Evaluation of Factors Associated With Response to Hepatitis B Vaccination in Patients With Inflammatory Bowel Disease

Abstract

It is recommended to investigate the serology of hepatitis B virus (HBV) and vaccinate seronegative patients at the time of diagnosis in inflammatory bowel diseases (IBD). This study aimed to investigate the efficacy of HBV vaccine and factors affecting the response.In this retrospective, observational study, HBV-seronegative IBD patients were administered 3 doses (at months 0, 1, and 6) recombinant 20 μg HbsAg. Patients’ demographics, IBD attributes, and treatment methods were investigated as the factors with potential impacts on vaccination outcomes.One hundred twenty-five patients with IBD were evaluated. The number of patients with Anti-HBs >10 IU/L was 71 (56.8%), and the number of patients with anti-HBs >100 IU/L was 50 (40%). Age, disease activity, Crohn disease subtype, and immunosuppressive treatment (IST) were found to have significant effects on immune response (P = 0.011, P < 0.001, P = 0.003, and P < 0.001, respectively). With multivariate analysis, age < 45 years (OR 3.1, 95% CI 1.2–8.3, P = 0.020), vaccination during remission (OR 5.6, 95% CI 2.3–14, P < 0.001), and non-IST (OR 11.1, 95% CI 2.9–43.2, P = 0.001) had favorable effects on the occurrence of adequate vaccine response.The likelihood of achieving adequate immune response with standard HBV vaccination protocol in IBD is low. Selecting vaccination protocols with more potent immunogenicity is a better approach to achieve effective vaccine response in patients with multiple unfavorable factors.

Serology of Viral Infections and Tuberculosis Screening in an IBD Population Referred to a Tertiary Centre of Southern Italy

“…Data from this study comparing the IBD population with a healthy population of the same age and geographical area confirm the significant loss of HBsAb titre among patients with IBD, with a greater tendency in CD than in UC (although the statistical significance was not achieved, most probably due to the sample size), as already reported in other studies [ 27 , 28 ].…”

“…Among yet identified risk factors for a missing seroprotection despite vaccination are diagnosis if CD, disease duration of more than 7 years, and an age at diagnosis of over 31 years [ 23 ], while conflicting data exist about the influence of immunosuppressive drugs on response to and on persistence of vaccine efficacy [ 15 , 27 , 28 ].…”

Compliance with the guidelines on recommended immunization schedule in patients with inflammatory bowel disease: implications on public health policies

“…Evidence on the immunogenicity and safety of vaccines in treated patients with IBD is still limited, as different immunomodulators can alter immune responses to vaccines [7,11,15]. According to some studies, patients with IBD had lower antibody responses after hepatitis B vaccination than the general population [7,20,21]. In other studies, IBD patients under treatment with infliximab and immunomodulatory therapy showed an impaired response to a single dose of trivalent inactivated influenza vaccine [22,23].…”

Seroconversion Analysis After Habitual Hepatitis B Vaccination Scheme in Patients With Inflammatory Bowel Diseases

“…Similarly, Gisbert et al also found worse vaccine response in patients using any immunosuppressant (20) . Cekic et al found that patients on corticosteroids and azathioprine in combination with anti-TNF had lower response to HBV vaccination (22) . Sempere et al also demonstrated worse response to vaccination in patients on corticosteroids therapy (11) .…”