الفهرس 
Material and methodsOnly 14 pages are availabe for public view
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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.