Hepatitis B vaccination effective in children exposed to anti-TNF alpha in utero.
J Crohns Colitis. 2018 May 03;:
Authors: de Lima A, Kanis SL, Escher JC, van der Woude CJ
INTRODUCTION: Neonates exposed to TNF alpha inhibitors in utero are born with detectable drug levels which can still be detected throughout the first year of life. Since 2011, the hepatitis B virus (HBV) vaccine is routinely administered to all newborns in the Netherlands. Adults treated with anti-TNF have been reported to respond inadequately to the HBV vaccine. The aim of this study was to compare anti-HBs levels in anti-TNF exposed children with non- exposed children following routine Dutch HBV vaccination.
METHODS: We performed a cross-sectional, controlled cohort study from 2014-2017 in a single, tertiary referral center. Pregnant women treated with anti-TNF for Inflammatory Bowel Disease (IBD) and their subsequent children were recruited from the IBD preconception outpatient clinic. Pregnant women not treated with anti-TNF for IBD and their subsequent children were eligible as controls. Adherence to the Dutch National Vaccination Programme was mandatory for participation in this study. A venous blood sample was obtained one month after final HBV vaccination. Anti-HBs levels were measured by ELISA.
RESULTS: Anti-HBs levels at 12 months did not differ between the anti-TNF exposed (n=15) and the control group (n=12) (>1000 IU/L vs >1000 IU/L, p=0.59). All children were successfully immunised against HBV, defined as anti-HBs>10 IU/L. Median anti-TNF levels determined in cord blood at birth were 9.0 µg/mL (IQR: 3.0-15.0 µg/mL) for IFX and 0.4. µg/mL (IQR: 0.3-0.6 µg/mL) for ADA. There were no differences in general birth and health outcomes.
CONCLUSION: Children born with detectable anti-TNF levels can be effectively vaccinated against HBV.
PMID: 29726943 [PubMed – as supplied by publisher]