Long-Term Humoral Response to Hepatitis B Vaccination in Patients with Inflammatory Bowel Disease in Oman: Impact of Prednisolone and Esomeprazole as Contributing Factors

Objectives: Inflammatory bowel disease (IBD) is a global health concern with increasing incidence. Many patients with IBD have impaired immunity, leading to suboptimal response to vaccines. Hepatitis B Virus (HBV) vaccination has been part of compulsory childhood immunization program since 1990 in Oman. Given the concerns about vaccine immunogenicity in patients with IBD, we designed this study to quantify the immune response to scheduled HBV vaccination in Omani patients with IBD and compare it with that in a matching control cohort of healthy Omani blood donors. Methods: This retrospective case-control study was conducted from 1 January to 31 May 2024, at Sultan Qaboos University Hospital. We enrolled a total of 252 participants: 126 patients with IBD and 126 controls. Baseline demographics, comorbidities, and viral serologies before and after vaccination were collected. The primary outcome was long term immune response to HBV vaccination. Secondary outcomes included identifying factors associated with suboptimal vaccine response. Results: Durable protective immune response to HBV vaccine was achieved in 29 (23.0%) patients with IBD and 109 (86.5%) controls. Prednisolone and esomeprazole therapies were both significantly associated with suboptimal vaccine response (p =0.016 and p < 0.001, respectively). There was no significant correlation between low immunogenicity to HBV vaccine and age, sex, type of IBD, comorbidities, or body mass index. Conclusions: Omani patients with IBD show markedly reduced long-term immunogenicity to HBV vaccination. Esomeprazole and corticosteroid therapies may be associated with this diminished response. These findings highlight the importance of reassessing the immunogenicity to HBV vaccination, and potentially other protective vaccinations, in all patients with IBD as part of their standard of care.