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Respuesta inmunológica de niños celiacos a la vacuna frente a la hepatitis B / Immune response to hepatitis B vaccination in children with celiac disease

Acta Pediatr Esp; 75(7/8): e102-e108, jul.-ago. 2017. tab
Article in Spanish | IBECS | ID: ibc-165544

INTRODUCTION:

A poor response of patients with celiac disease to the hepatitis B virus (HBV) vaccine has been reported, but there is controversy about its cause: it is unknown whether it is due to the presence of specific human leukocyte antigen genotypes among these patients, or by gluten intake. The aim of this study is to determine the immune response to the HBV vaccine in children with celiac disease in relation to gluten intake.

PATIENTS AND METHODS:

Quasi-experimental study. Vaccination status against HBV was compared in two groups of children with celiac disease: the first one was made up of children who received a conventional vaccination schedule at 0-2-6 months of age, and the second one was made up of those who did not respond to this primary vaccination and were revaccinated during the study, while they were following a gluten-free diet. Fisher’s exact test was used to determine the bilateral significance in the analysis of differences in response rates between the two groups.

RESULTS:

Responsiveness to HBV vaccine was observed in 17 of the 43 (39.5%) children who received their primary vaccination in neonatal age. Twenty-four children were revaccinated as they were following a gluten-free diet and all (100%) responded properly, with a bilateral significance (p= 0.0000002) in Fisher’s exact test.

CONCLUSIONS:

Children with celiac disease have a lower response to HBV vaccine in neonatal age than when they are treated with a gluten-free diet. Our study suggests that the activity of the celiac disease, which is directly related to gluten intake, may be the main reason for this lack of response (AU)
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