Advanced Biomedical Research
The Immune Response of Vaccination Against Hepatitis B virus in Iranian Patients Undergoing Chemotherapy
Authors
- Mohsen Meidani 1
- Farzin Khorvash 2
- Simin Hemati 3
- Farzaneh Ashrafi 4
- Behrouz Ataei 5
- Dana Daneshmand 5
1 Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan; Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Department of Infectious Diseases, Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
3 Department of Oncology and Radiotherapy, Isfahan University of Medical Sciences, Isfahan, Iran
4 Department of Hematology and Oncology, Isfahan University of Medical Sciences, Isfahan, Iran
5 Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Introduction: Hepatitis B virus (HBV) infection and its complications are major public health problems. As it is hard to treat and control the chronic state, control of disease depends on the prevention especially by vaccination. There is an impaired immune response to vaccinations including HBV in patients with some malignancies. The aim of this study is to assess the response rate of patients undergoing chemotherapy to HBV vaccination. Materials and Methods: All patients from two hematology/oncology clinics in Isfahan, Iran with the history of at least 1 month chemotherapy who had the inclusion criteria were enrolled in a case control study. Also a sex- and age-matched control group from healthy population was selected. They were vaccinated in a schedule of 0, 1, and 6 months and were examined for antibody titers 1 month after the last dose. The titers more than 10 mIU/ml were determined as positive response to vaccination. Results: In this study, 50 patients and 50 healthy subjects were enrolled. The two groups were age and sex matched (P > 0.05). Frequency of negative responses to HBV vaccination in case and control groups were 9 (18%) and 1 (2%), respectively (OR = 10.75, CI = 1.30–88.47, P = 0.027). Of 50 patients, 54%, 12%, 22%, and 12% had breast cancer, lymphoma, gastrointestinal, and genitourinary cancers, respectively, and frequency of negative responses were 3 (11%), 1 (16%), 4 (36.4%), and 1 (16%), respectively (P = 0.167). Conclusion: According to our results, malignancy and chemotherapy will have an important effect on the immune system and cause negative response to HBV vaccination. Our results revealed the importance of passive immunity and screening for HBV infection in patients undergoing chemotherapy. Also more studies for better vaccination schedules in this group of patients are recommended.
Keywords
| 1. |
McMahon BJ. Epidemiology and natural history of hepatitis B. Semin Liver Dis 2005;25(Suppl 1):3-8.  |
| 2. |
Nahar K, Jahan M, Nessa A, Tabassum S. Antibody responses after hepatitis B vacination among maintenance haemodialysis patients. Bangladesh Med Res Coun Bull 2011;37:88-91. |
| 3. |
Mohammad Nejad E, Jafari S, Mahmoodi M, Begjani J, Roghayyeh Ehsani S, Rabirad N. Hepatitis B virus antibody levels in high-risk health care workers. Hepat Mon 2011;11:662-3. |
| 4. |
Wistrom J, Ahlm C, Lundberg S, Settergren B, Tarnvik A. Booster vaccination with recombinant hepatitis B vaccine four years after priming with one single dose. Vaccine 1999;17:2162-5. |
| 5. |
Ganczak M. A cross-sectional study on anti hepatitis B immune status in vaccinated healthcare workers in the west pomeranian region of poland. Hepat Mon 2012;12:185-9. |
| 6. |
Wong EK, Bodsworth NJ, Slade MA, Mulhall BP, Donovan B. Response to hepatitis B vaccination in a primary care setting: Influence of HIV infection, CD4+ lymphocyte count and vaccination schedule. Int J STD AIDS 1996;7:490-4. |
| 7. |
Fisman DN, Agrawal D, Leder K. The effect of age on immunologic response to recombinant hepatitis B vaccine: A meta-analysis. Clin Infect Dis 2002;35:1368-75. |
| 8. |
Sabido M, Gavalda L, Olona N, Ramon JM. Timing of hepatitis B vaccination: Its effect on vaccine response in health care workers. Vaccine 2007;25:7568-72. |
| 9. |
Wood RC, MacDonald KL, White KE, Hedberg CW, Hanson M, Osterholm MT. Risk factors for lack of detectable antibody following hepatitis B vaccination of Minnesota health care workers. JAMA 1993;270:2935-9. |
| 10. |
Alavian SM, Mahboobi N. Anti-HBs antibody status and some of its associated factors in dental health care workers in Tehran University of Medical Sciences: Anti-HBs Ab and associated factors in dental society. Hepat Mon 2011;11:99-102. |
| 11. |
Grosso G, Mistretta A, Marventano S, Ferranti R, Mauro L, Cunsolo R, et al. Long-term persistence of seroprotection by hepatitis B vaccination in healthcare workers of southern Italy. Hepat Mon 2012;12:e6025. |
| 12. |
Coppola RC, Meloni A, Campagna M. Impact of universal vaccination against hepatitis B: The italian model. Hepat Mon 2012;12:417-9. |
| 13. |
Ramesh M, Marwaha R, Chawla Y, Trehan A. Seroconversion after hepatitis B vaccination in children receiving cancer chemotherapy. Indian Pediatr 2000;37:882-5. |
| 14. |
Alavian SM, Tabatabaei SV, Ghadimi T, Beedrapour F, Kafi-Abad SA, Gharehbaghian A, et al. Seroprevalence of Hepatitis B Virus Infection and Its Risk Factors in the West of Iran: A Population-based Study. Int J Prev Med 2012;3:770-5. |
| 15. |
Siber GR, Weitzman SA, Aisenberg AC, Weinstein HJ, Schiffman G. Impaired antibody response to pneumococcal vaccine after treatment for Hodgkin's disease. N Engl J Med 1978;299:442-8. |
| 16. |
Entacher U, Jurgenssen O, Thun-Hohenstein L, Simbruner G, Khoss A, Wank H, et al. Hepatitis B vaccination and immune response in children with malignant diseases. Eur J Pediatr 1985;144:160-3. |
| 17. |
Hovi L, Valle M, Siimes MA, Jalanko H, Saarinen UM. Impaired response to hepatitis B vaccine in children receiving anticancer chemotherapy. Pediatr Infect Dis J 1995;14:931-5. |
| 18. |
Berberoglu S, Büyükpamukcu M, Sarialioglu F, Akyüz C, Ilhan I. Hepatitis B vaccination in children with cancer. Pediatr Hematol Oncol 1995;12:171-8. |
| 19. |
Rosen HR, Stierer M, Wolf HM, Eibl MM. Impaired primary antibody responses after vaccination against hepatitis B in patients with breast cancer. Breast Cancer Res Treat 1992;23:233-40.
|
)