Immunomodulatory effects of HBsAg vaccine and levamisole in chronic hepatitis B and hepatitis B carrier children.

BACKGROUND/AIMS: Pathogenesis of chronic hepatitis B and hepatitis B carrier status is related to deficiencies in the immune system. Thus, treatments regulating the immune system are under discussion. The aim of this study was to investigate the effects of HBsAg vaccine and levamisole on lymphocyte subgroups and immunoglobulins in children with chronic hepatitis B and hepatitis B carriers.

METHODS: A total of 93 naive children (43 chronic hepatitis B carriers, 50 chronic hepatitis B patients) were treated in three groups with HBsAg vaccine, levamisole or levamisole plus HBsAg vaccine. Levamisole (ketrax) was delivered as 2.5 mg/kg/day per os, three times per week for three months; the vaccine (Gen HevacB) was administered subcutaneously as 20, 30, 40 microg at one-month intervals. Both medications were delivered at same dosages in the combined group. The examinations were performed at pre-treatment and at the end of the third month when the treatment concluded.

RESULTS: After treatments, CD3, CD4 and CD4/CD8 significantly increased and CD8 significantly decreased in chronic hepatitis B patient groups, except in the levamisole treated group. IgG and IgA were significantly decreased in all groups of chronic hepatitis B patients.

CONCLUSIONS: It was found that HBsAg vaccine induced cellular immunostimulation in children with chronic hepatitis B; however, levamisole did not. The immune cells of hepatitis B carriers did not manifest a significant change in any treatment group. Although there was no change in B-cell, significant decreases were determined in immunoglobulins (IgG, IgA), especially in chronic hepatitis B patients.