title: Efficacy of hepatitis B vaccination and revaccination and factors impacting on response in patients with inflammatory bowel disease.
abstract: OBJECTIVE
  We assessed the effectiveness of hepatitis B virus (HBV) vaccine in inflammatory bowel disease (IBD) patients, evaluated the impact of immunosuppressors and anti-tumor necrosis factor (anti-TNF) agents, and assessed the effectiveness of revaccination.
  
  
  METHODS
  IBD patients were vaccinated against HBV with a quick (0, 1, and 2 months) and double-dose schedule (Engerix B). A second vaccination was administered to nonresponders.
  
  
  RESULTS
  Of 241 vaccinated patients, anti-HBs was >10 IU/l in 59% and >100 IU/l in 39%. The response rate (anti-HBs >10 IU/l) was lower among patients under anti-TNF therapy: 46% vs. 62%. In the multivariate analysis, a lower response rate was demonstrated in older patients and those receiving anti-TNFs. The response rate (anti-HBs >100 IU/l) after revaccination was 42%.
  
  
  CONCLUSIONS
  The response rate to the HBV vaccination--even with a double-dose schedule--is very low in IBD patients, mainly in those receiving anti-TNFs. However, treatment with immunosuppressors did not affect the efficacy of the vaccine. A considerable--albeit insufficient--success rate may be obtained when two consecutive vaccination courses, each with a three-dose vaccine series, are administered.
authors.affiliation: Department of Gastroenterology and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa, Madrid, Spain. gisbert@meditex.es
authors.forename: J P
authors.initials: JP
authors.lastname: Gisbert
authors.forename: J R
authors.initials: JR
authors.lastname: Villagrasa
authors.forename: A
authors.initials: A
authors.lastname: Rodríguez-Nogueiras
authors.forename: M
authors.initials: M
authors.lastname: Chaparro
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D004334:Drug Administration Schedule; D005260:Female; D006509:Hepatitis B / Q000276:immunology / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D006801:Humans; D007117:Immunization, Secondary; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D017211:Treatment Failure; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000276:immunology
chemical_list: D017325:Hepatitis B Vaccines; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha