Seroprotection Status of Hepatitis B Vaccine in Children with Type 1 Diabetes Mellitus

Abstract

Background: "Type 1 diabetes mellitus [T1DM]" is the most common endocrine disease in the Pediatric population. It has been suggested that T1DM had inadequate immunological response to vaccines, including hepatitis B virus [HBV] vaccine. Aim of the Work:To evaluate the immunological status against HBV vaccine among children with T1DM, and assess various possible risk factors for immunity failure. Patients and Methods: A comparative cross-sectional study included 60 children [4-10 years] with T1DM [case group], and 60 healthy age-and sex-matched children [control group]. All included children had completed obligatory HBV vaccine. The evaluation of the immunological response was assessed through analysis of antibodies against HBV surface [HBsAB]. Seroprotection status to HBV vaccine was identified as plasma HBsAB of ≥ 10 mIU/ml. Results: The mean duration of T1DM was 2.03 ± 1.73 years. The frequency of immunity failure to HBV vaccine [nonresponders; HBsAB < 10 mIU/ml] was 51.7% among the case group, and 28.3% among the control group [P = 0.009]. Risk factors for immunity failure, as evaluated by regression analysis, were older age [P=0.002], and longer duration of T1DM [P=0.023]. Conclusion:Children with T1DM have a reduced level of HBV vaccine seroprotection when compared to the control group. Patients with older age and longer duration of T1DM showed a trend toward non-responding HbsAB titer. Longterm follow-up of responders is recommended to retest the level of immune response.