Hepatitis B Seroprotection in Pediatric Nephrotic Syndrome

Indian Pediatr. 2019 Aug 15;56(8):659-662.


Objective: To study the prevalence of Hepatitis B seroprotection in children (>1 y) with nephrotic syndrome vaccinated against Hepatitis B vaccine as per the Universal Immunization Program schedule (0,6,10,14 wk); to compare the Hepatitis B seroprotection rates and anti-HBs titers among different phenotypes of nephrotic syndrome; to evaluate the association between Hepatitis B seroprotection status and the immunosuppressive agents; and to study the correlation between anti-HBs titres and proteinuria.

Methods: Hepatitis B serology and anti-HBs titers were analyzed in 100 children (age-1-18 y) with different clinical phenotypes of nephrotic syndrome (cases) and 100 healthy controls.

Results: The proportion of seroprotected children among the cases and controls was 37% (n=37) and 61% (n=61), respectively (P<0.04). The median (IQR) anti- HBs antibodies titers among the cases was 75 (62.5, 81) mIU/mL and 112 (56, 367) mIU/mL among the controls (P=0.001). The proportion of seroprotected children among the steroid sensitive nephrotic syndrome, steroid-resistant nephrotic syndrome and controls was 40% (n=28), 30% (n=9) and 61% (n=61), respectively (P<0.01). No differences in the anti-HBs titers between children receiving steroids versus steroids along with other immunosuppressants were found. Weak negative correlation was noted between proteinuria and protective titers (r = -0.155; P=0.039).

Conclusions: Children with nephrotic syndrome, in general, and steroid-resistant nephrotic syndrome in particular, show poor seroprotection with Hepatitis B vaccination.

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Biomarkers / blood
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Hepatitis B Antibodies / blood*
  • Hepatitis B Vaccines / immunology*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Infant
  • Male
  • Nephrotic Syndrome / blood
  • Nephrotic Syndrome / drug therapy
  • Nephrotic Syndrome / immunology*
  • Nephrotic Syndrome / virology
  • Phenotype
  • Proteinuria / diagnosis
  • Proteinuria / immunology


  • Adrenal Cortex Hormones
  • Biomarkers
  • Hepatitis B Antibodies
  • Hepatitis B Vaccines
  • Immunosuppressive Agents