Development of multiple sclerosis after vaccination against hepatitis B: a study based on human leucocyte antigen haplotypes

Abstract

The aetiology of multiple sclerosis (MS) is still not fully understood. Infectious agents are believed to play a role in the development of this multifactorial disease. Cases in which this disease occurs after administration of both plasma-derived and recombinant hepatitis B vaccines have been reported. In this study, we compared a group of 11 MS patients who developed first clinical symptoms after hepatitis B vaccination (group I) with 71 MS patients who were never vaccinated against hepatitis B and were negative for hepatitis B serology (group II), and 20 healthy controls (group III). Mean age was 27.75 years (19-39) in group I, 30.16 years (18-50) in group II, and 34.4 years (18-50) in group III. Mean attack rate after 2 years was 1.5 in group I and 1.63 in group II. Mean Expanded Disability Status Scale score after 2 years was 1.31 in group I and 1.89 in group II. Human leucocyte antigen (HLA) typing and serology for hepatitis B surface antigen were performed in all groups. In groups I and II, HLA-DR2 was more frequent than in normal healthy subjects. This reflects the general role of HLA in the pathogenesis of MS but suggests that antigen presentation by different HLA is not involved in the development of MS after hepatitis B vaccination. Since there was no difference in the clinical features between vaccinated and nonvaccinated MS patients, this study supports recent reports that hepatitis B vaccination is safe in MS patients and that hepatitis B vaccination is not involved in the development of MS.

Molecular Detection of Epstein–Barr Virus, Human Herpes Virus 6, Cytomegalovirus, and Hepatitis B Virus in Patients with Multiple Sclerosis

“…Although some studies have suggested an association between hepatitis B vaccination and the development of MS, a large body of research studies rejects the possibility of any association between them. [28][29][30] We also evaluated CMV in our case and control groups. While only one positive CMV infection was detected in the control group, no case was detected in those with MS.…”

“…Although some studies have suggested an association between hepatitis B vaccination and the development of MS, a large body of research studies rejects the possibility of any association between them. 28 - 30 …”

Vaccination and autoimmunity: Influenza vaccination and association with multiple sclerosis

“…In 2002, the National Academy of Sciences' Institute of Medicine, after having examined the published, peer-reviewed scientific and medical literature, concluded the lack of association between hepatitis B vaccination and the CNS demyelinating disease 72 . Additionally, studies that have examined the potential effect of hepatitis B vaccination on relapses in people diagnosed with the MS disease could not demonstrate an increased risk of relapse 73,74 .…”

Specific aspects of modern life for people with multiple sclerosis: considerations for the practitioner

“…Live attenuated vaccines should be avoided for patients currently taking immunosuppressant medications and for a period of 3 months after discontinuation of treatment [Cahill et al 2010]. [Faure, 2005;Herroelen et al 1991;Monteyne and André, 2000;Ozakbas et al 2006;Salleras et al 2006]. The concerns relate, in part, to a report from France in the mid 1990s of a possible increase in autoimmune diseases, including MS, after hepatitis B vaccination.…”

“…Concerns have been raised regarding a potential relationship between hepatitis B vaccination and MS relapses [Faure, 2005; Herroelen et al . 1991; Monteyne and André, 2000; Ozakbas et al . 2006; Salleras et al .…”