Results of hepatitis B vaccination in sarcoidosis.
BACKGROUND
Sarcoidosis is known to be associated with defects in cellular immunity, especially in reference to T helper lymphocytes. Anergy to a tuberculin skin test is most characteristic of this disease.


OBJECTIVE
To further the data on impaired immunity, we studied the antibody response to hepatitis B vaccination in patients with sarcoidosis.


METHODS
Serologic markers of hepatitis B virus (HBV) (HBsAg, anti-HBs, anti-HBc) were studied in 40 patients with sarcoidosis (32 female, 8 male; mean age: 45 +/- 11 years, range: 25-66 years) with a mean duration of disease of 6 years. While all the markers were negative in 22 patients (55%), 2 had isolated anti-HBc positivity and 16 had both anti-HBc and anti-HBs antibodies. Thirty-five age- and sex-matched healthy subjects were studied as controls. Recombinant HBV vaccines (Genhevac B Pasteur, 20 microg) were administered (at 0, 1, and 6 months) to 16 of the seronegative cases and the controls and antibody titres were measured 1 month after the last dose. The tuberculin skin test was negative in all cases.


RESULTS
While none of the vaccinees in the diseased group responded, the control group yielded an antibody response rate of 85. 7% (30/35), with a mean titre of 257.9 mIU/ml.


CONCLUSIONS
Patients with sarcoidosis were invariably unresponsive to standard vaccination, while some of the diseased subjects had already mounted a natural antibody response, either before or after the development of the original disease. Cellular immunodeficiency in sarcoidosis could be a suitable model for studying immunological interactions between HBV and the host.
Mert
A
A
Department of Infectious Diseases, Cerrahpasa Medical Faculty, University of Istanbul, Istanbul, Turkey.
Bilir
M
M
Ozaras
R
R
Tabak
F
F
Karayel
T
T
Senturk
H
H
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006510:Hepatitis B Antibodies / Q000097:blood*; D017325:Hepatitis B Vaccines / Q000276:immunology*; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D012507:Sarcoidosis / Q000276:immunology*; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology*
D015415:Biomarkers; D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines