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Abstract Details
Reduced immune responses to hepatitis B primary vaccination in obese individuals with nonalcoholic fatty liver disease (NAFLD)
NPJ Vaccines. 2021 Jan 11;6(1):9. doi: 10.1038/s41541-020-00266-4.
Shivali S Joshi1, Rachelle P Davis2, Mang M Ma3, Edward Tam4, Curtis L Cooper5, Alnoor Ramji6, Erin M Kelly5, Saumya Jayakumar17, Mark G Swain1, Craig N Jenne2, Carla S Coffin8
Author information
1Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
2Department of Microbiology, Immunology & Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
5Ottawa Hospital Research Institute, Ottawa, ON, Canada.
6Division of Gastroenterology, University of British Columbia, Vancouver, BC, Canada.
7University of British Columbia, Vancouver, BC, Canada.
8Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. cscoffin@ucalgary.ca.
Abstract
Obesity and cirrhosis are associated with poor hepatitis B virus (HBV) vaccine responses, but vaccine efficacy has not been assessed in nonalcoholic fatty liver disease (NAFLD). Sixty-eight HBV-naïve adults with NAFLD were enrolled through the Canadian HBV network and completed three-dose HBV or HBV/HAV vaccine (Engerix-B®, or Twinrix®, GlaxoSmithKline). Anti-HBs titers were measured at 1-3 months post third dose. In 31/68 subjects enrolled at the coordinating-site, T-cell proliferation and follicular T-helper cells (pTFH) were assessed using PBMC. Immune response was also studied in NAFLD mice. NAFLD patients were stratified as low-risk-obesity, BMI < 35 (N = 40) vs. medium-high-risk obesity, BMI > 35 (N = 28). Anti-HBs titers were lower in medium/high-risk obesity, 385 IU/L ± 79 vs. low-risk obesity class, 642 IU/L ± 68.2, p = 0.02. High-risk obesity cases, N = 14 showed lower vaccine-specific-CD3+ CD4+ T-cell response compared to low-risk obesity patients, N = 17, p = 0.02. Low vaccine responders showed dysfunctional pTFH. NAFLD mice showed lower anti-HBs levels and T-cell response vs. controls. In conclusion, we report here that obese individuals with NAFLD exhibit decreased HBV vaccine-specific immune responses.