotection rate was 83.2% in group 1 and 80.2% in group 2 (p=0.74) and was 86% in healthy subjects, which didn't significantly differ with HCV positive and negative thalassemics (p>0.05). Moreover, the mean values of ALT among the responders and non-responder thalassemic patients were 55.5 ± 41.9 and 57.4 ±48.5 U/L respectively (p=0.802). During vaccination periods, patients in all 3 groups did not show any significant adverse reactions. Our study shows that three standard doses of HBV vaccine are immunogenic and safe in multi-transfused thalassemic patients with or without HCV infection.