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Am J Gastroenterol. 2003 Oct;98(10):2289-92

Hepatitis B vaccine nonresponse and celiac disease.

Noh KW, Poland GA, Murray JA.

Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA

There is a genetic predisposition to hepatitis B vaccine nonresponse. The
link between human leukocyte antigen (HLA) genotype and ineffective
development of immunity to the hepatitis B vaccine has been characterized
in multiple studies. Celiac disease has a strong association with a
particular HLA genotype of DQ2; interestingly, this HLA genotype is seen in
association with nonresponders to the hepatitis B vaccine. We report a
disproportionate number of patients with celiac disease who are
nonresponders to the hepatitis B vaccine series.We reviewed the hepatitis B
vaccine records, serological tests for anti-hepatitis B surface antigen
antibody (anti-HBs), and HLA genotypes of celiac disease patients
identified as nonresponders to hepatitis B vaccine. Subjects were
identified from a database of patients diagnosed with celiac disease at our
institution or referred to our center for evaluation and management of
celiac disease between November, 2000, and October, 2002.A total of 23
subjects were reviewed. All had a clinical and pathological diagnosis of
celiac disease. All subjects reported receiving the full series of
hepatitis B vaccinations. Of the subjects, 19 had testing for hepatitis B
vaccine response. Of these 19 subjects, 13 did not achieve long-term
immunity as seen by the negative qualitative or quantitative anti-HBs
antibody titer. All tested subjects were either homozygous or heterozygous
for DQ2.We postulate that celiac disease patients may have a significant
predisposition to hepatitis B vaccine nonresponse. Both celiac disease and
hepatitis B vaccine nonresponse is genetically mediated. Celiac disease
patients may have a failure of induction of humoral immune response needed
for development of long term immunity; the mechanism for this is unclear.

PMID: 14572581 [PubMed - in process]

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