Hepatitis B virus (HBV) infection continues to be a serious global health problem. Primary prevention through immunization remains the most effective way of controlling the spread of HBV. HBV vaccines are immunogenic in newborns and infants, and provide high seroprotection. During the course of HBV vaccination, we observed that substantial number of term infants had elevated CRP values without sepsis. Therefore, we prospectively studied IL-6 and CRP responses to HBV immunization, seeking to demonstrate that immunization stimulates elevation of IL-6 and CRP levels without clinical detoriation, and that usually there is no need for antibiotic treatment.
Subjects for the study were healty term infants without signs and symptoms of sepsis. IL-6, CRP, and white blood cell (WBC) levels were determined before immunization and 24 hours after immunization.
Study population included 70 infants. Significant increases in CRP were seen 24 hr after vaccination (p=0.000). Although CRP levels of 22 infants (31.4%) at second evaluation were above the cut-off (4.82 mg/ml), none of these infants had clinical symptoms of sepsis. After 48–72 hours, CRP level of all patients normalized with no blood culture positivity.
In conclusion, our study showed that HBV vaccine is highly immunogenic and responsible for CRP elevation in term infants without sepsis after first vaccination at birth. To the best of our knowledge this is the first study evaluating CRP response to HBV vaccine at birth in term infants. We suggest that this response should be encountered in differentiation of early neonatal sepsis to avoid unnecessary antibiotic use.
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