Hepatitis B immunization in sickle cell disease patients

Abstract

Introduction: Sickle cell disease, also known as sickle cell anaemia, is an inherited haemoglobinopathy resulting in the production of the abnormal haemoglobin of sickle cell disease: haemoglobin S. Sickle cell patients are exposed to frequent deglobulation crises, often requiring several blood transfusions and hospitalisations at risk of transmission of infectious diseases such as hepatitis B (HBV). The objective of our study is to describe the immunisation against hepatitis B of vaccinated sickle cell patients and then to propose a course of action for non-immunised patients in the Haematology Department of the Joseph Ravoahangy Andrianavalona University Hospital (JRAHU). Material and Methods: The study was a prospective descriptive study investigating on the immunisation against hepatitis B of vaccinated sickle cell patient’s patients in the Haematology Department of the Joseph Ravoahangy Andrianavalona University Hospital (JRAHU) from June 2019 to March 2020. The study population concerned all sickle cell disease children under 15 years of age, girls or boys, of any ethnic origin, with or without clinical or biological signs of hepatitis, vaccinated against hepatitis B according to expanded program of immunization with at least 3 injections of hepatitis B vaccine, transfused or not. The included patients were be tested for HBsAg and anti-HBsAb. Results: During the study period, a total of 36 sickle cell patients were included. The average age was 8.2 years with an extreme of 2 and 13 years. Of the 36 sickle cell patients vaccinated, none had HBsAg and 28 patients (77.8%) were anti-HBsAb positive, protected against hepatitis B and 8 patients (22.2%) were serologically negative and at risk of contracting hepatitis B. Conclusion: Sickle cell disease patients are exposed risk of transmission of infectious diseases, if their antibody level between 1 and 10 mIU mL-1 is considered a poor response, those affected should receive a booster.