[Comparison of anti-HBV vaccine efficacy given intradermally and intramuscularly in hemodialysis patients].
Patients chronically hemodialysed are recognised as a group of especially high risk for viral hepatitis B (HBV) infection. Moreover, their hyporesponsiveness to vaccination is widely known. So establishment of highly effective vaccination protocol is indispensable. We are presenting 5 year prospective observations of results of hemodialysis patients anti-HBV vaccination. 36 patients were vaccinated intramuscularly (among them 30 were revaccinated intradermally) and 40 patients--only intradermally. We revealed that seroprotective level of anti-HBs antibodies should be at least 100 IU/ml. We disclosed, that intradermal anti-HBV vaccination--compared to intramuscular--was significantly more effective (77.5%--and including answer in the second vaccination cycle 85.0%--vs 38.9%) and, moreover, less amount of vaccine could be used (28.2 micrograms--and for patients answering barely in the second vaccination cycle 53.7 micrograms--vs 123 micrograms). However, after intradermal vaccination seroprotective antibodies level falls faster and should be checked every 3 months. Patients answering efficiently to vaccination--comparing to answering inefficiently--have significantly higher albumin level and are younger. Moreover, higher dialysis dose favors the successful long-time answer to vaccination.
Miłkowski
A
A
Oddział Nefrologii i Dializoterapii, Wojewódzki Szpital Specjalistyczny, im. L. Rydgiera w Krakowie.
Wyrwicz
G
G
Kubit
P
P
Smoleński
O
O
D000328:Adult; D000368:Aged; D005260:Female; D006509:Hepatitis B / Q000209:etiology / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000032:analysis; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000276:immunology; D006801:Humans; D007271:Injections, Intradermal; D007273:Injections, Intramuscular; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis
D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines