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Abstract Virus B hepatitis remains one ofthe leading viral infections of man, that is associated with considerable morbidity and mortality in many parts of the world This work has been designed to evaluate the efficacy of hepatitis B vaccine, in inducing satisfactory anti - HBs levels in a large mixed population of individuals at risk of exposure to hepatitis B in different age groups and to determine the factors associated with good or poor response to HBV and to comment on the value of post _ immunization antibody assessment. Cases were divided according to age into three groups, group I : twenty nine infants and their mothers, group II : thirty four children aged (1-8) years and group III : eighty nine of medical and paramedical personnel aged (30 - 45) years were studied. For each case, history, complete clinical examination were done. Complete blood picture and liver function tests were investigated, serum HBsAg, HBsAb, HBcAb were performed, HB-vax (Recombinant yeast derived HB vaccine) was given in three doses , then HBsAg, HBsAb, HBcAb for all cases were done again. HBsAb titer was quantitated for HBsAb positive cases as a response to the vaccine, the obtained data were statistically analysed and the following results were found: ]’: The HBsAg carrier states (silent hepatitis) were of3.45%, 0%, 5.88%, 0% and 1.66% for pregnant mothers, infants, children, the medical group and the total of the examined groups respectively _________________________i_b_fo__S_U_M_M_A_RY AND CONCLUSJUN oIQ! ------------------ - 137 - 2- The infection rates (seropositive for I-IBVmarkers) were 24.14% for pregnant mothers, 6.9% for infants (transmitted passively intrauterine), 11.76% for children, 16.85% for medical and paramedical f,’TOUpand 15.47% for the total of the studied groups. 3- In distribution of the studied groups according to the immune response to HB vaccine it was 26.42% (non responders), 19.81% (fair and intermediate response), 32.08% (good response) and 21.70% (excellent response). 4- By titration ofHBsAb to vaccine responders of the studied groups, the following results were found: a- HBsAb titer (10 - 100 J.J1u/mL)was found in 18.18%, 33.33% and 26.53% of the responders for group I, II and III respectively. b- HBsAb titer (100 -1000JlIu/mL) was found in 45.46%, 44.44% and 42.86% of the responders for group I, II and III respectively. c- HBsAb titer (> 1000 J.J1u/mL)was found in 36.36%, 22.22% and 30.6 I% of the responders for group I, II and III respectively. 5- No significant differences were detected among group I, II and III as regard the response to HB vaccine in relation to age, these responses were 61.11 %, 72%, 77.77% and 73.58% for group I, II and III and the total of the studied groups respectively. 6- Response rate to HB vaccine for infants who were born to mothers with HBV positive markers was 56%. 7- The infection rates of HBV after vaccination were 4.34%, 0%, 3.17% and 2.7% for group I, II, III and the total of the studied groups respectively, with no statistical differences among them. 8- On follow up of the vaccinees the HBsAb was 61.11% for group one in the first year, then 50% and 33% of responders still had anti - HBs in the second and third years respectively. HBsAb in response to HB -------------------------------/-b--e--SUMMARY AND CONCLUSION ~ -- 138 _ vaccine in group III was 77.77% in the first year, then 83.33% and 62.5% of responders stilI had anti HBs in the second and third years respectively. 9- No significant difference was detected between both sex in vaccine responses, which were 60%, 75% and 79.48% for males and 62.5%, 69.23% and 75% for females in groups I, II and III respectively. Also there was no significant difference among males in each group as regard the vaccine response and age, while a significant difference was found among females of the studied groups as regard vaccine response and age. 10- No significant difference was found between males and females, who were HBV negatives of group III and indirect haemagglutination test of schistosomiasis, which was positive in 30.77% and 12.5% for males and females respectively. 11- A significant difference was detected among HB vaccine responders of group III and schistosomiasis, the vaccine response was 85.41% in iliA schistosomiasis negative group, 66.66% in positive iliA for schistosomiasis without hepatosplenomegaly and 33.33% in positive C schistosomiasis with hepatosplenomegaly. 12- No significant difference was detected between the non _anaemic and anaemic patients in response to HB vaccine. 13- Vaccination adverse events were recorded on follow up of the vaccinees, these were 7.63%, 3.05%, 6.87%, 5.34%, 3.82% and 12.21% for local swelling, soreness, erythema, tenderness, induration and fever respectively. 14- Jaundice during follow up of group III was observed in 5/78 (6.41%). 4/78 .(5.12%) of them were due to advanced decompensated chronic liver disease. The cause ofjaundice in 1/78 (1.29%) can’t be explained. |