Inadequate seroprotection against hepatitis B virus and one detected case of hepatitis C virus infection among patients with inflammatory bowel disease

Waszczuk, Ewa; Waszczuk, Karolina; Mulak, Agata; Paradowski, Leszek

doi:10.1097/meg.0000000000000613

Cited by 6 publications

(14 citation statements)

References 23 publications

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“…Among our vaccinated patients, 5/176 (2.8%) were infected by HBV, a finding consistent with data from Poland [ 17 ]. Possible explanation may include an HBsAb titre loss due to immunosuppressive therapies, a not perfectly performed vaccination or a not fully responsive immune system.…”

Section: Discussionsupporting

confidence: 91%

“…From our data, it appears that the risk of HBV infection increases with age; however, this result is surely influenced by the mandatory HBV vaccination. Another important issue is the relationship between IBD and HBsAb status in vaccinated IBD patients; we confirm the finding of Waszczuk et al [ 17 ] who reported a seroprotection rate of 54%, underlining that our patients were vaccinated long before the diagnosis of IBD was made. This confirms our previous finding in a much smaller cohort [ 26 ].…”

Section: Discussionsupporting

confidence: 89%

“…Contemporarily, we also registered the following data: gender, age, disease (ulcerative colitis, Crohn's disease, and IBD undefined (IBDU)), Montreal classification [ 14 ] prior to surgery (for patients with CD), year of diagnosis, time elapsed between diagnosis and infectious diseases screening, and therapies prior to screening. Furthermore, in consideration of the literature data concerning a more frequent loss of HBV vaccine titre in patients with IBD compared to the general population [ 15 – 17 ], the serologic status for HBV (HBsAb) in patients aged ≤37 years in 2016 (patients born later than 1979), that is, a population subjected to mandatory vaccination for hepatitis B in Italy (for vaccination strategy in Italy, see Zanetti et al [ 18 ]), was compared with that of a healthy control population (without IBD, no previous HBV infection, age ≤ 37 years) by retrospectively revising the charts of hospital employees subjected to regular working ability visits at the Occupational Medicine Unit of the University Hospital of Messina.…”

Section: Methodsmentioning

confidence: 99%

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

Ardesia

Costantino

Mondello

et al. 2017

Gastroenterology Research and Practice

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Background With the introduction of more potent immunosuppressive agents in inflammatory bowel disease, prevention of opportunistic infections has become necessary by introducing screening programs. Prevalence of the most important infectious agents may vary in different geographical areas. The aim of our study was to assess the immune status for hepatitis B, varicella, mononucleosis, and cytomegalovirus infection together with the determination of the hepatitis C and tuberculosis status in Southern Italy. Methods Prevalence of latent tuberculosis, together with serology of hepatitis B and C, Epstein-Barr virus, varicella zoster, and cytomegalovirus were collected by analysing retrospectively the clinical charts of IBD patients. Data were integrated with demographic and clinical features. Results Data from 509 IBD patients divided in two age groups showed a prevalence of HBV infection in nonvaccinated patients of 9%. Seroprotection (HBsAb) in vaccinated IBD patients was lower (p < 0.0001) compared with that in controls. Prevalences of herpesvirus infections fluctuate between 51% (CMV) and 85% (EBV) and 84% (VZV) in younger patients. Latent tuberculosis and hepatitis C infection were found only in patients > 37 years of age. Conclusions In younger patients, high susceptibility rates for primary herpesvirus infections should determine the choice of treatment. Loss of HBV seroprotection in already vaccinated patients should be considered for booster vaccination programs.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 89%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

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

Ardesia

Costantino

Mondello

et al. 2017

Gastroenterology Research and Practice

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“…After reviewing the full texts, 21 studies were included for the analysis 7,17–36 . Details of excluded studies are provided in Table S2 37–51 . Of the included studies, 17 were full articles 7,17–26,29,31–35 and 4 were published as abstracts 27,28,29,31 .…”

