Despoina N Maritsi1, Susan E Coffin2, Ioanna Argyri3, George Vartzelis3, Nick Spyridis3, Maria N Tsolia3. 1. Second Department of Paediatrics, P. & A. Kyriakou Children's Hospital, University of Athens, Greece. dmaritsi@gmail.com. 2. Division of Infectious Diseases, Centre for Paediatric Clinical Effectiveness, and Department of Infection Prevention, Children's Hospital of Philadelphia, PA, USA. 3. Second Department of Paediatrics, P. & A. Kyriakou Children's Hospital, University of Athens, Greece.
Abstract
OBJECTIVES: To describe the immunogenicity and side effects of immunisation against hepatitis A virus (HAV) in JIA patients on methotrexate treatment, who have not been previously exposed to HAV. METHODS: Case-control study performed in JIA patients and healthy controls matched on age and gender. The subjects received two doses of inactivated anti-HAV vaccine (720 mIU/ml) intramuscularly at 0 and 6 months. Seroconversion, seroprotection rates and anti-HAV-IgG titres were measured at 1, 7 and 18 months. Children were monitored for adverse events. RESULTS: 83 JIA patients and 76 controls were enrolled in the study. At one month, seroprotection rates were lower in children with, as compared to those without JIA (48.2% vs. 65%; p=0.05). At 7 and 18 months, rates of seroprotection rose significantly and were similar in both groups. The titre of anti-HAV-IgG was lower in children with JIA than healthy children at all time points (p<0.001). Vaccines were well tolerated. CONCLUSIONS: Two doses of inactivated HAV vaccine were well tolerated and immunogenic in most immunosuppressed children with JIA; however, a single dose of HAV vaccine was insufficient to induce seroprotection in half of the patients. Further studies are required to analyse the long-term immunity against HAV in this population and optimal HAV immunisation regimen.
OBJECTIVES: To describe the immunogenicity and side effects of immunisation against hepatitis A virus (HAV) in JIA patients on methotrexate treatment, who have not been previously exposed to HAV. METHODS: Case-control study performed in JIA patients and healthy controls matched on age and gender. The subjects received two doses of inactivated anti-HAV vaccine (720 mIU/ml) intramuscularly at 0 and 6 months. Seroconversion, seroprotection rates and anti-HAV-IgG titres were measured at 1, 7 and 18 months. Children were monitored for adverse events. RESULTS: 83 JIA patients and 76 controls were enrolled in the study. At one month, seroprotection rates were lower in children with, as compared to those without JIA (48.2% vs. 65%; p=0.05). At 7 and 18 months, rates of seroprotection rose significantly and were similar in both groups. The titre of anti-HAV-IgG was lower in children with JIA than healthy children at all time points (p<0.001). Vaccines were well tolerated. CONCLUSIONS: Two doses of inactivated HAV vaccine were well tolerated and immunogenic in most immunosuppressed children with JIA; however, a single dose of HAV vaccine was insufficient to induce seroprotection in half of the patients. Further studies are required to analyse the long-term immunity against HAV in this population and optimal HAV immunisation regimen.
Authors: Marc H Jansen; Christien Rondaan; Geertje Legger; Kirsten Minden; Yosef Uziel; Nataša Toplak; Despoina Maritsi; Mirjam van den Berg; Guy Berbers; Patricia Bruijning; Yona Egert; Christophe Normand; Marc Bijl; Helen Foster; Isabelle Kone-Paut; Carine Wouters; Angelo Ravelli; Ori Elkayam; Nicolaas M Wulffraat; Marloes W Heijstek Journal: Front Pediatr Date: 2022-07-06 Impact factor: 3.569