Intradermal hepatitis B vaccination in patients with advanced chronic renal failure: immunogenicity and follow-up.
BACKGROUND
Patients undergoing dialysis usually have a poor response to conventional hepatitis B vaccination.


OBJECTIVE
To observe the effects of intradermal hepatitis B (HB) vaccination in a 13-month prospective study of adult patients with end-stage renal failure. The patients were with or without previous hepatitis B vaccination, but all had antibody titres <10 mUI/mL.


METHODS
Patients were allotted to two groups: previous hepatitis B virus vaccination and no previous hepatitis B virus vaccination or anti-HBs titres <10 mUI/mL. Patients in both groups received 16 i.d. injections of 0.1 mL of hepatitis B virus vaccine over an eight-week period. Patients had antibody titres assessed before vaccination, 1 month after and every 3 months for a year. Antibody titres >/=10 mUI/mL were considered protective.


RESULTS
Seventy patients completed the protocol. Protective titres were elicited in 82% of each group. Age, time under dialysis, diabetes, smoking and body-mass index were not associated with seroconversion. Persistent protective titres >12 months occurred in 27 (58.7%). Adverse events were trivial.


CONCLUSIONS
Intradermal hepatitis B virus vaccination is an alternative in end-stage renal failure.
Morais
E O
EO
Disciplina de Infectologia, Departamento de Clínica Médica, Faculdade de Ciências Médicas, Unicamp, Campinas, SP, Brazil.
Resende
M R
MR
Oliveira
A M
AM
Sinkoc
V M
VM
Garcia
M T
MT
Angerami
R N
RN
da Silva
L J
LJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006509:Hepatitis B / Q000276:immunology / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000276:immunology; D006801:Humans; D007271:Injections, Intradermal; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000379:methods
D017325:Hepatitis B Vaccines