The Incidence of Low Seroimmunity to Hepatitis B Virus in Children with Inflammatory Bowel Disease

Abhishek Watts, William E. Bennett, Jean Molleston, Sandeep Gupta, Joseph Croffie, Shamaila Waseem, Brian A. McFerron, Steven Steiner, Sanjay Kumar, Charles Vanderpool, Emily C. Hon, Molly A. Bozic, Girish Subbarao, Marian Pfefferkorn

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

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 languageEnglish (US)
JournalJournal of Pediatric Gastroenterology and Nutrition
DOIs
StateAccepted/In press - Mar 22 2017

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Inflammatory Bowel Diseases
Hepatitis B virus
Incidence
Hepatitis B Antibodies
Immunologic Factors
Immunosuppressive Agents
Hepatitis B
Adrenal Cortex Hormones
Pediatrics
Time and Motion Studies
Colitis
Biological Products
Viral Load
Ulcerative Colitis
Crohn Disease
Vaccination
Age Groups
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Gastroenterology

Cite this

The Incidence of Low Seroimmunity to Hepatitis B Virus in Children with Inflammatory Bowel Disease. / Watts, Abhishek; Bennett, William E.; Molleston, Jean; Gupta, Sandeep; Croffie, Joseph; Waseem, Shamaila; McFerron, Brian A.; Steiner, Steven; Kumar, Sanjay; Vanderpool, Charles; Hon, Emily C.; Bozic, Molly A.; Subbarao, Girish; Pfefferkorn, Marian.

In: Journal of Pediatric Gastroenterology and Nutrition, 22.03.2017.

Research output: Contribution to journalArticle

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abstract = "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.",
author = "Abhishek Watts and Bennett, {William E.} and Jean Molleston and Sandeep Gupta and Joseph Croffie and Shamaila Waseem and McFerron, {Brian A.} and Steven Steiner and Sanjay Kumar and Charles Vanderpool and Hon, {Emily C.} and Bozic, {Molly A.} and Girish Subbarao and Marian Pfefferkorn",
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T1 - The Incidence of Low Seroimmunity to Hepatitis B Virus in Children with Inflammatory Bowel Disease

AU - Watts, Abhishek

AU - Bennett, William E.

AU - Molleston, Jean

AU - Gupta, Sandeep

AU - Croffie, Joseph

AU - Waseem, Shamaila

AU - McFerron, Brian A.

AU - Steiner, Steven

AU - Kumar, Sanjay

AU - Vanderpool, Charles

AU - Hon, Emily C.

AU - Bozic, Molly A.

AU - Subbarao, Girish

AU - Pfefferkorn, Marian

PY - 2017/3/22

Y1 - 2017/3/22

N2 - 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.

AB - 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.

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DO - 10.1097/MPG.0000000000001580

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