PEDIATRICS

F. Ozbay hosnut¹, F. Ozcay², E. Karada? Öncel¹, S. Sevmis³, H. Karakayali³, M. Haberal^4
1Pediatric Gastroenterology, Hepatology And Nutrition, Ba?kent University Hospital, Ankara/TURKEY, ²Pediatric Gastroenterology, Baskent University, Ankara/TURKEY, ³General Surgery And Transplantation, Baskent University, Ankara/TURKEY, ⁴General Surgery, Baskent University, Ankara/TURKEY

Body: Introduction: Hepatitis A virus (HAV) infections occur throughout the world, but are most commonly found in developing countries. Hepatitis A is a vaccine-preventable disease. It is shown that vaccination against hepatitis A is safe and efficient (94%) in healthy children and chronic liver disease patients. However, experience with vaccine administration in immune-compromised children is limited. The purpose of our study is to evaluate the efficiency of inactivated hepatitis A vaccine in children who underwent liver transplantation. Patients and methods: Between 2001-2009, 125 children, underwent liver transplantation in BaÅŸkent University Ankara Hospital. Patients, who were not under steroid therapy, were followed up at least 6 months after transplantation, and with normal liver function tests were included into the study. Patients with negative AntiHAV IgG received HAV vaccine 2 times with a 6 month interval. To evaluate the immune response, antiHAV seroconversion was assessed after 1 and 7 months from the first vaccination. Results: 89 patients were included into the study, 28 (31%) of them had negative anti HAVIgG levels. Of these patients, 24 were under tacrolimus, 3 under cyclosporine, 1 under sirolimus therapy. 15 of them were male, and 13 of female, with median age of 4 ½ years (23 months-18 years). AntiHAV IgG seroconversion was provided after the first dose of vaccination in 15 (53%) out of 28 patients. The second dose of vaccination was completed in 23 (82%) patients. Anti HAV IgG seroconversion was provided in 17 of 23 patients after the second dose (74%).There was no significant difference between seroconverted and non-seroconverted patients in terms of lymphopenia (<1000/mm³) during the vaccination period lasting six months (2/17 versus 1/6). No local or systemic side effects were seen. Conclusion:In our study, seroconversion rate against HAV vaccination obtained in liver transplanted children (74%) was satisfactory. Total lymphocyte countwas not useful predicting serologic response to hepatitis A vaccination.

Disclosure: All authors have declared no conflicts of interest.