Journal Article

Hepatitis B vaccine and risk of relapse after a first childhood episode of CNS inflammatory demyelination

Yann Mikaeloff, Guillaume Caridade, Saada Assi, Marc Tardieu and Samy Suissa

in Brain

Published on behalf of The Guarantors of Brain

Volume 130, issue 4, pages 1105-1110
Published in print April 2007 | ISSN: 0006-8950
Published online February 2007 | e-ISSN: 1460-2156 | DOI: http://dx.doi.org/10.1093/brain/awl368
Hepatitis B vaccine and risk of relapse after a first childhood episode of CNS inflammatory demyelination

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Public concern about possible increases in the risk of multiple sclerosis associated with hepatitis B vaccination has led to low vaccination coverage. We investigated whether this vaccination after a first episode of acute CNS inflammatory demyelination in childhood increased the risk of conversion to multiple sclerosis. We studied the French Kid Sclérose en Plaques (KIDSEP) neuropaediatric cohort of patients enrolled between 1994 and 2003 from their first episode of acute CNS inflammatory demyelination (inclusion in the cohort) until the occurrence of a second episode, up to 2005. A Cox proportional hazards model of time-dependent vaccine exposure was used to evaluate the effect of vaccination (hepatitis B, tetanus) during follow-up on the risk of second episode occurrence (conversion to multiple sclerosis). The cohort included 356 subjects with a mean follow-up of 5.8 years (SD 2.7). Relapse occurred in 146 (41%) subjects during follow-up; 33 subjects were exposed to hepatitis B vaccine and 28 to tetanus vaccine at some time during follow-up. The adjusted hazard ratio (HR) for relapse occurring within 3 years of hepatitis B vaccination was 0.78 (0.32–1.89) and during any time period was 1.09 (0.53–2.24). The adjusted HR for relapse occurring within 3 years of tetanus vaccination was 0.99 (0.58–1.67) and during any time period was 1.08 (0.63–1.83). We conclude that vaccination against hepatitis B or tetanus after a first episode of CNS inflammatory demyelination in childhood does not appear to increase the risk of conversion to multiple sclerosis, although the possibility of a small increase in risk cannot be excluded.

Keywords: child; epidemiology; hepatitis B vaccine; immune-mediated demyelination; multiple sclerosis

Journal Article.  3900 words. 

Subjects: Neurology ; Neuroscience

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