Diminished Antibody Response to Hepatitis B
Immunization in Children With Sickle Cell Disease
Jeffrey Hord, M.D.; Beth Windsor, B.S.N.; Maria Koehler, M.D., Ph.D.; Julie
Blatt, M.D.; Janine Janosky, Ph.D.; Joseph Mirro, M.D.
Summary:
Hepatitis B surface antibody titers were
routinely measured in 150 children with sickle cell disease (SCD) after
immunization, and the seroconversion rate was found to be lower than that in
the general population (89% vs. 97%, P = 0.002). Most of the children
who did not seroconvert after the series of 3 immunizations responded to
booster injections (93%). Therefore, we recommend the measurement of hepatitis
B surface antibody titers after immunization in those children with SCD at
greatest risk for hepatitis B infection. An additional dose of hepatitis B
vaccine should be administered to those without evidence of seroconversion.
From the Departments of Pediatric
Hematology/Oncology, Children's Hospital Medical Center of Akron, Akron,
Ohio (J.H.); Pediatric Hematology/Oncology, Children's Hospital of
Pittsburgh, Pittsburgh, Pennsylvania (B.W.); Medical Oncology, Astrazeneca
Pharmaceuticals, Wilmington, Delaware (M.K.); Pediatric
Hematology/Oncology, University of North Carolina, Chapel Hill, North
Carolina (J.B.); Family Medicine and Clinical Epidemiology, University of
Pittsburgh, Pittsburgh, Pennsylvania (J.J.); and St. Jude Children's
Research Hospital, Memphis, Tennessee (J.M.).
Address correspondence and reprint requests
to Jeffrey D. Hord, M.D., Division of Pediatric Hematology/Oncology,
Children's Hospital Medical Center of Akron, One Perkins Square, Akron, OH
44308. E-mail: jhord@ chmca.org.
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