Successful immune response to a recombinant hepatitis B vaccine in young patients with insulin-dependent diabetes mellitus.

The study aimed to evaluate the immune response to a recombinant hepatitis B vaccine in young patients with insulin-dependent diabetes mellitus (IDDM), in view of reports of reduced efficacy in adults with IDDM. Sixty-five young people with IDDM, age 4.5 to 27.5 and diabetes duration 0.3 to 19 years and 174 age- and sex-matched healthy subjects were injected with a recombinant hepatitis B vaccine at 0, 1 and 6 months intramuscularly in the deltoid region. Three (4.6%) IDDM patients and 2 (1.1%) controls were non-responders (HBsAb titre, < 2 IU l-1) and 1 control was a low responder (HBsAb titre = 10 IU l-1). Among the 3 non-responder IDDM subjects, 2 had other autoimmune disease. Median HBsAb titre was similar in responding patients (120 IU l-1 and controls (125 IU l-1). There were no significant correlations between antibody titre and age, diabetes duration, HbA1c or insulin requirement. No association was found between HBsAb titre and any HLA genotype or the presence of microangiopathy. IDDM does not adversely affect the immune response to a recombinant hepatitis B vaccine in children, adolescents, and young adults, who can thus expect to benefit from its use in situations of risk of contracting hepatitis.