Celiacs Have Sufficient Levels of Hepatitis B Vaccine Immunity and No Greater Risk of Infection

Celiac.com 04/28/2022 - Some studies have indicated that celiac disease patients may not fully respond to hepatitis B virus (HBV) vaccination, and may therefore be at greater risk of developing HBV infection. However, the data are far from conclusive. Also, there's not been much study on the risk of HBV infection in celiac disease patients.

To get a clearer picture of the issue, a team of researchers recently set out to assess the response to hepatitis B virus (HBV) vaccination and the risk of HBV infection in celiac disease patients.

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The research team included Nawras Habash; Rok Seon Choung; Robert M Jacobson; Joseph A. Murray; and Imad Absah. They are variously affiliated with the Division of Pediatric Gastroenterology and Hepatology; the Division of Community Pediatric and Adolescent Medicine, Division of Pediatric Infectious Diseases; the Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.

For their cross-sectional study, the team used data from the National Health and Nutrition Examination Survey (NHANES) database, from 2009–2014, to assess the rate of HBV vaccination, immune response, and HBV infection risk in patients with and without celiac disease. 

The team calculated the rate of HBV infection via retrospective analysis of two groups of patients. The first visited the Mayo Clinic from 1998–2021, while the second was a stable longitudinally observed cohort, the Rochester Epidemiology Project (REP), from 2010–2020.

Based on the NHANES data, the rate of HBV infection in the United States was 0.33%. Of 93 patients with celiac disease, 46 (49%) were vaccinated for HBV and of the remaining 19,422 without celiac disease, 10,228 (53%) were vaccinated. 

Twenty-two (48%) vaccinated patients with celiac disease had HBV immunity, while 4,405 (43.07%) of vaccinated patients without celiac disease had HBV immunity, which was not significantly different. 

NHANES data showed no cases of HBV infection in celiac patients. 

During the study period, the team found just over 3,500 patients with celiac disease who were seen at Mayo Clinic, and nearly four thousand patients with celiac disease in the REP database. Of those patients with celiac disease, only four (0.11%) at Mayo Clinic and nine (0.23%) of the REP patients had HBV infection.

These data show that the rate of HBV vaccination and immunity was similar for individuals with and without celiac disease. Overall, they showed no greater risk of HBV infection for celiac disease patients. 

Based on these results, HBV screening and HBV revaccination to increase immunity is not required for people with celiac disease.

Read more in the Journal of Pediatric Gastroenterology and Nutrition: March 2022 - Volume 74 - Issue 3 - p 328-332