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Immunogenecity of Hepatitis A and B Vaccination in Pediatric Patients With Inflammatory Bowel Disease

Urganci, Nafiye*; Kalyoncu, Derya

Journal of Pediatric Gastroenterology & Nutrition: April 2013 - Volume 56 - Issue 4 - p 412–415
doi: 10.1097/MPG.0b013e31827dd87d
Original Articles: Gastroenterology

Objectives: Aim of the study was to evaluate the response to hepatitis A and B vaccination in pediatric patients with inflammatory bowel disease (IBD).

Methods: A total of 47 patients with IBD (25 ulcerative colitis, 14 Crohn disease, and 8 indeterminate colitis) ages 3 to 17 years were compared with 50 healthy age- and sex-matched controls. Screening for hepatitis A and B serology was carried out before vaccination. Susceptible cases received 20 μg of recombinant DNA vaccine for hepatitis B (0, 1, and 6 months) and 720 milliELISA units of inactivated hepatitis A virus vaccine (HAV) (0 and 6 months). Postvaccination serologic evaluation was performed 1 month after the last dose of primary vaccination, 1 month after the booster dose, and once every year during follow-up.

Results: A total of 23 patients and 35 controls received HAV and protective anti-HAV antibodies were developed in all of the patients and controls (P = 1.00). Forty-seven patients and 50 controls received hepatitis B vaccine and 70.2% of the patients versus 90% of the controls achieved seroprotection (anti-HBs titers ≥10 mIU/mL) 1 month after primary vaccination (95% confidence interval 0.71–0.87, P = 0.02). The overall seroprotection rates were 96% in controls and 85.1% in patients after the whole hepatitis B vaccination series (95% confidence interval 0.83–0.95, P = 0.08). No significant reduction was observed in antibody response among patients and controls during the follow-up period.

Conclusions: The rate of seroconversion to the hepatitis B vaccine was lower in pediatric patients with IBD than in healthy controls and hepatitis A vaccine was highly immunogenic among patients with IBD.

*Division of Pediatric Gastroenterology

Department of Pediatrics, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.

Address correspondence and reprint requests to Derya Kalyoncu, Sisli Etfal Training and Research Hospital, 34270 Istanbul, Turkey (e-mail:

Received 30 September, 2012

Accepted 11 November, 2012

The authors report no conflicts of interest.

Copyright 2013 by ESPGHAN and NASPGHAN