P484 Hepatitis B vaccination in inflammatory bowel disease
Bibliographic record
Abstract
Inflammatory bowel disease (IBD) patients have a lower response to hepatitis B virus (HBV) vaccination, especially those receiving anti-TNF treatment. It has been suggested that modified dosing regimens may increase response rates in these patients. Our aim was to evaluate the efficacy of HBV vaccination in an IBD cohort as well as to identify the absence of response predictive factors. We also evaluated a revaccination protocol in patients who failed seroconversion with the standard regimen. Single-centre prospective observational study. All patients with IBD were evaluated for serological markers of HBV. The single dose HBV vaccine was administered at 0, 1 and 6 months to all seronegative patients. Subsequent determination of the anti-HBs antibody was recorded. An adequate immune response (AIR) to HBV was defined as more than 10 mIU/ml. A single booster regimen was administered to patients without AIR. A double-dose administration of the vaccine was administered at 0, 1 and 6 months to patients without AIR to the booster. We analysed AIR in patients with IBD in general and according to the therapeutic regimens (thiopurines and / or anti-TNF). The efficacy of the different vaccination regimens was also evaluated. Statistics - Chi-square and Exact tests. 118 IBD patients were evaluated [(43% males; mean age 52.5 years (20–80)], of which 55.8% with Crohn’s disease. 47.5% were on immunosuppressive therapy (40% of them on biologic agents). 31.7% had already been vaccinated and 35% were immune (Anti-HBs positive) to HBV. In the subgroup of patients previously vaccinated 13% (5 patients – 2 on thiopurines and 2 on anti-TNF) were not immune and 2 did not respond to booster vaccination. With respect to vaccination-naïve patients, seroconversion with standard protocol was significantly lower in those under immunosuppressive therapy (36% vs. 71%; p = 0.03). A tendency for a lower response was also identified in older patients at Crohn’s disease diagnosis (Montreal A3: 25% vs. Montreal A1/ A2: 52%; p = 0.159). A patient with AIR lost immunity under immunosuppressive therapy and regained it after a booster. The response rate of IBD patients to HBV standard protocol vaccination was significantly lower in those under immunosuppressive therapy. AIR needs to be regularly assessed and booster vaccination seems effective in a subgroup of patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".