Immune response to a heat-inactivated hepatitis B vaccine in patients undergoing hemodialysis. Enhancement of the response by increasing the dose of hepatitis B surface antigen from 3 to 27 micrograms.
In a randomized trial, 227 patients undergoing hemodialysis who were seronegative for all markers of hepatitis B virus were immunized at monthly intervals with three doses of either 3 micrograms or 27 micrograms of heat-inactivated hepatitis B HB-vaccine (CLB). Five months after the first injection, 77% of the patients in the 3-micrograms group and 94% in the 27-micrograms group manifested antibodies against hepatitis B surface antigen (anti-HBs). At month 12 the proportions of subjects with anti-HBs in the 3-micrograms and 27-micrograms groups had dropped to 68% and 87%, respectively. At all times, the differences in the anti-HBs conversion rate between the two treatment groups were significant. These results show that the impaired immune reactivity to hepatitis B vaccines of patients undergoing hemodialysis can be overcome by increasing the dose of the vaccine.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000276:immunology; D000917:Antibody Formation; D005260:Female; D006509:Hepatitis B / Q000209:etiology / Q000517:prevention & control*; D006514:Hepatitis B Surface Antigens / Q000008:administration & dosage; D006515:Hepatitis B virus / Q000276:immunology*; D006358:Hot Temperature / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D014613:Vaccines, Attenuated / Q000008:administration & dosage; D014765:Viral Vaccines / Q000008:administration & dosage*
D000914:Antibodies, Viral; D006514:Hepatitis B Surface Antigens; D014613:Vaccines, Attenuated; D014765:Viral Vaccines