Failure to respond to hepatitis B vaccine in children with celiac disease.
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.
Park
Seung-Dae
SD
Division of Pediatric Gastroenterology and Nutrition, North Shore-Long Island Jewish Health System, New Hyde Park, NY, USA. arai-k@ncchd.go.jp
Markowitz
James
J
Pettei
Michael
M
Weinstein
Toba
T
Sison
Cristina P
CP
Swiss
Steven R
SR
Levine
Jeremiah
J
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
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