Seroconversion following hepatitis B vaccination in childhood steroid sensitive nephrotic syndrome

Background: The commonest factor associated with frequent relapse in minimal change nephrotic syndrome is infection, either bacterial sepsis or viral infection. Among the viral infections, hepatitis B virus (HBV) has a prominent role. Steroid sensitive nephrotic syndrome (SSNS) patients are immunocompromised because of the disease itself as well its treatment with a steroid. Thus, their seroprotection will not be enough with conventional dose as that of a healthy person.

Objective: To evaluate the seroresponse among SSNS with hepatitis B (HB) vaccination when they were in remission, to compare the antibody titre between single and double dose and to find out whether there were any complications following HB vaccination. 

Method: A prospective study was conducted among thirty SSNS children from July 2012 to June 2013; children were randomly assigned to be given either 10μg (Group-A) or 20μg (Group-B) of HBV vaccine. The vaccine was administered intramuscularly according to 0, 1, 2 months protocol. After one month of the last dose of vaccine, seroprotection rate was measured.

Results: The mean vaccine titres of Group-A and Group-B were 25.60 ±19.97 mIU/ml and 617.47 ± 292.11 mIU/ml respectively. The mean vaccine titre difference between the 2 groups was statistically significant.

Conclusion: Seroconversion was better observed by double dose (1ml) of HB vaccine in comparison to the single dose (0.5 ml) in children with SSNS during the remission period. There were no complications following HB vaccine during the study period.