Section: Resultsmentioning

confidence: 99%

Meta‐analysis: hepatitis B vaccination in inflammatory bowel disease

Singh

Jena

Mahajan

et al. 2022

Aliment Pharmacol Ther

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Background:The response rate of hepatitis B virus (HBV) vaccination in patients with inflammatory bowel disease (IBD) is variable. Increasing dose or accelerated schedule is the suggested strategy to improve seroconversion. Aim:We performed a meta-analysis to determine the pooled response rate of HBV vaccination and to identify the predictors of seroconversion. Methods:We searched PubMed, Embase and Cochrane library databases. Studies reporting the response of HBV vaccination in IBD patients were included. Response was recorded as adequate immune response (AIR, >10 IU/L) and Effective immune response (EIR, >100 IU/L). Pooled AIR and EIR rates were calculated for different doses (10-20 μg or 40 μg) and schedules (standard: 0, 1 and 6 months or accelerated: 0, 1 and 2 months). Meta-analysis was performed to identify the predictors of response.Results: Twenty-one studies including 2602 patients were eligible. Pooled AIR and EIR rates after HBV vaccination were 62% (95% CI, 55-68) and 42% (95% CI, 37-48), respectively. Pooled AIR and EIR rates for standard and double dose were similar.Pooled AIR and EIR rates were also comparable for different schedules of HBV vaccination. Gender, IBD subtype and disease activity did not affect the response rate.Use of immunosuppression [immunomodulators (RR: 0.73, 95% CI, 0.62-0.87) and anti-TNFs (RR: 0.72, 95% CI, 0.60-0.87)] was a predictor of poor immune response compared to no immunosuppressive therapy. Conclusion:Patients with IBD have a poor serological response after HBV vaccination. HBV screening and vaccination should preferably be done before starting the immunosuppressive drugs.

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“…Similarly, results of two Greek studies also reported prevalence of 2.3%-5% among IBD patients, which was in accordance to what was expected[ 30 , 31 ]. In addition, a study from Poland, a country with intermediate endemicity, also showed that the prevalence of HBV infection among IBD patients was comparable to that of the general population[ 32 ]. The most recent study by Losurdo et al [ 33 ], published in 2020, evaluated the burden of viral hepatitis in IBD and demonstrated that HCV was more frequent than HBV infection in IBD patients but with low overall prevalence.…”

Section: Hbv Prevalence In Patients With Ibdmentioning

confidence: 99%

Management of hepatitis B virus infection in patients with inflammatory bowel disease under immunosuppressive treatment

Axiaris

Zampeli

Michopoulos

et al. 2021

WJG

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Hepatitis B remains a significant global clinical problem, despite the implementation of safe and effective vaccination programs. The prevalence of hepatitis B virus (HBV) in patients with inflammatory bowel disease (IBD) largely follows the regional epidemiologic status. Serological screening with hepatitis B surface antigen (HBsAg), and antibodies to hepatitis B surface (anti-HBs) and core (anti-HBc) proteins is a key element in the management of IBD patients and, ideally, should be performed at IBD diagnosis. Stratification of individual cases should be done according to the serologic profile and the IBD-specific treatment, with particular emphasis in patients receiving immunosuppressive regimens. In patients who have not contracted HBV, vaccination is indicated to accomplish protective immunity. Vaccination in immunosuppressed patients, however, is a challenging issue and several strategies for primary and revaccination have been proposed. The risk of HBV reactivation in patients with IBD should be considered in both HBsAg-positive and HBsAg-negative/anti-HBc-positive patients, when immunosuppressive therapies are administered. HBV reactivation is preventable via the administration of prophylactic nucleot(s)ide analogues and should be the standard approach in HBsAg-positive patients. HBsAg-negative/anti-HBc-positive patients represent a non-homogeneous group and bear a significantly lower risk of HBV reactivation. Biochemical, serological and molecular monitoring is currently the recommended approach for anti-HBc patients. Acute HBV infection is rarely reported in IBD patients. In the present review, we outline the problems associated with HBV infection in patients with IBD and present updated evidence for their management.

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Inadequate seroprotection against hepatitis B virus and one detected case of hepatitis C virus infection among patients with inflammatory bowel disease

Cited by 6 publications

References 23 publications

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

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

Meta‐analysis: hepatitis B vaccination in inflammatory bowel disease

Management of hepatitis B virus infection in patients with inflammatory bowel disease under immunosuppressive treatment

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