Efficacy of vaccination against viral hepatitis type B in children with the nephrotic syndrome

The purpose of the study was to estimate the efficacy of vaccination against viral hepatitis type B in children with the nephrotic syndrome and to estimate the probable cause-effect relationship between the occurrence of the nephrotic syndrome and infectious diseases and vaccination in children. The retrospective study comprised 235 nephrotic children aged 1-14 years hospitalized in the Department of Pediatric Nephrology at University Children Hospital, Lublin, between 1982 and 1997. 56 nephrotic children aged 2-13 years received vaccination against viral hepatitis type B. In 49 children the vaccine was administered during the treatment of the nephrotic syndrome and in the remaining 7 children--after completion of the therapy. Retrospective analysis revealed the presence of infection with hepatitis B virus in 30 (12.8%) nephrotic children. In 20 of those children the presence of infection with hepatitis B virus was detected during the second and succeeding relapses of the syndrome. In 15 (5.1%) children the nephrotic syndrome was probably induced by other infectious diseases and in 7 children the nephrotic syndrome developed as a result of active immunization. Among 56 children who received vaccination against viral hepatitis type B in 6 (10.7%) the increase of urinary protein excretion was observed and 5 developed a succeeding relapse of the syndrome. In 41 of 56 children who received vaccination against viral hepatitis type B the titers of anti-HBs antigen antibodies were measured. The protective titer of anti-HBs antigen antibodies was detected in 39 (95.1%) nephrotic children. It is well known that both active immunization and infectious diseases may induce the nephrotic syndrome. Despite this, vaccination against viral hepatitis type B in nephrotic children is highly recommended, since it influences favorably the further clinical course of the syndrome by the protection of the disease. In our study, none of the nephrotic children who received vaccination developed viral hepatitis type B.