炎症性肠病（IBD）患者感染乙型肝炎病毒（HBV）的风险增加，因此如果尚未感染或免疫，他们应该优先接种疫苗。我们评估了 IBD 患者接种 HBV 疫苗的效果以及不同因素对免疫反应的影响。我们还评估了无反应者中 2 种不同的重新接种策略的成功率。这是一项在 5 个三级中心进行的回顾性观察队列研究。所有患者均检测了乙型肝炎表面抗原、乙型肝炎表面抗原抗体（抗-HBs）和乙型肝炎核心抗原抗体。患者检测结果呈阴性，并在第 0、1 和 6 个月时接受了 20 µg 的标准治疗方案。无反应者（抗-HBs <10 IU/L）接受再接种方案，即在第 0、1 和 6 个月时接种 3 剂 40 µg，或在第 0、1 和 2 个月时接受 20 µg 加速接种方案。纳入了 409 名患者，其中 273 名患者（66.7%）（女性：49.5%；克罗恩病 [CD]：56.7%）对基线疫苗接种有反应。 273 例患者中，共有 189 例 (69.2%)（女性：48.1%；CD：60.3%）出现抗 HBs >100 IU/L。体重指数 <30 kg/m2 (P = .017) 呈正相关，而 CD 诊断 (P = .013)、广泛 UC (P <.0001)、肠外表现 (P = .001) 以及治疗免疫调节剂/抗肿瘤坏死因子 (P < .00) 对反应产生负面影响。 103名患者接受了重新接种，其中58.3%的患者抗-HBs达到>10 IU/L。两种重新接种策略同样有效。与普通人群相比，IBD 患者对 HBV 疫苗接种的反应较低。年龄、体重指数、类型、疾病活动度和免疫抑制会对反应产生负面影响。一半无反应者可能会受益于加强再接种尝试。© 作者 2024。由牛津大学出版社代表克罗恩病出版

Patients with inflammatory bowel disease (IBD) exhibit an increased risk for acquiring hepatitis B virus (HBV), thus they should be vaccinated preferably, if not already infected or immunized. We assessed the efficacy of HBV vaccination in IBD patients and impact of different factors on the immune response. We also evaluated the success rate of 2 different revaccination strategies in the nonresponders.This was a retrospective observational cohort study carried out in 5 tertiary centers. All patients were tested for hepatitis B surface antigen, antibodies against hepatitis B surface antigen (anti-HBs), and antibodies against hepatitis B core antigen. Patients tested negative and underwent the standard schedule with 20 µg at 0, 1, and 6 months. Nonresponders (anti-HBs <10 IU/L) were offered a revaccination scheme with either 3 doses of 40 µg at 0, 1, and 6 months or an accelerated scheme with 20 µg at 0, 1, and 2 months.A total of 409 patients were included, and 273 (66.7%) of those (females: 49.5%; Crohn's disease [CD]: 56.7%) responded to baseline vaccination. A total of 189 (69.2%) of 273 (females: 48.1%; CD: 60.3%) developed anti-HBs >100 IU/L. Body mass index <30 kg/m2 (P = .017) was positively associated, while diagnosis of CD (P = .013), extensive UC (P <.0001), extraintestinal manifestations (P = .001), and treatment with immunomodulators/anti-tumor necrosis factor (P < .00) negatively affected the response. Revaccination was offered to 103 patients, and 58.3% of them achieved anti-HBs >10 IU/L. Both revaccination strategies were equally effective.IBD patients demonstrate lower response to HBV vaccination compared with the general population. Age, body mass index, type, disease activity, and immunosuppression negatively affect the response. Half of nonresponders may benefit from an enhanced revaccination attempt.© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.