Mansour Hala H, Eskander Ayman E, Osman Sara M, Rady Normeen H
Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt.
Department of Clinical Pathology, Faculty of Medicine, Cairo University, Egypt.
Pediatr Gastroenterol Hepatol Nutr. 2024 Mar;27(2):104-112. doi: 10.5223/pghn.2024.27.2.104. Epub 2024 Mar 4.
Immunosuppressive therapy is frequently administered to patients with inflammatory bowel disease (IBD), which may make them more susceptible to infections like hepatitis B.
A cross-sectional study was conducted on patients aged 5-18 years diagnosed with IBD who visited a gastroenterology clinic along with controls who were the same age as the patients with IBD and were healthy overall. A logistic regression analysis using the independent variables of age, sex, race, disease phenotype, surgery, and medications and the dependent variable of adequate hepatitis B surface antibody (HBsAb) titers (>10 mIU/mL) was performed on quantitative serum HBsAb titers.
The study enrolled 62 patients, including 37 males and 25 females. Crohn's disease, ulcerative colitis, and indeterminate colitis were diagnosed in 16, 22, and 24 patients, respectively. Thirty-nine patients were taking corticosteroids at the time of the study, 42 were taking immunomodulators, and four were taking biologics. Compared to 44.7% of the control group, 9.3% of the patients had protective titers. Only 12 out of 62 patients had HBsAb titers greater than 10 million IU/mL. None of the patients who received biologics or corticosteroids and 3.2% of those who received immunomodulators were found to be seroimmuned.
The younger patients had the highest titers. Patient-specific factors that may impact these low titers include the length of the patient's illness and the use of immunosuppressants.
免疫抑制疗法常用于炎症性肠病(IBD)患者,这可能使他们更容易感染乙型肝炎等疾病。
对5至18岁诊断为IBD并前往胃肠病诊所就诊的患者进行横断面研究,并以与IBD患者年龄相同且总体健康的人群作为对照。对定量血清乙型肝炎表面抗体(HBsAb)滴度进行逻辑回归分析,自变量包括年龄、性别、种族、疾病表型、手术和用药情况,因变量为足够的HBsAb滴度(>10 mIU/mL)。
该研究纳入了62例患者,其中男性37例,女性25例。分别有16例、22例和24例患者被诊断为克罗恩病、溃疡性结肠炎和不确定性结肠炎。39例患者在研究时正在服用皮质类固醇,42例正在服用免疫调节剂,4例正在服用生物制剂。与对照组的44.7%相比,患者中有9.3%具有保护性滴度。62例患者中只有12例的HBsAb滴度大于1000万IU/mL。接受生物制剂或皮质类固醇治疗的患者中无一例血清免疫,接受免疫调节剂治疗的患者中有3.2%血清免疫。
年龄较小的患者滴度最高。可能影响这些低滴度的患者特异性因素包括患病时长和免疫抑制剂的使用。