Response to Hepatitis B Vaccination in Patients with Celiac Disease

Abstract

Abnormal immune response to gliadin, genetic, and environmental factors play a role in the pathogenesis of celiac disease (CD). Non-responsiveness to hepatitis B virus (HBV) vaccination is related to genetic features. Certain human leukocyte antigen (HLA) genotypes are more prevalent among non-responders to HBV vaccination. There is also a strong relationship between CD and these HLA genotypes. This study investigates the relationship between CD and non-responsiveness to HBV vaccination, with an emphasis on genotypic co-incidence. No statistically significant difference was noted between the ages and gender of CD patients and control subjects. Baseline serum IgA, IgM, and IgG levels of all CD patients were normal. Responsiveness to HBV vaccination was observed in 17 (68%) CD patients and all (100%) control subjects (P = 0.006). In conclusion, CD should also be sought in unresponders to HBV vaccine who are not immunosuppressed.

Role of Gluten Intake at the Time of Hepatitis B Virus Vaccination in the Immune Response of Celiac Patients

“…Ahishali et al (4) found that 68% of adults with CD were responsive to HBV vaccination; this percentage was significantly lower than that in the general population (100%). They also found a P Ͻ 0.05 for group A versus group B for HBsAb 10 -100 mIU/ml, for group A versus group B for HBsAb Ͼ100 mIU/ml, and for group B versus group C for HBsAb Ͻ10 mIU/ml.…”

“…Celiac disease (CD) is an HLA-associated immunological disease, and for this reason, a genetic predisposition as a possible cause of a lower grade of immunization to recombinant hepatitis B vaccines has been considered (4,5). In fact, HLA-DQ2 status may predispose CD patients to fail to develop immunity after hepatitis B vaccination through a Th2 response that is inadequate for B-cell differentiation and the formation of memory B cells (5).…”

Review article: prevention and management of hepatitis B and C infection in patients with inflammatory bowel disease

“…For example, the rate of response to HBV vaccine has been reported to be lower in patients with coeliac disease than in healthy individuals. 94 However, the response to HBV vaccine in coeliac children who were compliant with a gluten-free diet is no different from that of the healthy population. 95 Thus, coeliac disease may be one of the immune diseases associated with a reduced response to HBV vaccine; however, this lack of response might not be permanent, and a gluten-free diet and compliance with treatment may ameliorate the immune response to the vaccine.…”

Immune response to Hepatitis B vaccine in patients with celiac disease: A systematic review and meta-analysis

“…Therefore, we included 17 randomized clinical trials in the qualitative synthesis. [6][7][8][9][10][11][12][17][18][19][20][21][22][23][24][25][26] Three studies were further excluded because they lacked a control arm; 17-19 2 other studies, reporting both a retrospective and a prospective cohort of patients, were considered only for the retrospective design, since the prospective cohort lacked a control arm. 20,21 As a result, 14 studies were considered for the metaanalysis.…”

“…[3][4][5] Whether patients with CD have non-protective antibody responses to HBV vaccination more frequently than non-affected subjects is still debated in the literature. [6][7][8][9][10][11][12] This issue has not yet been addressed by systematic reviews or meta-analyses. The results of a meta-analysis dealing with the immune response to HBV vaccination in celiac disease could provide information for clinical practice guidelines for CD patient management, since HBV infection is a relevant topic in all age groups, and a crucial issue for people belonging to high risk groups.…”