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Effectiveness of Hepatitis B Vaccination for Patients With Inflammatory Bowel and Celiac Disease

delete2023-10-01
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OA
AI
J
Jessica A. Ulrich
N
Nawras W. Habash
Y
Yasmine A. Ismail
W
William J. Tremaine
A
Amy L. Weaver
J
Joseph A. Murray
E
Edward V. Loftus
A
Absah, Imad *
DOI:10.1016/j.cgh.2023.03.025delete
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Abstract

Abstract

En 中文
BACKGROUND & AIMS: Guidelines recommend measuring antibody (Ab) titers to hepatitis B virus (HBV) after vaccination for patients with inflammatory bowel disease (IBD) or celiac disease (CD) (patients with IBD/CD) and revaccinating when titers are low. Few data, however, support this recommendation. We aimed to compare effectiveness of HBV vaccination (immunity and infection rates) for patients with IBD/CD vs matched referents.METHODS: Using the Rochester Epidemiology Project, we performed a retrospective cohort study of patients first diagnosed with IBD/CD (index date) while residing in Olmsted County, Minnesota, from January 1, 2000, through December 31, 2019. HBV screening results were obtained from health records.RESULTS: In 1264 incident cases of IBD/CD, only 6 HBV infections were diagnosed before the index date. A total of 351 IBD/CD cases had documented receipt of 2 or more HBV vaccines before their index date and had hepatitis B surface antigen Ab (anti-HBs) titers measured after their index date. The proportion of patients with HBV-protective titers (double dagger 10 mIU/mL) decreased with time before plateauing, with protective titer rates of 45% at 5 up to 10 years and 41% at 15 up to 20 years after the last HBV vaccination. The proportion of referents with protective titers also decreased with time and was consistently higher than the levels of patients with IBD/CD within 15 years after the last HBV vaccination. However, no new HBV infection developed in any of 1258 patients with IBD/CD during a median follow-up of 9.4 years (interquartile range, 5.0-14.1 years).CONCLUSIONS: Routine testing of anti-HBs titers may not be indicated for fully vaccinated patients with IBD/ CD. Additional studies are needed to confirm these findings in other settings and populations.
Keywords:
Antibodies
Colitis
Gluten-sensitive enteropathy
Hepatitis
Immunization
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Clinical Gastroenterology and Hepatology cover
Clinical Gastroenterology and Hepatology
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mayo clinic
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