title: [Vaccination against hepatitis B in patients with chronic renal failure--twenty years follow-up].
abstract: OBJECTIVE
  The efficacy of vaccination against hepatitis B was evaluated in patients with chronic renal failure from 4 dialysis units in 1988-2010.
  
  
  METHODS
  Hepatitis B vaccination was started in 1 271 patients with chronic renal failure (606 female, 665 male). Patients received intramuscularly 3 doses of plasma-derived or since 1990, recombinant vaccine at the interval 0, 1 and 2 months for dialysis patients and 0, 1 and 6 months for pre-dialysis patients. Each vaccine contained 40 microg of hepatitis B surface antigen (HBsAg) in 1 002 patients, however only 20 microg HBsAg in 269 patients till 2000. Blood samples were obtained at the beginning of vaccination, 1-2 month after immunization and biannual thereafter. Serum samples were tested using ELISA methods for HBsAg and antibodies against hepatitis B surface and core antigens (anti-HBs, anti-HBc). The patients without protective anti-HBs level and the patients with waning of anti-HBs antibodies were revaccinated.
  
  
  RESULTS
  Anti-HBs antibodies after the third vaccine were investigated in 786 patients. Protective anti-HBs levels (> or = 10 IU/l) were proved in 49%, 65% and 74% patients after the third, fourth and fifth vaccine. The waning of protective anti-HBs antibodies was detected in 47% and 68% of patients during 3 and 5 years after vaccination. The new infections with HBsAg positive status were proved in 28 patients, in 27 of them in period 1988-1994. Anti-HBc seroconversion was observed in 10 patients.
  
  
  CONCLUSIONS
  Vaccination considerably reduced hepatitis B incidence in the patients with chronic renal failure during nineties. However still approximately one quarter of patients did not produce protective anti-HBs level after immunization with recombinant vaccine and new form of vaccination against hepatitis B may be considered also in the Czech Republic.
authors.affiliation: Klinika infekcního lékarství Fakultní nemocnice Ostrava. ludek.roznovsky@fnspo.cz
authors.forename: L
authors.initials: L
authors.lastname: Roznovský
authors.forename: J
authors.initials: J
authors.lastname: Tvrdík
authors.forename: L
authors.initials: L
authors.lastname: Kabieszová
authors.forename: L
authors.initials: L
authors.lastname: Petrousová
authors.forename: I
authors.initials: I
authors.lastname: Orságová
authors.forename: L
authors.initials: L
authors.lastname: Hozáková
authors.forename: I
authors.initials: I
authors.lastname: Lochman
authors.forename: A
authors.initials: A
authors.lastname: Kloudová
authors.forename: I
authors.initials: I
authors.lastname: Valkovský
authors.forename: P
authors.initials: P
authors.lastname: Letocha
authors.forename: S
authors.initials: S
authors.lastname: Schwarzová
authors.forename: M
authors.initials: M
authors.lastname: Hladík
authors.forename: A
authors.initials: A
authors.lastname: Zjevíková
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000276:immunology; D006801:Humans; D007117:Immunization, Secondary; D007676:Kidney Failure, Chronic / Q000276:immunology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D014611:Vaccination; D014614:Vaccines, Synthetic / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D014614:Vaccines, Synthetic