title: Immune response to hepatitis B virus vaccine in celiac subjects at diagnosis.
abstract: OBJECTIVE
  To evaluate hepatitis B virus (HBV) vaccine response and correlation with human leukocyte antigens (HLA) and/or gluten intake in celiac patients at diagnosis.
  
  
  METHODS
  Fifty-one patients affected by celiac disease, diagnosed at the Department of Pediatrics of the University of Catania (Italy), were recruited. All patients were tested at admission for immunization against HBV, according to findings from analysis of quantitative HBV surface antibody (anti-HBs). The anti-HBs titer was measured by enzyme-linked immunosorbent assay. Following the international standards, subjects with antibody titer < 10 IU/L were defined as non-responders. The prevalence of responders and non-responders among celiac subjects and the distribution of immunization for age were examined. In addition, the prevalence of responders and non-responders was assessed for correlation to HLA and clinical features at diagnosis of celiac disease.
  
  
  RESULTS
  The entire study population was divided into three groups according to age: 24 patients aged between 0 to 5.5 years (48.9%, group A); 16 aged between 5.5 and 9.5 years (30.61%, group B); 9 aged between 9.5 and 17 years (18.75%, group C). Comparison of the percentage of responders and non-responders between the youngest and the oldest age group showed no significant difference between the two groups (P > 0.05). With regard to the HLA haplotype, comparison of the distribution of vaccination response showed no statistically significant difference between the different genotypes (homozygosity for the HLADQ2 haplotype compared with HLADQ2/DQ8 heterozygosity or other haplotypes; P > 0.05). Moreover, distribution of the responders according to clinical features of celiac disease showed no statistically significant differences (P > 0.05).
  
  
  CONCLUSIONS
  This prospective study confirmed the lower percentage of response to HBV vaccine in celiac subjects. However, the underlying mechanism remains unclear and further studies are needed.
authors.affiliation: Martina Filippelli, Maria Teresa Garozzo, Antonino Capizzi, Massimo Spina, Lucia Tardino, Salvatore Leonardi, Department of Medical and Pediatric Sciences, University of Catania, 95100 Catania, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Filippelli
authors.affiliation: Martina Filippelli, Maria Teresa Garozzo, Antonino Capizzi, Massimo Spina, Lucia Tardino, Salvatore Leonardi, Department of Medical and Pediatric Sciences, University of Catania, 95100 Catania, Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Garozzo
authors.affiliation: Martina Filippelli, Maria Teresa Garozzo, Antonino Capizzi, Massimo Spina, Lucia Tardino, Salvatore Leonardi, Department of Medical and Pediatric Sciences, University of Catania, 95100 Catania, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Capizzi
authors.affiliation: Martina Filippelli, Maria Teresa Garozzo, Antonino Capizzi, Massimo Spina, Lucia Tardino, Salvatore Leonardi, Department of Medical and Pediatric Sciences, University of Catania, 95100 Catania, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Spina
authors.affiliation: Martina Filippelli, Maria Teresa Garozzo, Antonino Capizzi, Massimo Spina, Lucia Tardino, Salvatore Leonardi, Department of Medical and Pediatric Sciences, University of Catania, 95100 Catania, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Manti
authors.affiliation: Martina Filippelli, Maria Teresa Garozzo, Antonino Capizzi, Massimo Spina, Lucia Tardino, Salvatore Leonardi, Department of Medical and Pediatric Sciences, University of Catania, 95100 Catania, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Tardino
authors.affiliation: Martina Filippelli, Maria Teresa Garozzo, Antonino Capizzi, Massimo Spina, Lucia Tardino, Salvatore Leonardi, Department of Medical and Pediatric Sciences, University of Catania, 95100 Catania, Italy.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Salpietro
authors.affiliation: Martina Filippelli, Maria Teresa Garozzo, Antonino Capizzi, Massimo Spina, Lucia Tardino, Salvatore Leonardi, Department of Medical and Pediatric Sciences, University of Catania, 95100 Catania, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Leonardi
keywords: Celiac disease; Gluten; Hepatitis B virus vaccination; Human leukocyte antigens; Poor response