[Transient blood surface antigens of hepatitis B in patients on hemodialysis].
BACKGROUND
The presence of surface antigen of hepatitis B (HBsAg) virus in serum from recently vaccinated adults has been scarcely investigated. In this work, after the detection by chance of seven HBsAg-positive patients on hemodialysis who reported recent hepatitis B vaccination, a prospective study was undertaken to verify the presence and duration of post-vacunal antigenemia.


METHODS
Nineteen non-selected patients on hemodialysis were followed for serologic markers of hepatitis B, after receiving a dose of the recombinant vaccine (Engerix B) according to their vaccination schedule. Enzyme-immunoassay techniques were used for the study of serologic markers, and the reactivity of HBsAg was confirmed by means of a neutralization assay with specific anti-HBs antibodies.


RESULTS
After the administration of one vaccine dose, 31.5% of patients were HBsAg positive at least once. Antigenemia was identified more frequently 2 to 4 days (83.3%) after immunization. In all cases antigenemia was transient and had cleared after 11 days of vaccination. The follow-up of serologic markers revealed the absence of infection with virus B. Only 16.6% of patients with transient antigenemia responded to vaccination (titer of anti-HBs > or = 10 mIU/ml), while the corresponding percentage in the group of HBsAg-negative patients was 69.2% (p < 0.05). All patients were HCV and HIV negative.


CONCLUSIONS
A high frequency of post-vacunal antigenemia is reported in patients on hemodialysis, in absence of virus B infection as well as the possible relationship between the presence of transient antigenemia and the non-responder status.
Santana Rodríguez
O E
OE
Servicio de Microbiología, Hospital Universitario Insular de Gran Canaria.
Morillas Jarillo
C
C
Esparza Martín
N
N
Toledo González
A
A
Checa Andrés
M D
MD
Martín Sánchez
A M
AM
D000328:Adult; D000368:Aged; D000954:Antigens, Surface / Q000097:blood; D005260:Female; D006509:Hepatitis B / Q000276:immunology / Q000517:prevention & control; D006510:Hepatitis B Antibodies / Q000097:blood; D006511:Hepatitis B Antigens / Q000097:blood*; D017325:Hepatitis B Vaccines / Q000276:immunology; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D013997:Time Factors; D014614:Vaccines, Synthetic / Q000276:immunology
D000954:Antigens, Surface; C075654:Engerix-B; D006510:Hepatitis B Antibodies; D006511:Hepatitis B Antigens; D017325:Hepatitis B Vaccines; D014614:Vaccines, Synthetic
Antigenemia transitoria de superficie de la hepatitis B en pacientes en hemodiálisis.