Antibody Response to a seven valent Pneumococcal Vaccine in children with Chronic Liver Disease

Abstract

Infections are common in patients with chronic liver disease, especially those with cirrhosis. Patients with advanced liver disease, who develop bacterial infections, are at a substantially higher risk of death. As liver disease progresses, most immunizations lose their effectiveness. The efficacy of immunization decreases with disease progression; for this reason, these patients should be immunized as soon as possible, so vaccinations programme is recommended, as well as selective vaccinations against influenza, pneumococci and viral hepatitis, depending on the underlying chronic disease. However, there are few data about antibody responses to pneumococcal vaccine or the functional activities of these antibodies against pneumococci in cirrhotic patients. This study was conducted on randomly chosen 20 patients with chronic liver disease recruiting to the Pediatric Hepatolgy clinic, Ain Shams University Hospital between Febreuary 2012 and June 2012, they were 9 (45%) males and 11(55%) females. Twenty healthy well matched regarding age and sex class were included as control group. Age in the study group ranged between 7 months and 17 years with mean±SD (7.535±5.245). This study was conducted as case control study and all patients were subjected to full medical history with special stress on right hypochondrial pain, recurrent respiratory tract infection, itching, color of urine or stool and upper or lower GIT bleeding. Clinical examination was one with special stress on anthropometric measures including patient's weight and height and weight percentile and height percentile through plotting weight and height on the age- and gender-standard percentiles according to Egyptian growth charts. Liver and spleen size, ascites and signs of liver cell failure as jaundice, palmer erythema, lower limb edema or encephalopathy…etc.