RESUMO
BACKGROUND: Hepatitis B virus (HBV) vaccination is a well-known, safe and effective way for protection against HBV infection; however, non-responders remain susceptible to infection with HBV. This is so important in patients with any kind of chronic liver disease, especially chronic hepatitis C virus (HCV) patients in whom acute HBV infection may lead to decompensation of liver disease. Some of the studies have shown that immunogenicity of HBV vaccination is decreased in these patients. The aim of this study was to evaluate the efficacy and safety of double dose vaccination of HBV in these patients, compared with standard dose vaccination in similar patients and healthy adults. METHODS: A total of 64 patients with chronic HCV infection were randomized into 2 groups of 32. Group A received standard dose HBV vaccine, at 0, 1, 6 months, whereas group B received double dose HBV vaccine. Group C consisted of 32 healthy adults who also received standard dose vaccination. At 1 month after the end of vaccination, Hepatitis B surface antibody (HBsAb) titer was checked in all participants and the results were compared. RESULTS: There was no significant difference in age or sex among three groups. The response rate in groups B and C was 100% (all had HBsAb titer >10 mIU/mL), while in group A, 4 patients (12.5%) were non-responders (HBsAb titer < 10 mIU/mL). The difference in response rate was statistically significant between Group A and the other two groups (P < 0.05). CONCLUSIONS: The efficacy of standard dose HBV vaccination in patients with chronic HCV infection was suboptimal. Using double dose vaccination in these patients was an effective way to increase the antibody response.
RESUMO
BACKGROUND: To determine the prevalence of cryoglobulins in Iranian patients with systemic lupus erythematosus (SLE) and evaluate the correlation of cryoglobulins with disease activity in these patients. MATERIALS AND METHODS: In a cross-sectional study, we investigated 80 consecutive women who fulfilled the 1982 revised criteria of the American College of Rheumatology for the classification of SLE. All the patients had undergone a medical interview and general physical examination by a rheumatologist for clinical and serologic characteristics of SLE. For the determination of cryoglobulins, sera were collected by a standard protocol at 37°C, and after incubation at 4°C for seven days, the level of cryoglobulins was estimated for each patient. RESULTS: Cryoglobulins were detected in the sera of 39 (48.8%) patients. All of these patients had cryocrit over 5%. Disease was active in 30 patients [SLEDAI ≥6 (DAI: disease activity index)] and inactive in 50 (SLEDAI <6). There was no significant difference between active and inactive patients for the presence of serum cryoglobulins (r = 0.086, P = 0.56). A significant positive correlation was observed between antinuclear antibody (ANA), anti-dsDNA (dsDNA: Double-stranded deoxyribonucleic acid), CH50 (CH50: total hemolytic complement assay), and C-reactive protein (CRP) (r = 0.21, P = 0.004, r = 0.65, P = 0.001, r = 0.45, P = 0.023, r = 0.38, P = 0.036, respectively). Hepatitis C virus (HCV) infection was not detected in any of the SLE patients. CONCLUSION: Although the presence of cryoglobulins in the SLE patients correlated with positive anti-ds DNA and low CH50, it could not be predict activity of the disease.
RESUMO
To assess the frequency of hyperprolactinaemia and its possible clinical significance in patients with systemic lupus erythematosus (SLE). In this cross-sectional study, we determined serum prolactin (PRL) levels in 60 SLE female patients (age range 15-60 years). Disease activity was defined according to the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Serum PRL concentrations were determined by immunoradiometric assay. Elevated serum concentrations of PRL (>20 ng/ml) were found in 5 of 60 (8.4%) patients. No direct correlation between PRL levels with disease activity of SLE was found (r = 0.062, P = 0.39). SLE was active in 23 patients (SLEDAI ≥ 6) and inactive in 37 (SLEDAI < 6). In those with active disease, median PRL levels were lower (11.0 ng/ml) than normoprolactinaemic group (12.1 ng/ml). There was no significant difference in serum PRL levels between active and non-active patients (P = 0.07). There was a significant difference in the frequency of several clinical manifestations and serological parameters between SLE patients with normal and high prolactin (renal involvement, haematological manifestation and anti-ds DNA). This study has shown that hyperprolactinaemia is prevalent in random SLE patients. The elevated PRL levels seem not to be associated with disease activity. The mechanism and pathoaetiological and clinical significance of hyperprolactinaemia in a small subset of SLE patients remain unclear and a longer follow-up is necessary.
