Patients with rheumatoid arthritis (RA) could still be at risk for hepatitis B infection despite vaccination.

That was the conclusion of a study in which a majority of RA patients tested were not protected by the hepatitis B vaccination, according to a press release from the European League Against Rheumatism.

“People with RA have an increased risk of morbidity and mortality from infections, and to discover that immunization might not confer protection is a real concern,” said Misha Tilanus, medical student at Radboud University Medical Centre in the Netherlands. “It’s crucial that patients and healthcare practitioners are aware of this lack of efficacy and do all they can to minimize risk.”

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RA Patients and Hepatitis B: By the Numbers

In the study 47 patients with RA were vaccinated in an attempt to protect them against hepatitis B liver infection.

Their outcomes were compared to 156 similarly vaccinated healthcare workers over the course of 28 weeks. 

According to the study, the control patients had a higher response rate to the vaccine compared with RA patients (83 percent to 11 percent). 

Among the patients with RA, 42 of them were non-responders, four were considered to be low responders, and only one was a high responder. 

In comparison, there were 27 non-responders, 31 low responders, and 98 high-level responders in the control group of healthcare workers without RA. 

Researchers concluded that RA patients had a larger risk for not responding to the vaccine when compared to the control group, even when age and sex were factored in. 

There was also no notable differences based on what types of drugs the RA patients were taking at the time. This includes immunosuppressants, biologics, anti-TNF, and disease-modifying antirheumatic drugs (DMARDs).

In a statement to the press the researcher said: “Based on this study, hepatitis B vaccination is less effective in RA patients using biologicals and/or DMARDs than in the general population.”

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What Does This Mean for Patients with RA?

This could be alarming news for patients who live with RA. 

Hepatitis B can be life-threatening and patients with inflammatory autoimmune conditions are already more prone to liver disease and comorbidities involving inflammation of the liver and other vital organs. 

Worldwide, 2 billion people have become infected with hepatitis B — 12 million of them in the United States alone. RA affects about 1.3 million people.

One of these RA patients, Kathleen Cooper of Tacoma, Washington, said, “I won’t even bother with the hepatitis B vaccine after reading about this. I’m not anti-vaccination usually, but I’m not going to bother getting one with my haywire immune system, if there’s pretty good evidence that it isn’t going to work anyway. To be frank, what is the point?” 

Patients are advised to consult with doctors, however, before making a decision regarding whether or not to vaccinate given their specific illnesses and heath history. Generally speaking, vaccinations are recommended, but some patients who are prone to infection, allergic to a compound in the vaccine, or are immune-compromised may be advised not to get vaccinated. 

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