Kids with Arthritis Respond to Hepatitis B Vaccine

Hepatitis B vaccination can generate an adequate immune response in children with juvenile idiopathic arthritis (JIA) and this response is unaffected by the use of immune-suppressing drugs, new research suggests.

Hepatitis B vaccination can generate an adequate immune response in children with juvenile idiopathic arthritis (JIA) and this response is unaffected by the use of immune-suppressing drugs, new research suggests.As many as 300,000 children in America have JIA, a group of joint diseases for which the cause is poorly understood. In some cases, immune-suppressing drugs have proven effective.The new findings have important implications for developing countries where hepatitis B virus (HBV) infection is a common problem, lead author Dr. Ozgur Kasapcopur and colleagues, from Istanbul University in Turkey, note.Initially, researchers thought that hepatitis B vaccination might worsen persistent joint diseases in adults. However, it was later shown that this was not the case and, in fact, they had an effective immune response to the vaccine. Still, the matter has not been resolved in children.To address this issue, Kasapcopur’s team evaluated the safety and effectiveness of hepatitis B vaccination in 39 children with JIA and in 41 healthy children. The subjects were given the usual three doses of the vaccine when the study began, 1 month later, and then either 3 or 6 months later.With the exception of one JIA patient, all of the subjects displayed an anti-HBV immune response, the researchers report in the Annals of the Rheumatic Diseases.Antibody levels were lower in the JIA group than in the healthy group, but were still considered adequate for protection. Treatment with methotrexate or prednisolone, two commonly used immune-suppressing drugs, did not influence antibody levels in the JIA group.The vaccination schedule used did not affect antibody levels in the healthy group. In contrast, in the JIA group, there was a trend toward a better immune response when the final vaccine dose was given at 6 months rather than at 3.Hepatitis B vaccination appeared safe in the JIA group with none of the subjects experiencing a worsening of their disease.”Further studies are needed with larger numbers of patients to confirm these findings,” the authors state.(SOURCE: Annals of the Rheumatic Diseases, September 2004.)