Anti-phospholipid antibodies following vaccination with recombinant hepatitis B vaccine

Summary

This study was undertaken to evaluate the possible role of hepatitis B recombinant vaccine inducing the synthesis of IgG and IgM anti-cardiolipin antibodies (aCL), antibodies against β₂GPI (anti-β₂GPI), lupus anti-coagulant (LA), anti-nuclear antibodies and antibodies against extractable nuclear antigens (anti-ENA). The study population consisted of 85 healthy students (63 female, 22 male; mean age 20·8 years), vaccinated with three doses of recombinant DNA hepatitis B vaccine. One month after vaccination with the first dose of hepatitis B vaccine a minority of vaccinated individuals showed changes in IgG or IgM aCL or anti-β₂GPI or LA activity (P < 0·001). Among subjects in whom changes of IgG anti-β₂GPI were observed, a significantly higher number of increased (8/85) than decreased (2/85) values were found (P < 0·01). Analyses of paired data showed that differences in aCL or anti-β₂GPI levels before vaccination or 1 month later did not reach statistical significance. In two people aCL transitorily reached medium positivity after the first dose of hepatitis B vaccine with a drop 5 months later. Similar evident anti-β₂GPI fluctuation was also observed in one person. Another participant was initially low positive for IgG anti-β2GPI and the levels were increasing after vaccination. Two participants became positive for anti-nuclear antibodies during 6 months’ follow-up. There were no sex-dependent differences in tested antibodies observed and no associations between levels of aPL and levels of anti-HBV antibodies. We conclude that HBV can induce aPL, although rarely. In genetically susceptible individuals or together with some other triggers such combination might confer the risk of developing a continuous autoimmune response in an individual.