title: Vitamin D deficiency is associated with poor response to active hepatitis B immunisation in patients with chronic kidney disease.
abstract: Vitamin D deficiency is highly prevalent in patients suffering from chronic kidney disease. At present it is not known whether this condition is associated with poor response to hepatitis B vaccination in these patients. We performed a retrospective analysis of 200 patients with chronic kidney disease stages 3-5D, who had undergone hepatitis B vaccination with three 40 μg recombinant hepatitis B vaccine doses in a single centre. Anti-HBs antibody titres and 25-hydroxyvitamin D (25(OH)D) levels were measured by chemiluminescence immunoassays. Vitamin D deficiency with serum levels <10 ng/mL was found in 35.5% of patients. These patients had a lower seroconversion rate than did patients with levels ≥10 ng/mL (45% vs 64%; P=0.011) and their median (25th, 75th percentile) anti-HBs antibody titres were lower (0 (0, 117)IU/L vs 48 (0, 236.5)IU/L). Non-responders had lower 25(OH)D concentrations than did responders (12.9±6.5 ng/mL vs 15.1±7.4 ng/mL; P=0.034). Treatment with a vitamin D receptor activator had no influence on the immune response. In a multiple logistic regression analysis vitamin D deficiency (OR 0.480; P=0.023) and diabetes (OR 0.496; P=0.038) remained independent and significant negative predictors of seroconversion. In conclusion, in patients with chronic kidney disease vitamin D deficiency is associated with a poor antibody formation upon hepatitis B vaccination.
authors.affiliation: Department of Nephrology and Dialysis, Academic Teaching Hospital Feldkirch, Feldkirch, Austria.
authors.forename: Emanuel
authors.initials: E
authors.lastname: Zitt
authors.forename: Hannelore
authors.initials: H
authors.lastname: Sprenger-Mähr
authors.forename: Florian
authors.initials: F
authors.lastname: Knoll
authors.forename: Ulrich
authors.initials: U
authors.lastname: Neyer
authors.forename: Karl
authors.initials: K
authors.lastname: Lhotta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D006510:Hepatitis B Antibodies / Q000097:blood; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000276:immunology*; D006801:Humans; D007674:Kidney Diseases / Q000150:complications* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014808:Vitamin D Deficiency / Q000276:immunology*
chemical_list: D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines