Hepatitis B vaccination failure in celiac disease: is there a need to reassess current immunization strategies?
Human leukocyte antigen (HLA) phenotype DQ2 is considered the most important genetic marker for un-responsiveness to hepatitis B vaccine. Since celiac disease (CD) is also strongly associated with the same haplo-type it may be hypothesized that celiac patients are less able to respond to the vaccine. We report a retrospective study on celiac patients vaccinated with three doses of 10 microg at 3, 5 and 11 months of age by an intramuscular injection of a recombinant hepatitis B vaccine (Engerix B). We found 30 of 60 celiac patients (50%) unresponsive to vaccination and a significant higher number of responders among patients younger than 18 months at the time of celiac disease diagnosis. Our study confirms that celiac patients have a lower percentage of response to hepatitis B vaccination than healthy subjects. These findings provide useful information to evaluate if current vaccine strategies should be reassessed and if revaccination should be recommended.
Leonardi
S
S
Broncho-Pneumology & Cystic Fibrosis Unit, Department of Pediatrics, University of Catania, Catania, Italy. leonardi@unict.it
Spina
M
M
Spicuzza
L
L
Rotolo
N
N
La Rosa
M
M
D002446:Celiac Disease / Q000097:blood / Q000235:genetics / Q000276:immunology*; D005260:Female; D006683:HLA-DQ Antigens / Q000235:genetics; D006508:Hepatitis Antibodies / Q000097:blood*; D017325:Hepatitis B Vaccines / Q000276:immunology*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D014611:Vaccination; D014614:Vaccines, Synthetic / Q000276:immunology
C075654:Engerix-B; D006683:HLA-DQ Antigens; C053186:HLA-DQ2 antigen; D006508:Hepatitis Antibodies; D017325:Hepatitis B Vaccines; D014614:Vaccines, Synthetic