Hepatitis B vaccine response in obesity: A meta-analysis

Background: Hepatitis B vaccination is critical in preventing hepatitis B virus (HBV) infection and transmission. However, the impact of obesity on immune response to hepatitis B vaccine remains unclear. Methods: We performed a meta-analysis of the literature and summarized the results of immune response to hepatitis B vaccine among persons with and without obesity. We used Pubmed, Embase, Web of Science and Cochrane Library to identify all related studies between January 1973 and November 2015. Unadjusted and adjusted pooled OR and 95% CI were calculated by fixed-effect model or random-effect model according to the heterogeneity of the selected studies. Results: Totally, 16 studies contributed to the present meta-analysis. Fifteen of them provided absolute numbers of non-responders in obese group and non-obese group. Overall, we found that the obese population was significantly associated with non-response to hepatitis B vaccination (adjusted OR: 2.46, 95% CI: 1.50-4.03). Significant heterogeneity was present in most of the pooled analyses, but was markedly reduced when analyses were restricted to study reports with uniform criteria of obesity and restricted to study in adults. No publication bias was observed in the present analysis. Conclusions: The present meta-analysis suggested that obesity is significantly associated with the decreased response to hepatitis B vaccines. Future studies should be performed to unravel this relationship in order to prevent HBV infection and transmission. (C) 2016 Elsevier Ltd. All rights reserved.