Evaluation of immune response to hepatitis A vaccination and vaccine safety in juvenile idiopathic arthritis

Abstract

Background Autoimmune mechanisms and drugs used in treatment increase the risk of liver disease in patients with juvenile idiopathic arthritis (JIA) and hepatitis A virus (HAV) vaccination is important, especially in intermediate-endemicity areas like Turkey. In our study, we aimed to evaluate the immune response to hepatitis A vaccine and vaccine safety in children with JIA. Methods This study was carried out in our hospital’s Pediatric Rheumatology outpatient clinic and Healthy Child clinic between the years 2003 and 2008. The study group consisted of 47 children with JIA (23 male and 24 female) diagnosed according to International League of Associations for Rheumatology diagnostic criteria. The control group consisted of 67 healthy children (31 female, 36 male) who did not have a history of hepatitis A infection or vaccination. Both groups were vaccinated with two doses of hepatitis A vaccine at 6-month intervals. Anti-HAV IgG >80 MIU was accepted as positive response. Results There was no significant difference between the groups in terms of age and sex. None of the patients with JIA had fever, clinical worsening, or disease activation after vaccination. Anti-HAV IgG positivity rate was significantly higher in the control group ( p < 0.05). Anti-HAV IgG was negative in only four cases, and they were all male patients with systemic JIA who had active disease under anti-tumor necrosis factor treatment. Conclusion Hepatitis A vaccine was safe in patients with JIA, and response to vaccine did not differ between healthy children and patients with JIA except for children with active systemic JIA receiving anti-tumor necrosis factor alpha drugs.