title: The evaluation of immune responses to hepatitis B vaccination in diabetic and non-diabetic haemodialysis patients and the use of tetanus toxoid.
abstract: OBJECTIVE
  The aim of this study was to investigate whether haemodialysis (HD) patients suffering from diabetes mellitus could be considered at risk for the development of the protective antibodies to hepatitis B (HB) vaccination and, to evaluate the effectiveness of tetanus toxoid (TT) administrated 2 days before HB vaccination.
  
  
  METHODS
  Forty-nine HD patients were divided into two groups: group A (19 diabetic patients) and group B (30 non-diabetic patients). A dose of 40 microg recombinant HB vaccine was injected intramuscularly to the patients at 0, 1, 2 and 6 months.
  
  
  RESULTS
  After the completion of the course, the patients in group A were found to have a lower protective antibody rates than the patients in group B (57.8% vs 70%) (P > 0.05). After the administration of additional booster doses during 12 months, the protective antibody to hepatitis B surface antigen (HBsAb) levels were detected in 78.9% and 96.6% of the patients in group A and group B, respectively (P > 0.05). The patients not having protective HBsAb levels were administered TT and HB vaccines, and after course, all of them have produced protective HBsAb levels.
  
  
  CONCLUSIONS
  The present study showed that diabetic patients on HD may carry a greater risk of not seroconverting than non-diabetic ones for antibody response to HB vaccination. The use of TT 2 days before HB vaccination may be a useful and effective method of enhancing the immune response to HB vaccination, especially in the patients with diabetes mellitus on HD.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Medical Faculty, Mustafa Kemal University, Hatay, Turkey. sabahattinocak@hotmail.com
authors.forename: Sabahattin
authors.initials: S
authors.lastname: Ocak
authors.forename: Ali Fuat
authors.initials: AF
authors.lastname: Eskiocak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000276:immunology*; D005260:Female; D006510:Hepatitis B Antibodies / Q000097:blood; D017325:Hepatitis B Vaccines / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D013745:Tetanus Toxoid / Q000276:immunology*; D014611:Vaccination
chemical_list: D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines; D013745:Tetanus Toxoid