title: The response to hepatitis B vaccine: does it differ in celiac disease?
abstract: OBJECTIVE
  There is a relationship between nonresponsiveness to hepatitis B virus (HBV) vaccine and certain human leukocyte antigen (HLA) genotypes. In healthy population, 4-10% vaccine recipients fail to produce protective levels of antibodies to the HBV vaccine after standard immunization depending upon age and the presence of various underlying diseases. Celiac disease (CD) is an HLA-associated immunological disease. It has been suggested that certain HLA haplotypes which are linked to CD are associated with nonresponse to HBV vaccine as well. The aim of this study is to assess the response to HBV vaccine prospectively in a group of CD and to explore the potential link between CD and HBV vaccine nonresponse by studying shared HLA haplotypes.
  
  
  METHODS
  Sixty-three previously diagnosed celiac patients who were on a strict gluten-free diet (GFD) and 54 healthy children were evaluated serologically for anti-HBs status. Celiac children who were anti-HBs negative at baseline were fully vaccinated prospectively, and reevaluated for the response to HBV vaccine. To estimate the role of HLA type in HBV vaccine response in celiac patients, a subgroup of both patients and control participants had HLA genotypes performed.
  
  
  RESULTS
  At enrollment, 27 (67.5%) children with CD and 48 (85.2%) healthy children were anti-HBs positive, and the difference between patients and controls was statistically significant (P<0.05). However, failure to respond to HBV vaccine was only 3.6% (response rate 96.4%) in prospectively vaccinated celiac patients. There was no relationship between HLA type and vaccine nonresponse in our study group.
  
  
  CONCLUSIONS
  The response to HBV vaccine in celiac children who were compliant to GFD is not different from a healthy population. CD may be one of the immune diseases associated with a high rate of HBV vaccine nonresponse but it might not be permanent and treatment with GFD and compliance to the treatment may ameliorate the immune response to HBV vaccine in celiac children.
authors: Division of Pediatric Gastroenterology, Hepatology and Nutrition, Marmara University Medical School, Istanbul, Turkey. denizertem@marmara.edu.tr
authors: Deniz
authors: D
authors: Ertem
authors: Ismail
authors: I
authors: Gonen
authors: Cansaran
authors: C
authors: Tanidir
authors: Meltem
authors: M
authors: Ugras
authors: Aysegul
authors: A
authors: Yildiz
authors: Ender
authors: E
authors: Pehlivanoğlu
authors: Emel
authors: E
authors: Eksioglu-Demiralp
mesh_terms: D000293:Adolescent; D002446:Celiac Disease / Q000178:diet therapy / Q000235:genetics / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D055050:Diet, Gluten-Free; D005260:Female; D006680:HLA Antigens / Q000235:genetics*; D006239:Haplotypes; D006509:Hepatitis B / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood / Q000276:immunology; D017325:Hepatitis B Vaccines / Q000276:immunology* / Q000627:therapeutic use; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D008297:Male; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D006680:HLA Antigens; D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines