Common IBD Treatment May Affect Response to Hepatitis B Vaccine

HealthDay News — For patients with inflammatory bowel disease (IBD), infliximab and/or azathioprine treatment is associated with poor response rate to hepatitis B virus (HBV) vaccination, according to a study published in the Journal of Gastroenterology and Hepatology.

Patrícia Andrade, MD, from the Hospital de São João in Porto, Portugal, and colleagues examined the response rate to HBV vaccination in a cohort of patients with IBD treated with infliximab and/or azathioprine. The authors measured anti-HB titers; vaccination was considered efficient when titers were higher than 10 IU/L.

The researchers found that 79% of the 217 patients with IBD receiving infliximab who were vaccinated for hepatitis B had Crohn’s disease and the rest had ulcerative colitis. In 76% of patients, HBV vaccination was considered successful. Of 14 patients vaccinated after infliximab initiation, only two had antibody levels above 10 IU/L. 

Of those who received vaccination before infliximab initiation, antibody development occurred in 88% of those who were vaccinated before azathioprine initiation, compared with 55% among those who were vaccinated while receiving azathioprine. The only factors associated with weaker response to HBV vaccination were treatment with infliximab (adjusted odds ratio, 17.642) and treatment with azathioprine (adjusted odds ratio, 3.344).

“The response rate to the standard HBV vaccination in IBD patients is low mainly in those treated with infliximab and/or azathioprine,” the authors write.


1. Andrade P, Santos-Antunes J, Rodrigues S, et al. Treatment with infliximab or azathioprine negatively impact the efficacy of hepatitis B vaccine in inflammatory bowel disease patients. J Gastroen Hepatol. 2015; 30(11):1591-1595.