The role of zinc supplementation in humoral immune response to hepatitis B vaccination in infants: a double-blind randomized placebo-controlled trial

  • K. Suarca
  • Hendra S
  • B. N. P. Arhana
  • I K. G. Suandi
Keywords: zinc supplementation, serum zinc level, hepatitis B vaccination, anti-HBs titer

Abstract

Background Suboptimal zinc intake may depress thymus function,
lymphoproliferation, and T cell-dependent B-cell proliferation,
which can impair antibody production. Zinc supplementation can
improve immune function and reduce morbidity.
Objective To assess the effect of zinc supplementation on infants'
anti-HBs titer after hepatitis B vaccination.
Methods A double-blind randomized control trial of 66 healthy
infants in Pustu Dauh Puri, Denpasar Barat was conducted. Subjects
were followed from birth to three months of age and were placed
into two treatment groups using block randomization. One group
received zinc supplements with a standard hepatitis B vaccination
(zinc group, n=33) and the other group received placebo
supplements with standard hepatitis B vaccination (placebo group,
n=33). The serum zinc levels were measured at baseline and at
three months. The difference in levels of anti-HBs titer between the
zinc and placebo groups was the primary endpoint of this study.
Results The serum zinc levels were significantly higher in the zinc
group compared to the placebo group (P = 0.017), with a mean
difference of 18.76 miU/ml (95% CI 3.45 to 34.07). Regardless
of baseline serum zinc levels, the mean anti-HBs titers were
significantly higher in the zinc group compared to the placebo
group (P <0.0001; mean difference = 495.8 miU/mL; 95%
CI 362.32 to 629.44). Multivariate analysis showed that zinc
supplementation was the only variable that influenced anti-HBs
titer levels (P < 0.0001).
Conclusion Regardless of their initial zinc serum level, infants
receiving zinc supplements along with standard hepatitis B
vaccination have significantly higher levels of anti-HBs titers
than infants receiving hepatitis B vaccination without zinc
supplements.

Author Biographies

K. Suarca
Department of Child Health, Medical School, Udayana
University, Sanglah Hospital, Denpasar, Indonesia.
Hendra S
Department of Child Health, Medical School, Udayana
University, Sanglah Hospital, Denpasar, Indonesia.
B. N. P. Arhana
Department of Child Health, Medical School, Udayana
University, Sanglah Hospital, Denpasar, Indonesia.
I K. G. Suandi
Department of Child Health, Medical School, Udayana
University, Sanglah Hospital, Denpasar, Indonesia.

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Published
2016-09-15
How to Cite
1.
Suarca K, S H, Arhana B, Suandi IK. The role of zinc supplementation in humoral immune response to hepatitis B vaccination in infants: a double-blind randomized placebo-controlled trial. PI [Internet]. 15Sep.2016 [cited 28Mar.2024];48(6):374-0. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/632
Received 2016-09-14
Accepted 2016-09-14
Published 2016-09-15