Re: Hepatitis B vaccination/Deb

[Guest guest]

Dear Deb;

Here's some of my latest findings on hepatitis B vaccination, RA and

gastrointestinal reactions; you can track down the individual

references by going to the PubMed database and searching for the

appropriate PMID #

1. Geier DA, Geier MR (2002) A one year followup of chronic arthritis

following rubella and hepatitis B vaccination based upon analysis of

the Vaccine Adverse Events Reporting System (VAERS) database. Clin.

Exp. Rheumatol. 20: 767-771. PMID: 12508767. " This study revealed

that adult rubella and adult hepatitis B vaccines were statistically

associated with chronic arthritis which persisted for at least one

year. The etiology for these adverse reactions may involve autoimmune

mechanisms. "

2. Pope JE, s A, Howson W, Bell DA (1998) The development of

rheumatoid arthritis after recombinant hepatitis B vaccination. J.

Rheumatol. 25: 1687-1693. PMID: 9733447. " ... polymorphic residues in

the binding site of the MHC class II molecules of the affected

patients appear capable of binding some peptide sequences of the

recombinant vaccine peptides they received and may be responsible for

hepatitis B vaccine triggering development of RA in these cases.

Recombinant hepatitis B vaccine may trigger the development of RA in

MHC class II genetically susceptible individuals. "

3. Gross K, Combe C, Kruger K, Schattenkirchner M (1995)

Arthritis after hepatitis B vaccination. Report of three cases.

Scand. J. Rheumatol. 24: 50-52. PMID: 7863281. " These three cases

show that arthritis after hepatitis B vaccination probably is more

common than reported so far, especially in a genetically

predisposed subject (two of our patients expressed HLA-DR4). "

4. Usman A, Kimyai-Asadi A, Stiller MJ, Alam M (2001)

Lichenoid eruption following hepatitis B vaccination: first North

American case report. Pediatr. Dermatol. 18: 123-126. PMID: 11358552.

" Lichen planus is often found in association with a variety of

underlying conditions. In particular, liver diseases such as primary

biliary cirrhosis, primary sclerosing cholangitis, hepatitis C, and

hepatitis B have been implicated in cutaneous lichen planus. Of

interest, there is mounting evidence that lichen planus-like

eruptions can occur following administration of the hepatitis B

vaccine, which has recently become a routine immunization in many

parts of the world. We present what we believe to be the first North

American case of lichenoid drug eruption associated with the

hepatitis B vaccine and provide a brief review of other reported

cases of lichenoid eruption seen following hepatitis B vaccination. "

5. Geier DA, Geier MR (2002) Hepatitis B vaccination and adult

associated gastrointestinal reactions: a follow-up analysis.

Hepatogastroenterology 49: 1571-1575. PMID: 12397738. " Hepatitis B

vaccination was statistically associated by chi 2 analysis with

gastrointestinal reactions including: hepatitis, gastrointestinal

disease and liver function test abnormalities in comparison to our

vaccine control groups. The reaction rate observed is outweighed by

the benefits of the vaccine. Further analysis is needed to determine

the mechanisms by which hepatitis B vaccine is associated with

gastrointestinal reactions. "

6. Geier MR, Geier DA (2002) Hepatitis B vaccination safety. Ann.

Pharmacother. 36: 370-374. PMID: 11895045. " The results showed a

statistically significant increase in the incidence of adverse

reactions reported after adult hepatitis B vaccination when

compared with the incidence of adverse reactions reported to VAERS

about control vaccines. "

The link between the major histocompatibility complex class II (MHC

class II) (HLA-DR) gene variants and adverse reactions to hepatitis B

vaccination mentioned in some of the papers is interesting because

this gene has previously been shown to be involved in PSC

susceptibility:

Mehal WZ, Lo YM, Wordsworth BP, Neuberger JM, Hubscher SC, Fleming

KA, Chapman RW 1994 HLA DR4 is a marker for rapid disease progression

in primary sclerosing cholangitis. Gastroenterology 106: 160-167.

PMID: 8276178.

It might be worth exploring the vast quantity of data available at

the Vaccine Adverse Events Reporting System (VAERS) database

mentioned in a couple of the articles (those by Geier):

http://www.vaers.org/

Best regards,

Dave

(father of (19); PSC 07/03; UC 08/03)