Jump to content
  • Sign Up
  • Join Our Community!

    Get help in our celiac / gluten-free forum.

  • Jefferson Adams
    Jefferson Adams

    How Reliable is Hepatitis B Vaccination in People with Celiac Disease?

    Reviewed and edited by a celiac disease expert.

    Celiac.com 02/10/2012 - The HBV vaccine is usually effective against common hepatitis B virus (HBV) infection, with just 4-10% of vaccine recipients failing to respond to standard immunization. Some studies suggest that people with celiac disease may have high levels of resistance to the HBV vaccine, compared to the general population.

    vaccine.jpgA team of researchers recently took a look at the issue of HBV vaccine reliability in people with celiac disease.

    The study team included Mohammad Rostami Nejad, Kamran Rostami, and Mohammad Reza Zali. They are variously affiliated with the Research Center for Gastroenterology and Liver Disease at Shahid Beheshti University of Medical Sciences in Tehran, Iran, and with Acute Medicine at Dudley Group of Hospital in Dudley, UK. Together, they reviewed data from previous studies.

    The ability to respond to recombinant HBV vaccine is associated with certain gene sites. At those sites, certain HLA haplotypes, such as B8, DR3, and DQ2 are common genetic markers among non-responders.

    Since HLA genotypes play an important role in unresponsiveness to the HBV vaccine, and since 90-95% of people with celiac disease have HLA-DQ2, celiac disease may be a factor in this failure to respond to the HBV vaccine.

    For one study, Ertekin et al., a research team gave HBV vaccinations, according to a standard immunization schedule, to 52 children with celiac disease, and another twenty matched for age and sex.

    The average age of the celiac disease patients was 10.7 ± 4 years (range, 4-18 years). Anti-HBs titers were positive in 32 (61.5%) patients and negative in 20 (38.5%) patients, while they were positive in 18 (90%) of the children in the control group (P < 0.05). The review team found statistically significant differences between negative anti-HBs titers, clinical presentation of celiac disease, and dietary compliance in patients with celiac disease (P < 0.05).

    In all, 32 of the 52 children with celiac disease responded favorably to HBV vaccination. This was a substantially lower percentage that the 18 of 20 control subjects responded (P < 0.05).

    Ertekin et al. concluded that a significantly higher percentage of children with celiac disease failed to respond to hepatitis B vaccination, as compared with the control group.

    They concluded that response to the HBV vaccine in children with celiac disease should be investigated, and a different immunization schedule should be developed for them. They suggested that celiac children who follow a gluten-free diet may have a better immune response to the HBV vaccine.

    The data fits with previous studies that confirm the findings that children with celiac disease fail to respond to the HBV vaccine at significantly higher rates than do healthy children.

    In fact, the researchers point out a similar study on adults, Noh et al., revealed that, of 23 adults with celiac disease who had completed a full course of HBV vaccination, 19 tested positive for HBsAb and 13 failed to acquire proper long-term immunity.

    Another study, by Stachowski et al., further cemented this connection between HLA and non-responsiveness to HBV vaccine. In that study, 34 out of 153 patients with end-stage renal disease failed to respond to HBV vaccine, and HLA-DQ2 was found almost exclusively in the non-responder group.

    Long stretches of time between vaccination and antibody testing might be one reason even celiac disease patients who follow a gluten-free diet have significantly reduced post-vaccination levels of HBV antibody. Therefore, current guidelines recommend revaccinating celiac patients once they have established a reliable gluten-free diet.

    This study was not designed to assess the presence of HLA-DQ2 and HLA-DQ8 in the groups. Therefore, future studies assessing HLA haplotypes in celiac disease should seek to describe the role of HLA typing in response to HBV vaccination.

    The evidence indicates that early diagnosis of celiac disease, and treatment with a gluten-free diet may increase the overall percentage of patients responding favorably to the HBV vaccine.

    Treatment of celiac disease with a strict, gluten-free diet seems to play a positive role in the development of antibody memory.

    The review team points out that the high prevalence of celiac disease in the general population and a lack of response to HBV vaccine in untreated patients, invites routine assessment in patients with celiac disease receiving the HBV vaccine.

