Efficacy and long-term immunogenicity of hepatitis B vaccine in haemodialysis patients.
BACKGROUND
Hepatitis B vaccine is effective in protection against hepatitis B virus (HBV) infection in haemodialysis (HD) patients, but the antibody response is variable in this population and the persistence of immunity in them remains largely unknown. In this study we aimed to evaluate the efficacy and long-term immunogenicity of hepatitis B vaccine in HD patients.


METHODS
In this study, we initially offered HBV vaccination as double dose, four vaccine series schedule (40 microg injections intramuscularly in the deltoid muscle at 0, 1, 2 and 6 months) to 54 HD patients who were negative for hepatitis B core antibody and did not receive any dose of HBV vaccine previously. Serum levels of hepatitis B surface antibody (anti-HBs) tested 1-2 months after completion of vaccination. Then we follow the patients up to 1 year after primary vaccination to evaluate the persistence of immunity (as indicated by serum levels of anti-HBs higher than or equal to 10 IU/l).


RESULTS
After primary vaccination, 87% of patients developed anti-HBs levels above 10 IU/l. 27.8% and 59.2% of them were weak responders and high responders respectively. 13% of patients were non-responders. After 1-year follow-up, 18.18% of responders had lost their anti-HBs (transient responders). All of them were initially in weak responders group and had lower anti-HBs levels.


CONCLUSIONS
We found an average percentage of seroconversion after primary HBV vaccination in HD patients. Our study also supported this fact that an antibody titre above 100 IU/l following primary vaccination is necessary to maintain that level of antibody 1 year later.
Ramezani
A
A
Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran.
Eslamifar
A
A
Banifazl
M
M
Ahmadi
F
F
Maziar
S
S
Razeghi
E
E
Kalantar
E
E
Amirkhani
A
A
Aghakhani
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006509:Hepatitis B / Q000276:immunology*; D017325:Hepatitis B Vaccines / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D055815:Young Adult
D017325:Hepatitis B Vaccines