Hepatitis B Seroprotection in Pediatric Nephrotic Syndrome.

OBJECTIVE: To study the prevalence of Hepatitis B seroprotection in children (>1 y) with nephrotic syndrome vaccinated against Hepatitis B vaccine as per the Universal Immunization Program schedule (0,6,10,14 wk); to compare the Hepatitis B seroprotection rates and anti-HBs titers among different phenotypes of nephrotic syndrome; to evaluate the association between Hepatitis B seroprotection status and the immunosuppressive agents; and to study the correlation between anti-HBs titres and proteinuria. METHODS: Hepatitis B serology and anti-HBs titers were analyzed in 100 children (age-1-18 y) with different clinical phenotypes of nephrotic syndrome (cases) and 100 healthy controls. RESULTS: The proportion of seroprotected children among the cases and controls was 37% (n=37) and 61% (n=61), respectively (P<0.04). The median (IQR) anti- HBs antibodies titers among the cases was 75 (62.5, 81) mIU/mL and 112 (56, 367) mIU/mL among the controls (P=0.001). The proportion of seroprotected children among the steroid sensitive nephrotic syndrome, steroid-resistant nephrotic syndrome and controls was 40% (n=28), 30% (n=9) and 61% (n=61), respectively (P<0.01). No differences in the anti-HBs titers between children receiving steroids versus steroids along with other immunosuppressants were found. Weak negative correlation was noted between proteinuria and protective titers (r = -0.155; P=0.039). CONCLUSIONS: Children with nephrotic syndrome, in general, and steroid-resistant nephrotic syndrome in particular, show poor seroprotection with Hepatitis B vaccination.