Dinitrochlorobenzene skin testing predicts response to hepatitis B vaccine in dialysis patients.
The pattern of seroconversion and anti-HBs titres after 3 doses of hepatitis B vaccine was studied in 40 haemodialysis patients who had been grouped on the basis of their cell-mediated immune (CMI) response into strong or weak reactors. CMI response was determined by means of a dinitrochlorobenzene (DNCB) skin test. Titres of anti-HBs were comparable to those in healthy controls in 13 of 14 (93%) strong reactors but in only 9 of 26 (35%) weak reactors. Strong reactors had an equally satisfactory seroconversion rate with either 20 micrograms or 40 micrograms of vaccine whereas weak reactors had a negligible seroconversion rate with the 20 micrograms dose. In terms of hepatitis B prophylaxis, haemodialysis patients with a well preserved CMI response require only 20 micrograms of vaccine, with a consequent saving in cost. In contrast, it will be necessary to devise more effective immunisation schedules for most patients with a poor CMI response.
Bramwell
S P
SP
Tsakiris
D J
DJ
Briggs
J D
JD
Follett
E A
EA
Stewart
J
J
McWhinnie
D L
DL
Watson
M A
MA
Hamilton
D N
DN
Junor
B J
BJ
D000328:Adult; D004137:Dinitrochlorobenzene / Q000276:immunology*; D005260:Female; D006509:Hepatitis B / Q000517:prevention & control; D006510:Hepatitis B Antibodies / Q000096:biosynthesis*; D017325:Hepatitis B Vaccines; D006801:Humans; D008297:Male; D008875:Middle Aged; D009578:Nitrobenzenes / Q000276:immunology*; D006435:Renal Dialysis; D012882:Skin Tests; D014761:Viral Hepatitis Vaccines / Q000276:immunology*
D004137:Dinitrochlorobenzene; D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines; D009578:Nitrobenzenes; D014761:Viral Hepatitis Vaccines