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

Abstract

BACKGROUND: Patients with inflammatory bowel disease (IBD) vaccinated for hepatitis B have a low success rate in achieving protective antibody levels. The main factors suggested for this are IBD itself and the use of immunosuppressive drugs. OBJECTIVE: To evaluate the concentration of anti-HBs antibodies and to verify factors associated with the effectiveness of hepatitis B vaccination in patients with IBD. METHODS: This is a prospective, consecutive, observational, descriptive and analytical, non-randomized, qualitative study that evaluated the levels of anti-HBs antibodies in IBD patients at the Interdisciplinary Inflammatory Bowel Disease Clinic of the Family and Community Health Unit of UNIVALI - Itajaí, Santa Catarina. RESULTS: Thirty-six patients were vaccinated against hepatitis B virus (HBV), of which 29 were female. The average age was 46.2 years. Regarding the type of IBD, twenty-four patients had Crohn’s disease and the duration of inflammatory bowel disease was 74 months. Fifteen patients were on concomitant immunosuppressive therapy. The effective response rate to HBV vaccine was 72.2%, verified by anti-HBs titration ≥10 UI/L. Statistical analysis revealed a negative response to vaccination in patients with Crohn’s disease and immunosuppressive drugs. CONCLUSION: The success rate of HBV immunization in IBD patients is low compared to the general population. Type of disease and use of immunosuppressive drugs appear to influence the vaccine response.

Meta‐analysis: hepatitis B vaccination in inflammatory bowel disease

“…Therefore, a total of 1005 articles were screened for titles and abstracts and eventually 36 articles underwent full‐text screening ( Figure 1 ) . 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 .…”

“…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 . One included study was published in Spanish and translated to English 36 Table S3.…”

“…There were 21 studies which included 11 prospective studies 7,20,21,23–28,30,35 and 10 retrospective studies 17–19,22,29,31–34,36 . Prospective studies included two randomised controlled trials, 21,24 seven cohort studies 20,23,25–28,30 and two case–control studies 7,35 .…”

“…29 Standard doses of 10-20 μg (as recommended by manufacturer) were used for vaccination in 13 studies. 7,[17][18][19][20][22][23][24]28,31,33,35,36 Three studies used the double dose (40 μg) 26,27,30 and two studies compared the double dose with standard dose. 21,25 The exact dose of vaccine administered was not mentioned in three studies.…”

“…After reviewing the full texts, 21 studies were included for the analysis. 7,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] Details of excluded studies are provided in Table S2. [37][38][39][40][41][42][43][44][45][46][47][48][49][50][51] Of the included studies, 17 were full F I G U R E 1 PRISMA flowchart showing the selection of studies for the systematic review articles 7,[17][18][19][20][21][22][23][24][25][26]29,[31][32]…”