Department of Gastroenterology, Haydarpaşa Numune Education and Research Hospital, Tibbiye Cad. No:40, 34668 Üsküdar, Istanbul, Turkey.
Dig Dis Sci. 2012 Apr;57(4):1039-44. doi: 10.1007/s10620-011-1980-8. Epub 2011 Dec 7.
Hepatitis B (HBV) is a vaccine-preventable infection that may cause severe infections, particularly in patients who are being treated with immunosuppressive therapy [(i.e., inflammatory bowel disease (IBD)]. Limited data are available about IBD patients' response rate to HBV vaccine.
To assess the efficacy of HBV vaccine in IBD patients and healthy controls.
Serological markers of HBV were assessed in IBD patients, and HBV vaccine was administered to seronegative patients. The subsequent determination of anti-HBs antibody was recorded. An adequate immune response (AIR) and an effective immune response (EIR) to HBV were defined as more than 10 and 100 mIU/ml, respectively. The single dose vaccine was administered at 0, 1 and 6 months.
A total of 102 patients with IBD (39 Crohn's disease, 63 ulcerative colitis; 54 female, 48 male) and 52 (25 female, 27 male) healthy controls were included. Mean age for patients and controls were 38 ± 12 and 31 ± 8, respectively (P < 0.001). Both AIR and EIR were significantly lower in patients than in controls (P < 0.001), but they were similar between patients with CD and UC (P = 0.302). Forty-four (43%) patients were on immunosuppressive therapy before vaccination. After vaccination, 76 and 53% of the patients had AIRs and EIRs, respectively, whereas 100 and 87% of the controls had AIRs and EIRs, respectively (P < 0.001 and P < 0.001, respectively).
The response rate of IBD patients receiving HBV vaccinations were significantly lower compared to controls. The response rate of those receiving immunosuppressive therapy and with active disease was much too low. Vaccination should be given during remission and at immunosuppression-free times.
乙型肝炎（HBV）是一种可通过疫苗预防的感染，在接受免疫抑制治疗的患者（例如炎症性肠病（IBD）患者）中可能会引起严重感染。关于 IBD 患者对 HBV 疫苗的反应率，可用的数据有限。
评估 HBV 疫苗在 IBD 患者和健康对照者中的疗效。
评估 IBD 患者的 HBV 血清学标志物，并为血清阴性患者接种 HBV 疫苗。随后记录抗-HBs 抗体的测定值。将 HBV 疫苗的 1 剂接种方案设定为 0、1 和 6 个月。将对 HBV 的足够免疫反应（AIR）和有效免疫反应（EIR）定义为分别超过 10 和 100 mIU/ml。
共纳入 102 例 IBD 患者（39 例克罗恩病，63 例溃疡性结肠炎；54 例女性，48 例男性）和 52 名（25 例女性，27 例男性）健康对照者。患者和对照组的平均年龄分别为 38 ± 12 岁和 31 ± 8 岁（P < 0.001）。与对照组相比，患者的 AIR 和 EIR 均显著降低（P < 0.001），但 CD 患者和 UC 患者之间无差异（P = 0.302）。接种疫苗前，44 例（43%）患者正在接受免疫抑制治疗。接种疫苗后，分别有 76%和 53%的患者出现 AIR 和 EIR，而对照组中分别有 100%和 87%的患者出现 AIR 和 EIR（P < 0.001 和 P < 0.001）。
与对照组相比，接受 HBV 疫苗接种的 IBD 患者的反应率显著降低。正在接受免疫抑制治疗且疾病处于活动期的患者的反应率太低。应在缓解期和无免疫抑制治疗时期进行疫苗接种。
