According to the results of a recent study, an aggressive revaccination strategy involving 3 additional hepatitis B (HBV) vaccine doses is recommended for inflammatory bowel disease (IBD) patients with initial HBV vaccination failure.  

In order to determine the effectiveness of revaccination strategies after initial HBV vaccination failure, this retrospective cohort study analyzed the relationship between hepatitis B surface antibody (HBsAb) seroconversion and administration of additional vaccine doses. “Inclusion criteria are as follows: age ≥18, diagnosis of Crohn disease (CD) or ulcerative colitis (UC), inadequate HBsAb <10 IU/L following initial HBV vaccination series, subsequent administration of 1–3 additional doses of HBV vaccine with follow-up serum HBsAb measurements,” the study authors stated.

The primary outcome of the study was attaining HBsAB >10 IU/L. Patients were stratified by the number of doses received ( ≤2 or 3) and outcomes were stratified by age (≥40 years old or < 40 years old). A total of 149 patients were included in the study.

Baseline characteristics were reported as: 54.4% female, 77.9% white, 72.6% with Crohn disease, and mean age of 46.2. The study authors reported that, according to their analysis, there was both a positive as well as statistically significant relationship between subsequent HBsAb seroconversion and the number of revaccination doses a patient received. “Patients of all ages and age ≥40 years, who received 3 additional doses of vaccine, were more likely to achieve seroprotective HBsAb levels than patients who received 1 or 2 doses (OR 1.77, P=.01; OR 1.9, P=.03, respectively, after adjusting for age, sex, race, immunosuppressive medication exposure, time between vaccine/titer),” the study authors reported. Results showed that 62.9% of patients  responded to the 3-dose series vs 40.2% of patients who received 1 or 2 doses.

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Based on the findings of this study, the authors concluded that for patients with IBD with initial HBV vaccination failure, an aggressive revaccination strategy including 3 additional HBV vaccine doses should be recommended in order to develop seroprotective levels of HBsAb.

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