Normal immune response to hepatitis B vaccine in patients with Down's syndrome. A basis for immunization guidelines
C. L. Troisi, D. A. Heiberg and F. B. Hollinger
Institutionalized patients with Down's syndrome (DS) are uniquely
predisposed to develop chronic hepatitis B infection following exposure.
Therefore vaccination is particularly warranted, but there have been
concerns that these individuals may react suboptimally. We examined the
immune responses of 62 institutionalized patients with DS to 20 and 40
micrograms of hepatitis B vaccine inactivated (Heptavax-B) over one year.
The subjects were matched by weight, age, and sex. Seroconversion rates and
levels of antibodies to hepatitis B surface antigen (anti-HBs) were
comparable to those found in a normal population and were higher than those
found in immunocompromised patients undergoing hemodialysis. The anti-HBs
levels were consistently higher in the 40-micrograms vaccine group. In
patients with DS who were over 30 years old, age was a significant factor
in predicting anti-HBs responses. Conversely, in younger subjects, weight
was negatively correlated with anti-HBs levels. These data clearly indicate
that patients with DS respond normally to hepatitis B surface antigen
vaccination and need not be considered a special group when guidelines for
vaccination are recommended.