    Lastly, the review team notes that non-responsiveness to HBV vaccine may indicate undiagnosed celiac disease or noncompliance with gluten-free diet.

    SOURCE:
    Hepat Mon. 2011 August 1; 11(8): 597–598.
    doi:  10.5812/kowsar.1735143X.761


    User Feedback

    Recommended Comments

    Thanks for the interesting note about this research. I'm curious if the researchers controlled for other factors that are known to diminish response to the Hep B vaccine such as obesity, smoking and age...

    Share this comment


    Link to comment
    Share on other sites

    Thanks for the interesting article and summary of trial outcomes.

     

    I have many symptoms of celiac such as anemia, vitamin deficiency, gastrointestinal issues, etc. However, when tested for celiac antibodies they came back negative. I wrote off celiac disease as a possible cause. At minimum this article pushes me in the direction that I should pay for genetic testing for celiac to confirm. Kind of expensive.

     

    I did not respond to hepatitis b vaccinations originally. I tested negative for hepatitis viruses as well.

     

    I took the first two series of shots for hepatitis B at a hospital I volunteered at.

     

    I took the first two series of shots at my new job 10-11 months later after first original shot. Started another new job, finished the third shot of the second series on time. Was tested and I did not respond after 5 injections.

     

    Started the hepatitis B and hepatitis A 2 series shot, I responded. Doctor said people usually have a higher titer but at least I met the minimum titer amount for immunity especially since I work in the healthcare field. He said I may need a booster over time and or that is just how my immunity cells respond.

     

    Thanks again.

    Share this comment


    Link to comment
    Share on other sites


    Join the conversation

    You are posting as a guest. If you have an account, sign in now to post with your account.
    Note: Your post will require moderator approval before it will be visible.

    Guest
    Add a comment...

    ×   Pasted as rich text.   Paste as plain text instead

      Only 75 emoji are allowed.

    ×   Your link has been automatically embedded.   Display as a link instead

    ×   Your previous content has been restored.   Clear editor

    ×   You cannot paste images directly. Upload or insert images from URL.


  • About Me

    Jefferson Adams is Celiac.com's senior 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 science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. 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.

  • Related Articles

    Scott Adams
    Troncone R, Greco L, Mayer M, Mazzarella G, et. al.
    Gastroenterology, 1996; 111: 318-324
    The final paragraph says:
    In conclusion, our data show that approximately half of the siblings of patients with celiac disease show signs of sensitization to gluten as they mount an inflammatory local response to rectal gluten challenge. The genetic background and the clinical...

    Jefferson Adams
    Celiac.com 06/26/2007 - In a study published recently in the Scandinavian Journal of Gastroenterology, researchers found that celiac patients commonly have high rates of anti-Saccharomyces cerevisiae antibodies (ASCA). A team of researchers recently set out to assess the frequency anti-Saccharomyces cerevisiae antibodies (ASCA) in patients with celiac disease.
    The team...

    Jefferson Adams
    Celiac.com 06/30/2008 - The results of a Hungarian study published recently in the June issue of Pediatrics suggest that people with untreated celiac disease show abnormal resistance to the hepatitis B (HBV) vaccine, while celiac patients on a gluten-free diet show a near normal response to the vaccine.
    A team of doctors led by Dr. Eva Nemes, at the University of Debrecen, administered...

    Jefferson Adams
    A team of researchers recently took a look at how well the hepatitis B vaccine protected people with celiac disease over time. Specifically, they evaluated what is called long-term antibody persistence and immune memory to hepatitis B virus in adult celiac patients vaccinated as adolescents.
    The research team included F. Zingone, F. Morisco, A. Zanetti, L. Romanò, G. Portella,...

  • Forum Discussions

    I cannot expound on the factual information listed in previous posts. I can, however, encourage you to follow your instincts as the mom, but also caution you with the statement that it takes a lot of time to heal. My 12 year old daughter has...
    Sounds yummy.  I am trying a new recipe -  https://www.health.com/recipes/veggie-enchiladas-with-creamy-poblano-sauce  
    So first, nobody here has called you ignorant. Second, "What the animal, eats you eat" isn't correct, especially if you are implying that gluten fed animals mean that their meat would not be gluten-free. There is no research to back this up...
×
×
  • Create New...