P465 Inadequate immunisation against viral hepatitis B and no detected cases of hepatits C infection among patients with Inflammatory Bowel Disease
K. Waszczuk*1, E. Waszczuk2, A. Mulak2, L. Szenborn1, L. Paradowski2
1Wroclaw Medical University, Department of Pediatrics and Infectious Diseases, Wroclaw, Poland, 2Wroclaw Medical University, Department of Gastroenterology and Hepatology, Wroclaw, Poland
Hepatitis B (HBV) vaccination, screening for HBV vaccine-induced seroprotection and screening for hepatitis C (HCV) infection are recommended in patients with inflammatory bowel disease (IBD).
The aim of the study was to assess the immune status for HBV and HCV in Polish IBD patients. We examined 98 patients aged 18-91 yrs (mean 38 years; 55 men) with IBD hospitalised in the Department of Gastroenterology and Hepatology from November 2013 to March 2014. We did not included in the study patients with previously documented HBV or HCV infection. There were 61 patients with colitis ulcerosa (62%) and 37 (38%) with Crohn's disease; mean IBD duration was 8 years. In all patients antiHBsAb, antiHBcAb, HBsAg, and antiHCVAb were determined. Additionally, patients completed a questionnaire comprised of demographic data, IBD medical history and HBV vaccination history. The level of antiHBsAb ≥ 10 IU/l was considered as immunity to HBV infection. Patients with positive antiHBcAb or HBsAg were considered as HBV infected. Patients with positive antiHCVAb were considered as HCV infected (current or past infection). The chi-square test was used for cross-classification tables.
Among 54 IBD patients who reported previous HBV vaccination, we detected 6 new cases of HBV infection. Overall, we found HBV infection in 13 patients. Forty three subjects (44%) had antiHBsAb level lower than 10 IU/l. In the subgroup of 48 vaccinated and non-infected patients 43 (90%) had the recommended level of anti-HBsAb ≥ 10 IU/l and only 21 (44%) reached a cut-off level of 100 IU/l. There were no differences in the uptake of hepatitis B vaccine with regards to differing educational levels (p=0.44) and place of residency (p=0.68). We did not detect any positive antiHCV antybodies result.
HBV vaccine uptake is moderate despite the recommendations. All patients with IBD, even if previously HBV vaccinated, should be tested for antiHBsAb and in the case of non-response to vaccination, markers of HBV infection should be checked. Patients with IBD may need booster doses in order to maintain antiHBsAb levels ≥10 IU/l. Gastroenterologists should be more involved in HBV vaccine promotion to improve hepatitis B immunisation coverage.