The summaries are free for public
use. The Chronic Liver Disease
Foundation will continue to add and
archive summaries of articles deemed
relevant to CLDF by the Board of
Trustees and its Advisors.
Abstract Details
Maintaining Hepatitis B Protection in Immunocompromised Pediatric Rheumatology and Inflammatory Bowel Disease Patients
J Rheumatol. 2021 Aug;48(8):1314-1321. doi: 10.3899/jrheum.200283. Epub 2020 Aug 1.
Najla Aljaberi1, Enas Ghulam2, Emily A Smitherman3, Leslie Favier4, Dana M H Dykes5, Lara A Danziger-Isakov6, Rebecca C Brady6, Jennifer Huggins7
Author information
1N. Aljaberi, MBBS, MSc, J. Huggins, MD, Division of Pediatric Rheumatology, Cincinnati Children's Hospital Medical Center, Ohio, USA; najlaaljaberi@gmail.com.
2E. Ghulam, PhD, College of Sciences and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
3E.A. Smitherman, MD, MSc, Division of Pediatric Rheumatology, University of Alabama at Birmingham, Alabama, USA.
4L. Favier, MD, MSc, Department of Pediatric Rheumatology, Children's Mercy, Kansas City, Missouri, USA.
5D.M. Dykes, MD, Department of Pediatric Gastroenterology, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
6L.A. Danziger-Isakov, MD, MPH, R.C. Brady, MD, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Ohio, USA.
7N. Aljaberi, MBBS, MSc, J. Huggins, MD, Division of Pediatric Rheumatology, Cincinnati Children's Hospital Medical Center, Ohio, USA.
Abstract
Objective: Hepatitis B virus (HBV) infection remains a significant public health challenge, particularly for immunocompromised patients. Our aim was to evaluate the serologic immunity in immunocompromised rheumatology and inflammatory bowel disease (IBD) patients, assess factors for serologic nonimmunity, and evaluate their response to 1 HBV booster dose.
Methods: Immunocompromised rheumatology and IBD patients with completed HBV screening were identified. A chart review was performed to collect demographics, clinical information, baseline HBV serology results, and serologic response to booster vaccination. Serologic nonimmunity was defined as a negative/indeterminate hepatitis B surface antibody (anti-HBs) level.
Results: Among 580 patients, 71% were nonimmune. The highest portion of nonimmune patients were 11-18 years old (P = 0.004). There was no significant difference between immune and nonimmune patients with regards to diagnosis (P = 0.34), age at diagnosis (P = 0.64), duration of treatment (P = 0.07), or type of medications (P = 0.08). Sixty-two percent of those who received a booster vaccine were rescreened, and most (68%) seroconverted. In those 18 years or older, only half seroconverted.
Conclusion: Results of this study support the benefit of HBV screening in immunosuppressed patients. Beginning at age 11 years, most patients lacked serologic immunity to HBV. Seroconversion for most patients 11-18 years occurred after 1 booster vaccine. Thus, for immunocompromised patients without recent HBV serologic data, obtaining the HBV serology beginning at age 11 years might be considered. Those 18 years and older were least likely to seroconvert after 1 booster, indicating that they may benefit from receiving the 3-dose HBV vaccine series.