HBV infection, vaccination and autoimmunity

• Vol 10 • January 2008 HBV: Infection, Vaccination and Autoimmunity The idea that infectious agents in general, and viruses in particular, could trigger the development of autoimmune diseases in genetically susceptible individuals has been raised in various clinical and epidemiological studies [1]. Also included in the medical literature are case reports, ecological association studies, as well as some animal studies relating to a wide range of autoimmune diseases temporally associated with vaccination [2]. In addition, vaccines contain peptides that are homologous to viral antigens. Therefore, it is not surprising that the question of whether vaccination could lead to autoimmune illness has been the focus of many scientific debates [3]. However, there is no conclusive evidence for a causal link between vaccination and the development of autoimmune diseases [4] since it has not been determined whether available epidemiological tools are sensitive enough to detect such a link [5]. The debate rages on. Different studies have linked hepatitis B virus with various types of autoimmune phenomena – from the generation of autoantibodies to the development of autoimmune diseases [6]. Distribution of the hepatitis B vaccine indeed led to a dramatic reduction in HBV complications in countries that implemented large-scale vaccination programs [7], but large series of autoimmune adverse events were reported following this vaccine [8,9]. In this review we will summarize the relevant data regarding HBV and hepatitis B vaccination and their association with autoimmunity.