Sujal Kumar Bokshi¹* and Ashesh Chowdhury²

¹MBBS, MPhil (Immunology), MO in Charge of Pathology and RMO, District Hospital, Narail, Bangladesh

*Corresponding Author: Sujal Kumar Bokshi, MBBS, MPhil (Immunology), MO in Charge of Pathology and RMO, District Hospital, Narail, Bangladesh. Email: sujalbokshi@gmail.com.

Received: July 03, 2023; Published: July 13, 2023

Abstract

Background: The immune status is usually hampered in patients with diabetes mellitus. They are more prone to develop infections. In diabetic patients’ a higher prevalence of hepatitis B virus infection is also observed, which leads to more severe complications. The Hepatitis B vaccine is used to prevent hepatitis B virus infection, but there remains uncertainty about vaccine response in diabetic patients. The global pandemic of diabetes principally involved type 2 diabetes.

Aim of the Study: To find out the immune responses of diabetic patients to the hepatitis B vaccine, as measured by seromarkers, may help identify potential factors influencing vaccine efficacy and inform targeted interventions to improve immunization outcomes in this population.

Methods: This was a cohort study where 33 diabetic patients were included as the experimental group and 34 non-diabetic healthy persons were included as a control group. They all were serum HBsAg, anti-HBs and anti-HBc test negative. The experimental and control groups were similar statistically regarding age, gender, serum bilirubin, ALT and serum creatinine. All the participants were vaccinated with the hepatitis B vaccine following a 0, 1, and 6-months schedule. The vaccine responses in the diabetic and non-diabetic groups were compared depending on zero markers (anti-HBs titer, IL-2 and IFN-γ) levels following vaccination. In the case of type 2 diabetic subjects, the seromarkers were also correlated with the duration of diabetes.

Result: The correlation between the duration of type 2 diabetes and serum IFN-γ allowing hepatitis B vaccination is shown in figure 1. Here the correlation coefficient (r) was -0.105, and the p-value was >0.05. So, the correlation between the duration of type 2 diabetes and serum IFN-γ following hepatitis B vaccination was negative but insignificant. The correlation between the duration of type 2 diabetes and serum IFN-γ following hepatitis B vaccination was also negative but insignificant because the r-value was -0.139 and the p-value was >0.05.

Conclusion: The serum value of IFN-γ was significantly lower in the diabetic subjects than in non-diabetic subjects following hepatitis B vaccination. The percentage of seroprotective titer was nearly the same for diabetic and non-diabetic subjects. Serum IL-2 and anti-HBs titer showed no significant difference between diabetic and non-diabetic subjects. The correlations of serum anti-HBs titer, IFN-γ and IL-2 with the duration of diabetes were found negative, but the correlations were not significant.

 Keywords: Seromarkers; Hepatitis B Vaccine; Type 2 Diabetic Patients

References

1. Wild S., et al. “Global prevalence of diabetes: estimates for the year 2000 and projections for 2030”. Diabetes Care5 (2004): 1047-1053.
2. Demir M., et al. “The prevalence of occult hepatitis B virus infection in type 2 diabetes mellitus patients”. European Journal of Gastroenterology and Hepatology7 (2008): 668-673.
3. Waters RS., et al. “The effects of interleukin-2 on immune response regulation”. Mathematical Medicine and Biology: a Journal of the IMA1 (2018): 79-119.
4. Kak G., et al. “Interferon-gamma (IFN-γ): Exploring its implications in infectious diseases”. Biomolecular Concepts1 (2018): 64-79.
5. Hyer RN and Janssen RS. “Immunogenicity and safety of a 2-dose hepatitis B vaccine, HBsAg/CpG 1018, in persons with diabetes mellitus aged 60–70 years”. Vaccine39 (2019): 5854-5861.
6. Jaroszewicz J., et al. “Hepatitis B surface antigen (HBsAg) levels in the natural history of hepatitis B virus (HBV)-infection: a European perspective”. Journal of Hepatology4 (2010): 514-522.
7. Ljubic S., et al. “Pulmonary infections in diabetes mellitus”. Diabetologia Croatica4 (2004): 115-124.
8. Catrina EL., et al. “Soft tissue infections: risk factors in diabetes mellitus patients”. Maedica A Journal of Clinical Medicine4 (2009).
9. Ronald A and Ludwig E. “Urinary tract infections in adults with diabetes”. International Journal of Antimicrobial Agents4 (2001): 287-292.
10. Eckhard M., et al. “Fungal foot infections in patients with diabetes mellitus–results of two independent investigations”. Mycoses 50 (2007): 14-19.
11. Burke A Cunha. Diabetic food infections” (2009).
12. Davila JA., et al. “Diabetes increases the risk of hepatocellular carcinoma in the United States: a population-based case control study”. Gut4 (2005): 533-539.
13. Amarapurkar DN., et al. “Impact of diabetes mellitus on outcome of HCC”. Annals of Hepatology2 (2008): 148-151.
14. El-Serag HB., et al. “Diabetes increases the risk of chronic liver disease and hepatocellular carcinoma”. Gastroenterology2 (2004): 460-468.
15. Garcia-Compean D., et al. “Liver cirrhosis and diabetes: risk factors, pathophysiology, clinical implications and management”. World Journal of Gastroenterology: WJG3 (2009): 280.
16. Alexiewicz JM., et al. “Polymorphonuclear leukocytes in non-insulin-dependent diabetes mellitus: abnormalities in metabolism and function”. Annals of Internal Medicine12 (1995): 919-924.
17. Delamaire M., et al. “Impaired leucocyte functions in diabetic patients”. Diabetic Medicine1 (1997): 29-34.
18. Delespesse G., et al. “Cell-mediated immunity in diabetes mellitus”. Clinical and Experimental Immunology4 (1974): 461.
19. Alba-Loureiro TC., et al. “Neutrophil function and metabolism in individuals with diabetes mellitus”. Brazilian Journal of Medical and Biological Research 40 (2007): 1037-1044.
20. Rostami N., et al. “Comparison of immune response to hepatitis B vaccine between term and preterm infants at birth” (2006).
21. Awofeso N. “Hepatitis B vaccination in prisons”. Bulletin of the World Health Organization7 (2002): 569-574.

Citation

Citation: Sujal Kumar Bokshi and Ashesh Chowdhury. “Study Between Seromarkers (IL-2, IFN-γ and Anti-HBS Titer) and Type 2 Diabetic Subjects with Duration of Diabetes Following Hepatitis B Vaccination". Acta Scientific Microbiology 6.8 (2023): 19-25.

Copyright

Copyright: © 2023 Sujal Kumar Bokshi and Ashesh Chowdhury. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.