Hepatitis B vaccine often fails the first time for those with celiac disease

If you have celiac disease, it is important for you to be aware that individuals with this disease have a very high rate of non-responsiveness to the hepatitis B vaccine. This means that even if you have received the vaccine, it may have failed to elicit protective levels of antibodies, in which case you may still be vulnerable to contracting the hepatitis B virus (HBV).

This link may have a genetic root: the most common genetic marker associated with unresponsiveness to the hepatitis B vaccine is human leukocyte antigen (HLA) phenotype DQ2, a marker that is also prevalent among those who have celiac disease. In a recent retrospective study, published in the medical journal, Vaccine,1 50% of celiac disease patients failed to respond after receiving a normal course of the hepatitis B vaccine, compared to 11.6% of the non-celiac control group. The study included 60 patients who had tested positive for celiac disease with both serological testing and biopsy analysis. They had also all received injections of the hepatitis B vaccine at ages 3, 5, and 11 months, as is standard practice. Those diagnosed with celiac disease at younger than 18 months of age were more likely to respond positively to the vaccine. Aside from celiac disease, there are other non-genetic factors associated with an increased risk of non-responsiveness to the hepatitis B vaccine, which include obesity, smoking, drug use, alcoholism, infections, immune-suppression, and age (children typically receive the vaccine before one year of age).

The study’s authors noted that previous research has not shown any similar correlation with other types of vaccines and, therefore, it seems unique to the hepatitis B vaccine. The researchers suggest a re-evaluation of the hepatitis B vaccination standards for celiac disease patients. If you are concerned about your hepatitis B vaccination status, talk to your physician. A quick blood test will reveal if the appropriate vaccine-induced antibodies are active in your body.

First published in the Inside Tract® newsletter issue 179 – 2011
Image Credit: © bigstockphoto.com/Creativa Images
1. Leonardi S et al. Hepatitis B vaccination failure in celiac disease: Is there a need to reassess current immunization strategies? Vaccine. 2009;27:6030-33.