Efficacy of hepatitis B vaccination and revaccination and factors impacting on response in patients with inflammatory bowel disease

Am J Gastroenterol. 2012 Oct;107(10):1460-6. doi: 10.1038/ajg.2012.79.


Objectives: We assessed the effectiveness of hepatitis B virus (HBV) vaccine in inflammatory bowel disease (IBD) patients, evaluated the impact of immunosuppressors and anti-tumor necrosis factor (anti-TNF) agents, and assessed the effectiveness of revaccination.

Methods: IBD patients were vaccinated against HBV with a quick (0, 1, and 2 months) and double-dose schedule (Engerix B). A second vaccination was administered to nonresponders.

Results: Of 241 vaccinated patients, anti-HBs was >10 IU/l in 59% and >100 IU/l in 39%. The response rate (anti-HBs >10 IU/l) was lower among patients under anti-TNF therapy: 46% vs. 62%. In the multivariate analysis, a lower response rate was demonstrated in older patients and those receiving anti-TNFs. The response rate (anti-HBs >100 IU/l) after revaccination was 42%.

Conclusions: The response rate to the HBV vaccination--even with a double-dose schedule--is very low in IBD patients, mainly in those receiving anti-TNFs. However, treatment with immunosuppressors did not affect the efficacy of the vaccine. A considerable--albeit insufficient--success rate may be obtained when two consecutive vaccination courses, each with a three-dose vaccine series, are administered.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Drug Administration Schedule
  • Female
  • Hepatitis B / immunology
  • Hepatitis B / prevention & control*
  • Hepatitis B Vaccines / administration & dosage*
  • Hepatitis B Vaccines / immunology*
  • Humans
  • Immunization, Secondary
  • Immunosuppressive Agents / administration & dosage*
  • Immunosuppressive Agents / adverse effects*
  • Inflammatory Bowel Diseases / drug therapy*
  • Inflammatory Bowel Diseases / immunology*
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Treatment Failure
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*
  • Tumor Necrosis Factor-alpha / immunology


  • Hepatitis B Vaccines
  • Immunosuppressive Agents
  • Tumor Necrosis Factor-alpha