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  • Jefferson Adams
    Jefferson Adams

    Does Gluten Intake at the Time of Hepatitis B Vaccination Influence the Immune Response of Celiac Disease Patients?

    Reviewed and edited by a celiac disease expert.

    Celiac.com 06/07/2013 - A number of studies have indicated that people with celiac disease have an inadequate response to hepatitis B vaccination. In an effort to better understand the issue, a team of researchers recently set out to assess hepatitis B vaccination response in relation to gluten exposure status in patients with celiac disease.

    Photo: CC--alegryaThe research team included F. Zingone, P. Capone, R. Tortora, A. Rispo, F. Morisco, N. Caporaso, N. Imperatore, G. De Stefano, P. Iovino, and C. Ciacci. They are affiliated with the Department of Medicine and Surgery at the University of Salerno in Salerno, Italy.


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    To measure the gluten exposure status at the time of vaccination, they compare three groups of patients, along with a control group. In all, the study included 163 celiac patients.

    • Group A contained 57 patients exposed to gluten, including patients vaccinated as 12-year-old adolescents, for whom celiac disease diagnosis was established after vaccination.
    • Group B contained 46 patients not exposed to gluten, including patients vaccinated as 12-year-old adolescents and on a gluten-free diet at the time of vaccination.
    • Group C was composed of 60 infants, including those vaccinated at birth.
    • Group D included 48 healthy, vaccinated, non-celiac subjects.

    The researchers then compared the response of celiac patients to hepatitis B vaccination with the response by healthy subjects. They found that 43.9% of patients in group A, 34.8% of patients in group B, 58.3% of patients in group C, and 8.3% of patients in group D showed inadequate response to hepatitis B immunization.

    Overall, group A versus group D, P less than 0.001; group B versus group D, P = 0.002; group C versus group D, P = 0.001, while they found no significant difference for group A versus group B and group A versus group C.

    This study suggests that gluten exposure does not influence the response to hepatitis B immunization, and that the human leukocyte antigen likely plays the main immunological role in poor responses to hepatitis B-vaccinated celiac patients.

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    58.3% of infants had an inadequate response to the hepatitis B vaccination, and yet it is standard protocol to give the hepatitis B shot at birth. This ineffectiveness is one more reason it's madness to give the shot to infants.

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    58.3% of infants had an inadequate response to the hepatitis B vaccination, and yet it is standard protocol to give the hepatitis B shot at birth. This ineffectiveness is one more reason it's madness to give the shot to infants.

    I disagree. Over 40% of these infants had an adequate response and therefore would be protected if exposed to hepatitis B prior to future vaccinations. As always, it is important to assess risk vs. benefit when deciding about any vaccine for any individual, but the fact that only part of the population responded is not necessarily a reason to avoid/delay vaccination. If there is risk of exposure to hepatitis B, then it is likely better to protect some infants versus protecting none.

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  • About Me

    Jefferson Adams is Celiac.com's senior staff writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, science, and advanced research, and scientific methods. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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