P782 Immune status to viral infectious diseases and associated factors in Korean patients with inflammatory bowel diseases
H.S. Hong1, J. Jung2, S.H. Park3, S.M. Noh4, E.H. Oh4, J.Y. Kim4, J. Kim4, S.W. Hwang3, D.H. Yang4, J.S. Byeon4, S.J. Myung4, S.K. Yang3, B.D. Ye3
1Asan Medical Centre, Department of Internal Medicine, Seoul, Republic of Korea, 2Asan Medical Centre, Department of Infectious Diseases, Seoul, Republic of Korea, 3Asan Medical Centre, Department of Gastroenterology- Inflammatory Bowel Disease Centre, Seoul, Republic of Korea, 4Asan Medical Centre, Department of Gastroenterology, Seoul, Republic of Korea
Background
Data on the protective immune status against measles, mumps, rubella, varicella zoster virus (VZV), hepatitis A virus (HAV) and Epstein–Barr virus (EBV) infection among inflammatory bowel disease (IBD) patients is still lacking. Therefore, we investigated seropositivity to viral infectious diseases and associated factors in Korean IBD patients.
Methods
In this retrospective cohort study, serum immunoglobulin G (IgG) antibody positivity against measles virus, mumps virus, rubella virus, VZV, HAV and EBV viral capsid antigen (VCA) were measured in consecutive patients with Crohn’s disease (CD) or ulcerative colitis (UC) who first visited the IBD clinic of Asan Medical Centre, Seoul, Korea. Seropositivities and their associated factors were analysed.
Results
Of 263 study subjects, one hundred sixty seven (67.3%) were males. Median age at diagnosis of IBD and median age at serologic tests were 28 years (interquartile range [IQR], 20–41) and 30 years (IQR, 22–46), respectively. UC patients were 50.9% (n = 134) and median disease duration at serologic tests were 6 months (IQR, 0–59). One hundred eighty two patients (69.2%) were not under any immunosuppressive therapy. Seropositivity rates were 84.0% for measles, 85.2% for mumps and 66.5% for rubella. IgG anti-VZV positivity rates were 87.4%, but only half (50.0%) were positive for IgG anti-HAV. IgG against EBV VCA was positive in 93.6%. Younger age at IBD diagnosis (<40 years) was independently associated with non-protection status against measles (odds ratio [OR], 8.76; 95% confidence interval [CI], 2.06–37.30). Younger age (<40 years) at serologic test was independently associated with non-protection status against rubella (OR, 2.08; 95% CI, 1.16–3.73) and HAV (OR, 9.07; 95% CI, 4.51–18.24). Among 182 patients who were not under any immunosuppressive therapy, seropositivity rates were 83.0% for measles, 85.2% for mumps, 67.6% for rubella, 88.9% for VZV, 52.5% for HAV and 92.0% for EBV VCA, respectively. Younger age at IBD diagnosis (<40 years) was independently associated with non-protection status against measles (OR, 14.41; 95% CI, 1.91–108.78) and HAV (OR, 14.52; 95% CI, 4.85–43.49). IBD type, UC was independently associated with seroprotection status against HAV (OR, 2.55; 95% CI, 1.28–5.09) among patients who were not under immunosuppressive therapy.
Conclusion
Seroprotection rates for common vaccine-preventable diseases and EBV among Korean IBD patients with or without immunosuppressive therapy were similar to those of the general Korean population. In the young age group under 40 years old, immunity to measles, rubella and HAV is needed to be checked together with proper vaccination as needed.