Volume 2002, Issue 1

Abstract

The prevalence of Hepatitis A, B and C infection was assessed in sixty children with Down's syndrome (DS) and compared with sixty children with normal mentality by screening for HBsAg, HBeAg, anti-HBe, anti-HBc, anti-HBs and anti-HCVand HAV-Ig. Both groups had received three doses of recombinant DNA hepatitis vaccine at 0,1 and 6 months of age.

None of the children in either group were found to have any hepatitis viral antiginaemia, hepatitis marker or to have chronic viral hepatitis.

Hepatitis B vaccine protective efficacy which was es-tablished by the presence of anti-HBs >10 mil], was sig-nificantly lower in the DS than the control group (28.3% Vs 85%,p < 0.001).

None of the children in the DS group, after the age of seven years, had protective anti-HBs level as compared to 79% of the children in the control group.

Booster doses are not recommended for normal chil-dren even if they lose their antibody to HBV vaccine be-cause of the presence of immune memory. However, in children with DS, because of their immune deficiency, low vaccination response, and their predisposition to chronic hepatitis infection especially at school age, we recommend booster HBV vaccination for them at school entry.

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2002.1.10
2002-06-01
2024-03-28
Loading full text...

Full text loading...

References

  1. Nespoli L, Burgio GR, Ugazio AG, Maccario R. Immunolo-gical features of Downs syndrome: A review. J Intellect Disabil Res. 1993 Dec; 37:Pt 6:543551.
    [Google Scholar]
  2. Oda M, Hakamada R, Ono K, Higurashi M. A seroimmunolo-gical analysis of Down's syndrome. Gerontology. 1993; 39:Suppl 1:1623.
    [Google Scholar]
  3. Cuadrado E, Barrena MJ. Immune dysfunction in Down 5 syndrome: primary immune deficiency or early senescence of the immune system. Clin Immunol Immunopathol. 1996 Mar; 78:3:209214.
    [Google Scholar]
  4. Schoub BD, Johnson S, McAnerney JM, Blackburn NK. Hepatitis B virus prevalence in two institutions for the mentally handicapped. S Afr Med J. 1993 Sep; 83:9:650653.
    [Google Scholar]
  5. Lundig S, Hansen KS, Kragsgaard K, Rosdahl N, Smith G, Wantzin PS. Occurrence of Hepatitis B and C among mentally retarded. UgeskrLaeger. 1999 Aug; 161:31:43934396.
    [Google Scholar]
  6. Ahman L, Back E, Bensch K, Ollen P. Non-efficacy of low dose intradermal vaccination against Hepatitis B in Down's syndrome. Scand infectious Dis. 1993; 25:1:1623.
    [Google Scholar]
  7. Breuer B, Friedman SM, Millner ES, Kane MA, Snyder RH, Maynard JE. Transmission of Hepatitis B virus in classroom contacts of mentally retarded carriers. JAMA. 1985; 245::31903195.
    [Google Scholar]
  8. Rua Armesto MJ, Ramirez Marin M. Predisposition of Down's syndrome to chronic infection with Hepatitis B virus. An Esp Pediatr. 1993 Jun; 38:6:529531.
    [Google Scholar]
  9. Poovorawan Y, Sanpavat S, Pongpunlert W, Chumdermpadet-suk S, Sentrakul P, Safary A. Protective efficacy of a recombi-nant DNA Hepatitis B vaccine in neonates of HBe-Antigen positive mothers. JAMA. June 9; 261:22.
    [Google Scholar]
  10. Kuwang-Juei Lo, Shou-Dong Lee, Yang-Te Tsai, Tzee Chung Wu, Cho-Yu Chan, Gran-Hum Chen, Ching-Lan Yeh. Long-term immunogenicity and efficacy of Hepatitis B vaccine in infants born to HBeAg-positive HBsAg-carrier mothers. Hepatology. 1988; 8:6:16471650.
    [Google Scholar]
  11. Lee CL, Ko YC. Hepatitis B vaccination and hepatocellular carcinoma in Taiwan. Pediatrics. 1997; 99::351353.
    [Google Scholar]
  12. Szmuness W, Stevens CE, Harley EJ;, et al., Hepatitis B vaccine: demonstration of efficacy in a controlled trial in a high risk population in the U.S. N Eng J Med. 1980; 303::833834.
    [Google Scholar]
  13. Bloom B, Hellman A, Fendrick A, et al., reappraisal of Hepatitis B virus vaccination strategies using cost-effectiveness analysis. Ann intern Med. 1993; 118::293306.
    [Google Scholar]
  14. Kane M. Epidemiology of hepatitis B infections in North America. Vaccine. 1995; 13:Suppl 1:516517.
    [Google Scholar]
  15. Margolis HS, Alter MJ, Hadler SC. Hepatitis B: evolving epidemiology and implications for control. Sem Liv Dis. 1991; 11::8492.
    [Google Scholar]
  16. Centers for Disease control. Hepatitis B virus: a comprehen-sive strategy for eliminating transmission in the United States through universal childhood vaccination: recommendation of the Immunization Practices Advisory Committee (ACIP). MMWR. 1991; 40:No. RR-13:125.
    [Google Scholar]
  17. Francis DP, Hadler SC, Thompson SE;, et al., Prevention of hepatitis B with vaccine. Report of the centers for disease control multi-center efficacy trial among homosexual men. Ann Int Med. 1982; 97::362366.
    [Google Scholar]
  18. Beasly RP, Hwang LY, Lee GC, et al., Prevention of perinatally transmitted hepatitis B virus with hepatitis B immunoglobulin 1 and hepatitis B vaccine. Lancet. 1983;, 1099-102. j.
    [Google Scholar]
  19. Mahoney F, Woodruff B, Erben J;, et al., Evaluation of a 1 Hepatitis B immunization program on the prevalence of <  hepatitis B virus infection. J infect Dis. 1993; 167::203207.
    [Google Scholar]
  20. Edmunds W, Medley G, Nikes D. Cost-effectiveness of hepatitis B virus immunization. JAMA. 1982; 97::362366.
    [Google Scholar]
  21. World Health Organization. Progress in the control of viral hepatitis: memorandum from a WHO meeting. Bull WHO. 1988; 66::443455.
    [Google Scholar]
  22. National Advisory Committee on Immunization. Statement on universal immunization against hepatitis B. Can Dis Wkly rep. 1991; 17::165171.
    [Google Scholar]
  23. Bell A. Universal hepatitis B immunization: the British Columbia experience. Vaccine. 1995; 13:suppl 1:S77S81.
    [Google Scholar]
  24.   Report of the working group on the possible relationship between hepatitis B vaccination and the chronic fatigue syndrome. Can MedAssos J. 1993; 149:3:314319.
    [Google Scholar]
  25. Committee on Infectious Diseases. 1997 Red Book. 24th ed. Elk Grove Village, IL: American Academy of Pediatrics 1997;:1819.
    [Google Scholar]
  26. Dobs on S, Scheifele D, Bell A. Assessment of a universal, school-based hepatitis B program. JAMA. 1995; 274::12091213.
    [Google Scholar]
  27.   RCPCH. Medicines for Children. 1999 Aug;:266267.
    [Google Scholar]
  28. Committee on Infectious Diseases. 1997 Red Book. 24th ed. Elk Grove Village, IL: American Academy of Pediatrics 1997:p.255.
    [Google Scholar]
  29. Centers for Disease control. Update on Hepatitis B prevention. MMW. 1987; 36::353366.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/qmj.2002.1.10
Loading

Most Cited Most Cited RSS feed