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Peer reviewedOpen accessHepatitis BHepatitis DHepatitis CHepatitis EHepatitis A

Reduced immune responses to hepatitis B primary vaccination in obese individuals with nonalcoholic fatty liver disease (NAFLD)

npj Vaccines·

Shivali S. Joshi, Rachelle P. Davis, Mang M. Ma, Edward Tam, Curtis L. Cooper, Alnoor Ramji, Erin M. Kelly, Saumya Jayakumar, Mark G. Swain, Craig N. Jenne, Carla S. Coffin

DOI
10.1038/s41541-020-00266-4
PMID
33431890
PMCID
PMC7801497
OpenAlex
W3120401733
Study type
Journal article
Publisher
Springer Science and Business Media LLC
Article type
journal-article
Integrity
current

Why this research matters now

The findings suggest that obese individuals with NAFLD may have suboptimal immune responses to standard hepatitis B vaccination, potentially requiring modified vaccination strategies or monitoring in this population.

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Structured evidence summary

Research question

The study assessed hepatitis B vaccine efficacy in adults with nonalcoholic fatty liver disease, stratified by obesity risk class.

Study design

Sixty-eight HBV-naïve adults with NAFLD completed a three-dose HBV or HBV/HAV vaccine series through the Canadian HBV network. Anti-HBs titers were measured one to three months after the third dose, and T-cell responses were assessed in a subset of 31 participants. A mouse model of NAFLD was also used to study immune response.

Population and setting

The study enrolled HBV-naïve adults with NAFLD in Canada, stratified into low-risk obesity (BMI less than 35) and medium/high-risk obesity (BMI 35 or greater) groups.

Main findings

Anti-HBs titers were significantly lower in medium/high-risk obesity patients compared to low-risk obesity patients. High-risk obesity cases also exhibited reduced vaccine-specific CD4+ T-cell responses and dysfunctional follicular T-helper cells. The NAFLD mouse model similarly showed lower anti-HBs levels and T-cell responses versus controls.

Public-health relevance

The findings suggest that obese individuals with NAFLD may have suboptimal immune responses to standard hepatitis B vaccination, potentially requiring modified vaccination strategies or monitoring in this population.

Important limitations

This summary is limited to the supplied single-article abstract and metadata. The original paper is required for decision-grade interpretation, including details on sample selection, potential confounders, statistical power, and generalizability beyond the Canadian cohort.

GIDS interpretation

This peer-reviewed journal article on vaccine effectiveness in NAFLD patients was published in npj Vaccines and is indexed under hepatitis B, treatment, vaccination, and vaccine effectiveness topics. It may inform clinical guidance for at-risk populations but does not represent surveillance or outbreak data.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 12 auditable classifier relationships to diseases, places, topics, and study design.

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