Intest Res 2018; 16(3): 400-408  https://doi.org/10.5217/ir.2018.16.3.400
Nonimmunity against hepatitis B virus infection in patients newly diagnosed with inflammatory bowel disease
Seong Jae Yeo1, Hyun Seok Lee1, Byung Ik Jang2, Eun Soo Kim1, Seong Woo Jeon1, Sung Kook Kim1, Kyeong Ok Kim2, Yoo Jin Lee3, Hyun Jik Lee3, Kyung Sik Park3, Yun Jin Jung4, Eun Young Kim5, Chang Heon Yang6, Crohn’s and Colitis Association in Daegu-Gyeongbuk (CCAiD)
1Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, 2Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, 3Department of Internal Medicine, Keimyung University School of Medicine, Daegu, 4Department of Internal Medicine, Daegu Fatima Hospital, Daegu, 5Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, 6Department of Internal Medicine, Dongguk University School of Medicine, Gyeongju, Korea
Correspondence to: Hyun Seok Lee, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, 807 Hoguk-ro, Buk-gu, Daegu 41404, Korea. Tel: +82-53-200-2603, Fax: +82-53-200-2027, E-mail: lhsworld@nate.com
Co-Correspondence to Byung Ik Jang, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, Korea. Tel: +82-53-620-3831, Fax: +82-53-654-8386, E-mail: jbi@med.yu.ac.kr
Received: November 6, 2017; Revised: January 15, 2018; Accepted: January 16, 2018; Published online: March 6, 2018.
© Korean Association for the Study of Intestinal Diseases. All rights reserved.

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Abstract
Background/Aims: This study aimed to elucidate the prevalence of hepatitis B virus (HBV) serologic markers in Korean patients newly diagnosed with, but not yet treated for inflammatory bowel disease (IBD). Methods: We prospectively enrolled 210 patients newly diagnosed with IBD (109 with ulcerative colitis and 101 with Crohn’s disease). Hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core antibody (anti-HBc) levels were measured and compared with those of 1,100 sex- and age-matched controls. Results: The prevalence of chronic HBV infection (positive HBsAg, positive anti-HBc, and negative anti-HBs results) and past infection (negative HBsAg, positive anti-HBc, and positive or negative anti-HBs results) were not significantly different between the patients and controls (chronic HBV infection: IBD, 3.8% vs. control, 4.9%, P=0.596; past infection: IBD, 26.2% vs. control, 28.8%, P=0.625). The patients with IBD aged <20 years were at a higher susceptibility risk (nonimmune) for HBV infection than the controls (IBD, 41.5% vs. control, 22.4%; P=0.018). In the multivariate analysis, an age of <20 years (P=0.024) and symptom duration of ≥12 months before diagnosis (P=0.027) were identified as independent risk factors for nonimmunity against HBV infection. Conclusions: The patients newly diagnosed with IBD were susceptible to HBV infection. The frequency of nonimmunity was high, especially in the patients aged <20 years and those with a longer duration of symptoms before diagnosis. Therefore, it is necessary to screen for HBV serologic markers and generate a detailed vaccination plan for patients newly diagnosed with IBD.
Keywords: Inflammatory bowel disease; Colitis, ulcerative; Crohn disease; Hepatitis B virus; Vaccination


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