Seroconvertion to hepatitis B vaccine after weight reduction in obese non-responder

Abstract

SUMMARYDecreased responses to hepatitis B vaccine have been associated with some host conditions including obesity. Susceptible non-responders to a primary three-dose vaccine series should be revaccinated. Those who maintain a non-responder condition after revaccination with three vaccine doses are unlikely to develop protection using more doses. This is a description of an obese woman who received six doses of hepatitis B vaccine and persisted as a non-responder. She was submitted to a vertical banded gastroplasty Roux-en-Y gastric bypass Capellas's technique. After weight reduction, she received three additional doses of vaccine and seroconverted. Further studies should help clarify the need to evaluate antibody levels and eventually revaccinate the increasing population of individuals who undergo weight reduction.

Influences of obesity on the immunogenicity of Hepatitis B vaccine

“…[21][22][23][24] Moreover, the study conducted by Dinelli et al reported that the obese women who did not response to 6 doses of recombinant hepatitis B vaccine, was seroconverted after weight reduction. 25 To further understand the impaired responses of HBV vaccination, we recently performed a meta-analysis to characterize the relationship between obesity and immune response to hepatitis B vaccine. 26 Based on the collection the original papers about hepatitis B vaccine in obesity published between 1973 and 2015, our results further showed that obesity was significantly associated with non-response to hepatitis B immunization ( ).…”

Efficacy of an Accelerated Hepatitis B Vaccination Program During Pregnancy

“…Although limited data are available, small studies have reported improved seroconversion rates in obese patients with increasing needle length, dose and formulation of vaccine, and weight reduction surgery. [21][22][23][24] Other factors that have been found to correlate poorly with immune response such as smoking and age were not associated with seroconversion in our cohort. Compliance rates for hepatitis B vaccination completion varies depending on the population.…”

Assessment of immune response to Hepatitis B vaccine by estimation of anti - HBs antibody titer among immunized health care workers

“…Weber et al observed that antibody responses to hepatitis B vaccine were significantly reduced in obese individuals as compared with non-obese people [34]. Dinelli et al reported that the obese women who did not response to 6 doses of recombinant hepatitis B vaccine, showed sero-conversion subsequent to weight reduction [35].A suggested mechanism causing inappropriate immune responses in obese individuals may be leptininduced systemic inflammation and alterations in innate and adaptive immune responses [36].…”