Background: Sarcoidosis is known to be associated with defects in cellular immunity, especially in reference to T  helper lymphocytes. Anergy to a tuberculin skin test is most characteristic of this disease. Objectives: To further the data on impaired immunity, we studied the antibody response to hepatitis B vaccination in patients with sarcoidosis. Methods: Serologic markers of hepatitis B virus (HBV) (HBsAg, anti-HBs, anti-HBc) were studied in 40 patients with sarcoidosis (32 female, 8 male; mean age: 45 ± 11 years, range: 25–66 years) with a mean duration of disease of 6 years. While all the markers were negative in 22 patients (55%), 2 had isolated anti-HBc positivity and 16 had both anti-HBc and anti-HBs antibodies. Thirty-five age- and sex-matched healthy subjects were studied as controls. Recombinant HBV vaccines (Genhevac B Pasteur, 20 µg) were administered (at 0 , 1, and 6 months) to 16 of the seronegative cases and the controls and antibody titres were measured 1 month after the last dose. The tuberculin skin test was negative in all cases. Results: While none of the vaccinees in the diseased group responded, the control group yielded an antibody response rate of 85.7% (30/35), with a mean titre of 257.9 mIU/ml. Conclusions: Patients with sarcoidosis were invariably unresponsive to standard vaccination, while some of the diseased subjects had already mounted a natural antibody response, either before or after the development of the original disease. Cellular immunodeficiency in sarcoidosis could be a suitable model for studying immunological interactions between HBV and the host.

Keywords:
Sarcoidosis, Hepatitis B vaccination
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© 2000 S. Karger AG, Basel
2000
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