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Response to Hepatitis A and B Vaccination in Pediatric Patients With Celiac Disease

Urganci, Nafiye*; Kalyoncu, Derya

Journal of Pediatric Gastroenterology & Nutrition: April 2013 - Volume 56 - Issue 4 - p 408–411
doi: 10.1097/MPG.0b013e31827af200
Original Articles: Gastroenterology

Objectives: The aim of the study was to evaluate the response to hepatitis A and B vaccinations in pediatric patients with celiac disease (CD).

Methods: Thirty patients with CD ages 1 to 15 years were compared with 50 healthy age-, sex-, and body mass index–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 (HAV) vaccine (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: Sixteen patients and 35 controls received hepatitis A vaccine; protective anti-HAV antibodies were developed in 12 (75%) of the patients and all of the controls (75% vs 100%, respectively; 95% confidence interval [CI] 0.47–0.92, P = 0.007). Thirty patients and 50 controls received hepatitis B vaccine, and 70% of the patients vs 90% of the controls achieved seroprotection (anti-HBs titers ≥10 mIU/mL) 1 month after primary vaccination (95% CI 0.74–0.90, P = 0.03). Four patients were unresponsive to both of the vaccines. The overall seroprotection rates were 96% in controls and 80% in patients after the whole hepatitis B vaccination series (95% CI 0.04–0.18, P = 0.04). No significant reduction was observed in antibody response among patients and controls during follow-up period.

Conclusions: The rate of seroconversion to the hepatitis B virus- and HAV vaccine is lower in patients with CD than in healthy controls.

*Division of Pediatric Gastroenterology

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

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

Received 26 July, 2012

Accepted 10 September, 2012

The authors report no conflicts of interest.

Copyright 2013 by ESPGHAN and NASPGHAN