The effect of hepatitis B vaccination on the incidence of childhood HBV-associated nephritis

Abstract

The aim of the present study was to investigate the effect of a vaccination program for hepatitis B virus (HBV) on the incidence of HBV-associated glomerulonephritis (HBV-GN). In total, 727 renal biopsies were carried out at our hospital from November 1979 through March 2002. Two groups were established. Group A included those biopsied from November 1979 through December 1991 (prior to the HBV vaccination program) and group B from January 1992 through March 2002. Group B was divided into five subgroups (B₁ to B₅), with an interval of 2 years between each subgroup. Patients were divided into those with or without a history of HBV vaccination. Of the 727 renal biopsies, 64 fulfilled the criteria of HBV-GN, There were 28 cases of the 211 cases in group A and 36 cases of the 516 cases in group B (X ²=7.397,P<0.01). The incidence in group A and group B₁ through B₅ was 13.27% (28/211), 13.04% (9/69), 7.32 (6/82), 6.25% (4/64), 4.88% (4/82), and 5.94% (13/219), respectively (X ²=9.627, P<0.01). Only 8 of the 231 vaccinated children had HBV-GN, while there were 48 HBV-GN cases of the 381 non-vaccinated children (X ²=14.44, P<0.001). There were only 6 cases of membranous nephropathy (MN) in the vaccinated group, while 40 cases of MN occurred in the non-vaccinated group (X ²=12.92, P<0.01). There were 8 children that developed HBV-GN with abnormal serum HBV markers despite HBV vaccination. Two mothers of these 8 children had evidence of HBV infection. The incidence of HBV-GN in children has been decreasing each year since the implementation of the nationwide HBV vaccination program in Shanghai, China. Furthermore, since childhood MN is associated with HBV, vaccination can also reduce the incidence of childhood MN.