Effect of granulocyte macrophage colony stimulating factor on hepatitis-B vaccination in haemodialysis patients.
OBJECTIVE
Haemodialysis patients often fail to respond to hepatitis B vaccination. There are various agents that can be used as vaccine adjuvant in chronic renal failure patients on haemodialysis. In this study, the adjuvant effect of granulocyte macrophage colony stimulating factor (GMCSF) is compared with that of control subjects.


METHODS
In this study, eight patients were started on 150 mcg of GMCSF subcutaneously 24 hours prior to intramuscular hepatitis B vaccination (20 mcg of genetically engineered vaccine at the same site). The antibody response to surface antigen (anti HBsAg) in these patients were compared with those of eight control subjects who received standard three doses of monthly 40 mcg of same hepatitis B vaccine.


RESULTS
In the control study, only two patients developed significant antibody response to surface antigen whereas seven of eight patients in GMCSF group developed significant antibody titres (> 10 IU/L). The sero-protection rate was 87.5% in GMCSF group and 25% in control group.


CONCLUSIONS
This study shows that GMCSF offers significantly better seroprotection against hepatitis B compared to standard dose of vaccination in patients with chronic renal failure on haemodialysis.
Sudhagar
K
K
Madras Institute of Nephrology, Vijaya Health Centre, Chennai.
Chandrasekar
S
S
Rao
M S
MS
Ravichandran
R
R
D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000328:Adult; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000008:administration & dosage / Q000276:immunology*; D017325:Hepatitis B Vaccines / Q000276:immunology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000276:immunology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis
D000276:Adjuvants, Immunologic; D017325:Hepatitis B Vaccines; D016178:Granulocyte-Macrophage Colony-Stimulating Factor