Meta-analysis: hepatitis B vaccination in inflammatory bowel disease
Corresponding Author
Anupam Kumar Singh
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Correspondence
Anupam Kumar Singh, Department of Gastroenterology, Nehru Hospital, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, India.
Email: [email protected]
Search for more papers by this authorAnuraag Jena
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Search for more papers by this authorGaurav Mahajan
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Search for more papers by this authorRitin Mohindra
Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Search for more papers by this authorVikas Suri
Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Search for more papers by this authorVishal Sharma
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Search for more papers by this authorCorresponding Author
Anupam Kumar Singh
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Correspondence
Anupam Kumar Singh, Department of Gastroenterology, Nehru Hospital, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, India.
Email: [email protected]
Search for more papers by this authorAnuraag Jena
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Search for more papers by this authorGaurav Mahajan
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Search for more papers by this authorRitin Mohindra
Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Search for more papers by this authorVikas Suri
Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Search for more papers by this authorVishal Sharma
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Search for more papers by this authorAs part of AP&T’s peer review process, a technical check of this meta-analysis was performed by Dr Y Yuan. The Handling Editor for this article was Dr Cynthia Seow, and it was accepted for publication after full peer-review.
Summary
Background
The response rate of hepatitis B virus (HBV) vaccination in patients with inflammatory bowel disease (IBD) is variable. Increasing dose or accelerated schedule is the suggested strategy to improve seroconversion.
Aim
We performed a meta-analysis to determine the pooled response rate of HBV vaccination and to identify the predictors of seroconversion.
Methods
We searched PubMed, Embase and Cochrane library databases. Studies reporting the response of HBV vaccination in IBD patients were included. Response was recorded as adequate immune response (AIR, >10 IU/L) and Effective immune response (EIR, >100 IU/L). Pooled AIR and EIR rates were calculated for different doses (10–20 μg or 40 μg) and schedules (standard: 0, 1 and 6 months or accelerated: 0, 1 and 2 months). Meta-analysis was performed to identify the predictors of response.
Results
Twenty-one studies including 2602 patients were eligible. Pooled AIR and EIR rates after HBV vaccination were 62% (95% CI, 55–68) and 42% (95% CI, 37–48), respectively. Pooled AIR and EIR rates for standard and double dose were similar. Pooled AIR and EIR rates were also comparable for different schedules of HBV vaccination. Gender, IBD subtype and disease activity did not affect the response rate. Use of immunosuppression [immunomodulators (RR: 0.73, 95% CI, 0.62–0.87) and anti-TNFs (RR: 0.72, 95% CI, 0.60–0.87)] was a predictor of poor immune response compared to no immunosuppressive therapy.
Conclusion
Patients with IBD have a poor serological response after HBV vaccination. HBV screening and vaccination should preferably be done before starting the immunosuppressive drugs.
CONFLICT OF INTEREST
None.
Open Research
DATA AVAILABILITY STATEMENT
No data are available.
Supporting Information
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|---|---|
| apt16880-sup-0001-DataS1.docxWord 2007 document , 4.8 MB |
Data S1 |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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