OBJECTIVES:: Patients with inflammatory bowel disease (IBD) often receive immunosuppressive therapy which may make them vulnerable to infections such as hepatitis B. We hypothesized that hepatitis B virus (HBV) titers are low in the vaccinated pediatric IBD population. The aims of our study were to identify the incidence of lower titers of hepatitis B surface antibody (HBsAb) and determine which patient factors may be associated with lower HBsAb titers. METHODS:: Patients with diagnosis of IBD, ages 5–18 years, were prospectively enrolled. Patients were confirmed to have had a full series of hepatitis B vaccination. Quantitative serum HBsAb titers were measured and logistic regression analysis with independent variables of age, gender, race, disease phenotype, surgery, medications and a dependent variable of adequate HBsAb titers (> 10?mIU/mL) was performed. RESULTS:: Of the 116 patients enrolled, 57 were male and 59 were female. 75 patients had a diagnosis of Crohnʼs disease; 32 had a diagnosis of ulcerative colitis; and 9 patients had been diagnosed with indeterminate colitis. At the time of the study, 15 patients were on corticosteroid, 66 on an immunomodulator, and 53 on a biologic. 60% of patients in the 5–10 year age group had protective titers vs 22–27% in the older groups, p?=?0.04. Only 28% of the 116 patients had HBsAb titers of more than 10mIU/ml. 20% of the patients on corticosteroids, 27% on immunomodulators and 24% on biologics were found to be seroimmune. CONCLUSION:: Nearly two-thirds of pediatric IBD patients have low titers against HBV. Titers were highest in the younger patients. No patient-specific variable, such as the use of immunosuppressants, appeared to influence these low titers.
|Original language||English (US)|
|Journal||Journal of Pediatric Gastroenterology and Nutrition|
|State||Accepted/In press - Mar 22 2017|
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health