Inadequate seroconversion rates in celiac disease after 3 doses of hepatitis B vaccine, administered at 3, 5 and 11 months of life

Abstract

Celiac disease (CD) is a clinical condition potentially impairing the immune system. We tested the hypothesis that CD could hinder seroconversion following hepatitis B vaccine (HBV). We compared 81 consecutive CD patients (24 male and 57 female) with a median [interquartile range (IQR)] age of 10 (7) yr (range 2–30 yr) and 50 controls (26 male and 24 female) with a median (IQR) age 7 (7) yr (range 1–26 yr) who received a standard immunisation schedule with HBV given at 3, 5 and 11 mo of. The median (IQR) interval from the last dose of HBV was higher in CD patients as compared to controls [10 (7), range 2–29 yr vs. 6 (7), range 1–26 yr; P < 0.0001]. The median (IQR) age of gluten introduction was comparable in the two groups [6 (1), range 4–12 mo vs. 6(1), range 5–11 mo]. The median (IQR) duration of gluten intake in the CD group was 3.5 (4.8) yr (range 0.2–12.3 yr). 33 of 81 (40%) CD patients did not seroconvert (anti-HBs < 10 IU/mL), compared with 10 of 50 (20%) controls (P < 0.05). The odds ratio of a protective anti-HBs titer in CD patients vs. controls was 0.36 (95% 0.16–0.83, P < 0.0001), and was not associated with gender, interval from the last administration of HBV, or duration of pre-diagnosis gluten intake in CD patients. Our results are consistent with previous observations that CD patients are less likely to be protected by HBV, which may have important public health implications.

Keywords

Celiac disease - HBV vaccine - seroconversion - immune network