Increasing serum creatinine and age reduce the response to hepatitis B vaccine in renal failure patients.
The relationship between diminished response to hepatitis B vaccine in renal failure patients and serum creatinine level, age and other factors is unknown. The immune response of patients with renal failure of varying severity to hepatitis B vaccine was determined in this study. Sixty-eight patients with renal failure of varying severity who were negative for hepatitis B markers received four doses of hepatitis B vaccine, and anti-HBs titers were determined at 0, 1, 2, 3, 6, 8 and 12 months. Maximum anti-HBs titers were seen at 8 months. At this time 86% of patients with creatinine < or = 4 mg/dl but only 37% with creatinine > 4.0 mg/dl had a protective titer of > or = 10 mIU/ml (p < 0.002). Age was inversely related to anti-HBs titer (p = 0.045) and was independent of serum creatinine in predicting antibody response. We conclude that all patients with chronic renal failure should be immunized against hepatitis B as early as possible in the development of their disease, to ensure maximum response, and to minimize the effects of elevated serum creatinine and increasing age.
Department of Gastroenterology, Soroka University Medical Center of Kupat Holim, Israel.
G M
GM
Fraser
N
N
Ochana
D
D
Fenyves
L
L
Neumann
R
R
Chazan
Y
Y
Niv
S
S
Chaimovitch
D000328:Adult; D000375:Aging / Q000097:blood / Q000276:immunology*; D000704:Analysis of Variance; D003404:Creatinine / Q000097:blood*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006510:Hepatitis B Antibodies / Q000096:biosynthesis*; D017325:Hepatitis B Vaccines / Q000276:immunology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000276:immunology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index
D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines; D003404:Creatinine