Hepatitis B vaccine and uveitis: an emerging hypothesis suggested by review of 32 case reports

Abstract

Objective: To report a possible association between hepatitis B vaccine and uveitis.Methods: Spontaneous reports from the National Registry of Drug-Induced Ocular Side Effects, the World Health Organization, and the Food and Drug Administration were collected on hepatitis B vaccine associated with uveitis between 1982 and 2009. In addition, we performed a Medline literature search using the keywords of uveitis, iritis, or vitritis, in combination with vaccines and hepatitis B vaccine. Data garnered from the spontaneous reports included age, gender, adverse drug reaction, temporal association of uveitis with vaccine doses, concomitant drugs, other systemic disease, recovery, and recurrence after repeat dosage.Results: Thirty-two case reports of uveitis occurring after hepatitis B vaccine were reported to the spontaneous reporting databases. The mean age of the patients was 29 years (1–57 years), with 8 male and 24 female patients. The mean number of days until uveitis was reported after vaccination was 3 days (1–15 days). The uveitis was reported to occur after the first vaccination in 15 patients, after the second vaccination in 3 patients, and after the third vaccination in 3 patients; the duration of time to occurrence of uveitis was not reported for 9 patients. One patient had recurrent uveitis after both the second and third doses of vaccine. One patient had recurrent uveitis after the first and second doses of vaccine.Conclusion: Hepatitis B vaccine may have a possible association with the development of uveitis in some patients. Immune complex deposition and adjuvant effects are potential pathogenic mechanisms.