Factors for hepatitis B vaccination and abnormal liver function in Chinese patients with inflammatory bowel disease: a single center experience

J Dig Dis. 2013 Nov;14(11):596-603. doi: 10.1111/1751-2980.12089.

Abstract

Objectives: We aimed to determine the prevalence of chronic and past hepatitis B virus (HBV) infection in Chinese patients with inflammatory bowel disease (IBD), and to determine the risk factors associated with having received no vaccination for HBV and abnormal liver function among our patients.

Methods: The prevalence of chronic or past infection with HBV infection and effective HBV vaccination were determined in patients with IBD who attended the IBD Clinic of the Queen Mary Hospital in Hong Kong, China. Risk factors associated with the absence of HBV vaccination and abnormal liver function were identified.

Results: A total of 267 Chinese IBD patients (166 ulcerative colitis and 101 Crohn's disease) were enrolled. The mean follow-up period was 10.5 years. Chronic and past HBV infection was detected in 6.7% and 28.5% patients, respectively. Altogether 102 patients lacked effective HBV vaccination. Multivariate analysis found that elder age at diagnosis of IBD (OR 1.02, 95% CI 1.00-0.94) and the absence of using thiopurine (OR 0.53, 95% CI 0.29-0.94) were associated with the presence of anti-HBs. Abnormal liver function was detected in 27 (10.1%) patients. The use of anti-tumor necrosis factor agents (OR 4.6, 95% CI 1.3-16.0), previous bowel resection (OR 3.7, 95% CI 1.5-9.2) and male gender (OR 4.4, 95% CI 1.4-13.7) were significant risk factors for abnormal liver function.

Conclusions: The use of thiopurine and younger age at diagnosis were associated with no vaccination against HBV in Chinese IBD patients. Chronic or past HBV infection was, however, not associated with abnormal liver function in these patients.

Keywords: Chinese; hepatitis B; thiopurine; vaccine.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Alanine Transaminase / blood
  • Female
  • Follow-Up Studies
  • Hepatitis B Antibodies / blood
  • Hepatitis B Surface Antigens / blood
  • Hepatitis B Vaccines / administration & dosage*
  • Hepatitis B, Chronic / complications*
  • Hepatitis B, Chronic / physiopathology
  • Hepatitis B, Chronic / prevention & control
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Inflammatory Bowel Diseases / complications*
  • Inflammatory Bowel Diseases / drug therapy
  • Inflammatory Bowel Diseases / physiopathology
  • Liver / physiopathology*
  • Male
  • Mercaptopurine / analogs & derivatives
  • Mercaptopurine / therapeutic use
  • Middle Aged
  • Risk Factors
  • Vaccination / statistics & numerical data

Substances

  • Hepatitis B Antibodies
  • Hepatitis B Surface Antigens
  • Hepatitis B Vaccines
  • Immunosuppressive Agents
  • azathiopurine
  • Mercaptopurine
  • Alanine Transaminase