Neurology Department, Centro Hospitalar Universitário de Lisboa Central, Portugal.
Neurology Department, Centro Hospitalar Universitário de Lisboa Central, Portugal; Neurology Department, Centro Hospitalar Barreiro Montijo, Portugal.
Mult Scler Relat Disord. 2021 May;50:102859. doi: 10.1016/j.msard.2021.102859. Epub 2021 Feb 23.
HBV screening and immunization is recommended in all MS patients and is mandatory before the start of some DMT. However, studies evaluating the immune response to HBV vaccine in MS patients are scarce. We aimed to evaluate the seroprotection rate following HBV immunization in MS patients and to assess if older age and DMT-treatment influenced seroprotection. We conducted a cohort study between 2016 and 2020 and compared the immune response to HBV vaccine in MS patients under different DMTs and in patients 50 years old or younger and older than 50. We found that patients under non-injectable DMT presented lower rates of seroprotection comparing to patients under injectable DMT's or without treatment. In patients older than 50, although the seroprotection rate was similar to the remaining patients, the antibody anti-HBV surface antigen titers following HBV immunization were lower and patients were more likely to require a 4th dose of the vaccine to achieve seroprotection. Our findings highlight to need to consider HBV immunization in MS patients early in the disease course, in order to ensure a proper immune response to the vaccine.
HBV 筛查和免疫接种建议在所有 MS 患者中进行，并且在开始某些 DMT 之前是强制性的。然而，评估 MS 患者对 HBV 疫苗的免疫反应的研究很少。我们旨在评估 MS 患者接种 HBV 疫苗后的血清保护率，并评估年龄较大和 DMT 治疗是否会影响血清保护率。我们在 2016 年至 2020 年间进行了一项队列研究，并比较了不同 DMT 下的 MS 患者、50 岁及以下的患者和 50 岁以上的患者对 HBV 疫苗的免疫反应。我们发现，与接受注射性 DMT 或未接受治疗的患者相比，接受非注射性 DMT 的患者的血清保护率较低。对于 50 岁以上的患者，尽管血清保护率与其余患者相似，但 HBV 免疫接种后抗 HBV 表面抗原抗体滴度较低，且更有可能需要接种第 4 剂疫苗才能达到血清保护。我们的研究结果强调需要在疾病早期考虑对 MS 患者进行 HBV 免疫接种，以确保对疫苗产生适当的免疫反应。
