title: Failure to respond to hepatitis B vaccine in children with celiac disease.
abstract: OBJECTIVE
  To determine whether children with celiac disease (CD) fail to show a response to hepatitis B virus (HBV) vaccine more frequently than children without CD.
  
  
  METHODS
  This was a prospective study that compared the response to HBV, tetanus, rubella, and Haemophilus influenzae type b (Hib) vaccines between children with CD and age- and sex-matched control subjects.
  
  
  RESULTS
  The study population included 26 patients with CD and 18 age- and sex-matched controls. All had received the full complement of childhood vaccinations. A significantly higher proportion of subjects in the CD group (14 of 26) failed to respond to HBV vaccine compared with controls (2 of 18; 53.9% vs 11.1%; P < 0.05). Patients with CD were 8.33 times more likely to test negative for hepatitis B surface antigen than control subjects (95% CI, 1.5-46.5). By contrast, all of the subjects in both groups tested positive for rubella antibodies; only 1 subject in the CD group tested negative for tetanus antibody versus none in the control group (3.9% vs 0%; P = 1.0). The percentage of subjects who tested negative for Hib antibodies was similar in the 2 groups (CD, 33.3%; control, 44.4%; P = 0.53).
  
  
  CONCLUSIONS
  More than 50% of children with CD do not show a response to standard vaccination regimens for HBV. Given the large number of children with CD throughout the world, this observation suggests that there is a large HBV-susceptible population despite widespread vaccination. Current immunization strategies may need to be reassessed to protect this population and achieve the goal of universal protection.
authors.affiliation: Division of Pediatric Gastroenterology and Nutrition, North Shore-Long Island Jewish Health System, New Hyde Park, NY, USA. arai-k@ncchd.go.jp
authors.forename: Seung-Dae
authors.initials: SD
authors.lastname: Park
authors.forename: James
authors.initials: J
authors.lastname: Markowitz
authors.forename: Michael
authors.initials: M
authors.lastname: Pettei
authors.forename: Toba
authors.initials: T
authors.lastname: Weinstein
authors.forename: Cristina P
authors.initials: CP
authors.lastname: Sison
authors.forename: Steven R
authors.initials: SR
authors.lastname: Swiss
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Levine
mesh_terms: D000293:Adolescent; D016667:Bacterial Capsules; D002446:Celiac Disease / Q000097:blood / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D018073:Haemophilus Vaccines; D006514:Hepatitis B Surface Antigens / Q000097:blood* / Q000276:immunology; D017325:Hepatitis B Vaccines / Q000276:immunology*; D006801:Humans; D008297:Male; D011135:Polysaccharides, Bacterial; D011446:Prospective Studies; D012411:Rubella Vaccine / Q000276:immunology; D013744:Tetanus Toxin / Q000276:immunology
chemical_list: D018073:Haemophilus Vaccines; C044237:Haemophilus influenzae type b polysaccharide vaccine; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D011135:Polysaccharides, Bacterial; D012411:Rubella Vaccine; D013744:Tetanus Toxin