Hepatitis B vaccine in hemodialysis patients with hepatitis C viral infection.
Patients on hemodialysis therapy are at a relatively high risk of exposure to hepatitis B virus (HBV) infection. The prevalence of hepatitis C virus (HCV) infection is even higher and was reported as 33.2% in Taiwan. Although the efficacy of hepatitis B vaccine was well documented, the vaccination schedule in hemodialysis patients is not clearly defined. And under such a high prevalence of HCV infection, little is known about the influence of HCV imposing on HBV vaccination. We studied 50 chronic hemodialysis patients who were serologically negative for the hepatitis B surface antigen (HBsAg), the antibody to the hepatitis B surface antigen (anti-HBs) and the antibody to the hepatitis B core antigen (anti-HBc); 26 of them were positive for the antibody to hepatitis C virus (anti-HCV) test. Recombinant hepatitis B vaccine (Engerix-B) 40 micrograms per dose was administered by the intramuscular route at deltoid region at 0, 1, 2, 6 and 12 months respectively to all the patients. Forty-six patients had completed the study. The effective seroconversion rate (serum anti-HBs titer > 10 mIU ml-1) at 1 month after the final vaccine was 76.1% (35/46). The effective conversion rates of the anti-HCV(+) group to the anti-HCV(-) were 75% versus 77.3% (P = 0.857). Geometric mean anti-HBs titers were 177.67 mIU ml-1 versus 189.28 mIU ml-1 (P = 0.867). Our results showed that five-dose injections of HBV vaccine do not present a superior outcome to the four-dose regimen comparing to published data. The status of positivity of anti-HCV do not pose an suboptimal effect on HBV vaccination of hemodialysis patients.
Cheng
C H
CH
Division of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan.
Huang
C C
CC
Leu
M L
ML
Chiang
C Y
CY
Wu
M S
MS
Lai
P C
PC
D000328:Adult; D000368:Aged; D005260:Female; D006510:Hepatitis B Antibodies / Q000097:blood; D017325:Hepatitis B Vaccines / Q000276:immunology*; D006526:Hepatitis C / Q000276:immunology*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D014611:Vaccination
D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines; D018937:Hepatitis C Antibodies