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.
Fraser
G M
GM
Department of Gastroenterology, Soroka University Medical Center of Kupat Holim, Israel.
Ochana
N
N
Fenyves
D
D
Neumann
L
L
Chazan
R
R
Niv
Y
Y
Chaimovitch
S
S
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