炎症性肠病患者的乙型肝炎疫苗应答：系统评价和荟萃分析。
Hepatitis-B Vaccine Response in Inflammatory Bowel Disease Patients: A Systematic Review and Meta-analysis.
机构信息
Gastroenterology, Hepatology & Nutrition, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.
Gastroenterology & Hepatology, University of Utah Health, Salt Lake City, Utah, USA.
出版信息
Inflamm Bowel Dis. 2021 Oct 18;27(10):1610-1619. doi: 10.1093/ibd/izaa353.
BACKGROUND
Data on efficacy of hepatitis-B vaccine (HBV) in patients with inflammatory bowel disease (IBD) is limited. Our aim was to review the literature and perform meta-analysis of available studies to quantify efficacy of HBV in patients with IBD.
METHODS
We conducted a comprehensive search of several databases (inception to July 2020) to identify studies evaluating efficacy of HBV in patients with IBD. Random effects model was used to calculate the pooled rates and I2 percentage values were used to assess the heterogeneity.
RESULTS
A total of 14 studies (2375 patients) were included. Four data sets were available from 2 studies that compared HBV response in patients with IBD against healthy controls. The pooled odds ratio of HBV response in IBD patients was 0.13 (95% CI, 0.05-0.33, P = 0.001). The pooled proportion of adequate immune response (AIR) was 64% (95% CI, 55-72.1, P = 0.003) from 13 data sets, and effective immune response (EIR) was 39.7% (95% CI, 30.7-49.5, P = 0.04) from 10 data sets.
CONCLUSION
Patients with IBD on immunosuppression demonstrated significantly reduced HBV response as compared with general population.
背景
关于乙型肝炎疫苗（HBV）在炎症性肠病（IBD）患者中的疗效的数据有限。我们的目的是回顾文献并对现有研究进行荟萃分析，以量化 HBV 在 IBD 患者中的疗效。
方法
我们对多个数据库（从开始到 2020 年 7 月）进行了全面搜索，以确定评估 HBV 在 IBD 患者中疗效的研究。使用随机效应模型计算汇总率，并用 I2 百分比值评估异质性。
结果
共纳入 14 项研究（2375 例患者）。有 2 项研究的 4 个数据集比较了 IBD 患者与健康对照组的 HBV 反应，可用于比较。IBD 患者 HBV 反应的汇总优势比为 0.13（95%CI，0.05-0.33，P=0.001）。13 个数据集的适当免疫反应（AIR）汇总比例为 64%（95%CI，55-72.1，P=0.003），10 个数据集的有效免疫反应（EIR）为 39.7%（95%CI，30.7-49.5，P=0.04）。
结论
与一般人群相比，接受免疫抑制治疗的 IBD 患者的 HBV 反应明显降低。
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