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Low immunity to HBV common in pediatric IBD patients
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ORLANDO — Pediatric patients with inflammatory bowel disease who received a full series of hepatitis B virus infection vaccinations may develop lower immunity, according to a poster presented at the Advances in Inflammatory Bowel Disease annual conference.
Researchers, including Abhishek Watts, MD, division of pediatric gastroenterology, hepatology and nutrition, Indiana University School of Medicine, analyzed data of 116 pediatric patients with IBD from the Children and Hoosier Immunization Registry Program database or from records from their primary physicians at Riley Hospital for Children, Indiana. All the patients’ serum hepatitis B surface antigen (HBsAg) titers were measured.
“We hypothesized that serological hepatitis B virus titers may be low in the vaccinated pediatric IBD population, which might be due to a patient’s demographic/clinical factors or medications,” the researchers wrote.
Univariate regression analysis showed that among patients aged 5 to 10 years, 60% had sufficient HBV immunity compared with 20% of patients aged 11 to 15 years and 25% aged 16 to 18 years (P = .01). Male patients showed more immunity compared with females (35% vs. 20%; P = .18), and patients with indeterminate colitis showed more immunity compared with patients with ulcerative colitis or Crohn’s disease (35% vs. 25% vs. 30%; P = .85).
Logistic regression analysis showed multiple variables and medications altered the rate of impact on HBV immunity as follows: UC (OR = 0.85; 95% CI, 0.26-2.75); surgery (OR = 1.08; 95% CI, 0.09-12.7); male gender (OR = 1.97; 95% CI, 0.77-5.01); steroids (OR = 0.62; 95% CI, 0.12-3.11); among others.
“Approximately 70% of the pediatric IBD patients have low immunity to the HBV,” the researchers wrote. “No patient-specific variable, such as the use of immunosuppressants, appeared to influence these low titers. This raises the possibility that waning immunity is a feature of the autoimmune process itself.”
The researchers concluded: “Further age-matched prospective studies comparing healthy controls and children with IBD will need to delineate if IBD alone leads to the waning of protective titers independent of other factors.” – by Melinda Stevens
Reference: Watts A, et al. Abstract P-222. Presented at: Advances in Inflammatory Bowel Diseases; Dec. 10-12, 2015; Orlando, Fla.
Disclosures: Healio Gastroenterology was unable to confirm relevant financial disclosures at the time of publication.