5.1 Hepatitis B vaccination in juvenile idiopathic arthritis

Objective—To evaluate the responsiveness to hepatitis B vaccination in children with juvenile idiopathic arthritis (JIA) and to determine a useful vaccination schedule.

Patients and methods—39 (18 female, 21 male) children with JIA who were all in remission and HBsAg negative were enrolled into the study group. The control group consisted of 41 healthy children (21 female, 20 male). The children were divided into two groups and given two different vaccination schedules. The first group were vaccinated at 0, 1, and 3 months while the children in the second group were vaccinated at 0, 1, and 6 months respectively. Those weighing above 20 kg were vaccinated with a 20 μg dose of DNA recombinant vaccine and those below 20 kg were given 10 μg. Positive responsiveness to the vaccine was defined as an anti-HBs titre >10 mIU/ml.

Results—All children with the exception of one child with systemic JIA developed antibody response. None of the patients with JIA had a flare up or clinical deterioration related to the vaccination. There was no statistical difference of antibody levels between the subgroups of patients with JIA. The mean (SD) antibody levels in the children with JIA were significantly lower (175.5 (118.4) mIU/ml) than those of the healthy subjects (317.08 (180.5) mIU/ml) There was no difference between the sexes in vaccine responsiveness. When the antibody levels between the two vaccination schedules were compared in healthy children, there was no statistical difference. However, there was a slightly higher, but statistically insignificant, response in JIA subjects …