Multiple HBV vaccines superior for seroconversion failure in patients with IBD

CHICAGO — Patients with inflammatory bowel disease who failed seroconversion following initial hepatitis B vaccine were more likely to achieve higher titer levels after three vaccine doses compared with those who received only one or two doses, according to a presentation at Digestive Disease Week.

The retrospective study comprised 149 patients seen in a large tertiary care facility between 2000 and 2014 who were diagnosed with either Crohn’s disease or ulcerative colitis and had inadequate baseline HBsAb titers following prior vaccination. Mean age was 46 years, 63% were older than 40 years, 54% were women, 78% were white, mean BMI was 28 kg/m² and approximately 73% had CD compared with patients who had UC.

Patients were included in the study if they had a history or presence of one or more positive HBsAb levels less than 10 IU/L and had follow-up HBsAb levels after revaccination.

In this study, 63 patients received one dose, 25 received two doses, 88 received one to two doses and 61 received three doses. At follow-up, mean titers were 122.8 IU/L for one to two doses and 263.8 IU/L for three doses. Further, 41.3% of patients with one dose, 40% of patients with two doses and 62.3% of patients with three doses achieved 10 or more HBsAb levels (P = .04).

Patients older than 40 years were less likely to respond to any additional vaccination compared with younger patients (41.3% vs. 63.6%; P < .01). Patients older than 40 years who received three doses had higher mean titers (P = .03) compared with all ages of patients who received one or two (P < .01). Additionally, patients who were exposed to immunosuppressive therapy within 6 months of their titer measurements were less likely to seroconvert after any additional vaccinations (P < .01).

“Our findings suggest that following initial hepatitis B vaccine failure, IBD patients of all ages are more likely to seroconvert to higher titer levels following three additional vaccine doses administered sequentially rather than just one or two,” Perry Pratt, MD, from the Boston Medical Center, Massachusetts, said in the presentation. “Of course, additional randomized studies are needed to further characterize these findings.” – by Talitha Bennett

References:

Pratt P, et al. Abstract 203. Presented at: Digestive Disease Week; May 6-9, 2017; Chicago.

Disclosure: Pratt reports no relevant financial disclosures.