Pediatr Gastroenterol Hepatol Nutr.  2020 Mar;23(2):132-136. 10.5223/pghn.2020.23.2.132.

Effect of a Gluten Free Diet on Hepatitis B Surface Antibody Concentration in Previously Immunized Pediatric Celiac Patients

  • 1Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva, Israel.
  • 2Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
  • 3Department of Pediatric, Shaare Zedek Medical Center, Jerusalem, Israel.
  • 4Pediatric Rheumatology Clinic, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
  • 5Pediatric Gastroenterology Institute, Shaare Zedek Medical Center and The Hebrew University of Jerusalem, Jerusalem, Israel.


To evaluate the effect of gluten-free diet (GFD) on hepatitis B surface antibody (HBsAb) concentrations among previously immunized pediatric celiac disease (CD) subjects.
We retrospectively evaluated pediatric CD subjects in serological remission who were previously immunized for hepatitis B virus as infants. The temporal relationship between HBsAb concentration, the amount of time on a GFD, and age were evaluated.
Overall, 373 CD subjects were analyzed: 156 with HBsAb sampled prior to GFD initiation and 217 after initiation of a GFD and in serological remission. Median age at HBsAb concentration measurement for those before and after GFD initiation was 5.3 years (interquartile range [IQR], 3.1-9.2 years) and 7.6 years (IQR, 5.4-10.9 years), respectively (p<0.001). There was no sex difference between the groups. The median time of HBsAb measurement was 2 months (IQR, 0-5.7 months) before and 12.8 months (IQR, 5.3-30.3 months) after initiation of GFD. The HBsAb concentration was low in 79 (50.6%) and 121 (55.7%) subjects before and after GFD initiation, respectively (p=0.350). Age was inversely associated with low HBsAb concentrations. Neither being on a GFD nor sex was associated with low HBsAb concentrations.
Adherence to a GFD does not affect HBsAb concentration in children with CD. Age is inversely associated with HBsAb concentration.


Antibodies; Immunization; Serology; Child

MeSH Terms

Celiac Disease
Diet, Gluten-Free*
Hepatitis B virus
Hepatitis B*
Retrospective Studies
Sex Characteristics


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