Fernández Sánchez-Escalonilla Sara, Esparcia Rodríguez Óscar, López Canto Sara, Cantero Escribano José Miguel, Molina Cabrero Francisco Jesús, Gómez-Juárez Sango Ana, García Guerrero Jesús
Medicina Preventiva y Salud Pública. Complejo Hospitalario Universitario de Albacete. Albacete. España.
Rev Esp Salud Publica. 2022 Feb 18;96:e202202020.
Patients with Inflammatory Bowel Disease (IBD) are at increased risk of hepatitis B virus (HBV) infection as well as a lower response to vaccination. This study aimed to analyze the immune response after vaccination against HBV in patients diagnosed with IBD and its associated factors.
A retrospective observational study was conducted on patients with IBD treated at the vaccination clinic for at-risk patients at the during the period 2011-2018. Immune response after vaccination and associated factors were determined using logistic regression models.
231 patients were included. HBV Vaccination had an optimal immune response in 82.7% of the patients. The likelihood of response to vaccination increased in those diagnosed with ulcerative colitis (OR 2.90; 95% CI 1.11-7.61) and decreased with age (80% lower in those aged 40-55 years (OR 0.20; 95% CI 0.05-0.83) and 88% lower in those over 55 years of age (OR 0.12; 95% CI 0.03-0.53) compared to those under 40 years of age) and pharmacological immunosuppression (OR 0.20; 95% CI 0.58-0.71).
The decrease in the immunogenicity of the vaccine against hepatitis B in patients with IBD after the beginning of immunosuppressive treatment, as well as with age, make early vaccination a priority in this kind of patients.
炎症性肠病（IBD）患者感染乙型肝炎病毒（HBV）的风险增加，且对疫苗接种的反应较低。本研究旨在分析确诊为IBD的患者接种HBV疫苗后的免疫反应及其相关因素。
对2011年至2018年期间在高危患者疫苗接种门诊接受治疗的IBD患者进行回顾性观察研究。使用逻辑回归模型确定疫苗接种后的免疫反应及相关因素。
纳入231例患者。82.7%的患者对HBV疫苗接种有最佳免疫反应。溃疡性结肠炎患者对疫苗接种产生反应的可能性增加（比值比[OR]2.90；95%置信区间[CI]1.11 - 7.61），且随着年龄增长而降低（40 - 55岁患者降低80%[OR 0.20；95%CI 0.05 - 0.83]，55岁以上患者降低88%[OR 0.12；95%CI 0.03 - 0.53]，与40岁以下患者相比）以及药物性免疫抑制（OR 0.20；95%CI 0.58 - 0.71）。
免疫抑制治疗开始后以及随着年龄增长，IBD患者中乙型肝炎疫苗的免疫原性降低，这使得早期接种疫苗成为这类患者的优先事项。
