A randomized controlled trial of two schedules of hepatitis B vaccination in predialysed chronic renal failure patients.
BACKGROUND
Patients with chronic renal disease should be vaccinated as soon as dialysis is forestalled, and this could improve the seroconversion of hepatitis B vaccination.


OBJECTIVE
In this study, we aimed to compare seroconversion and immune response rates using 4 doses of 40 μg and 3 doses of 20 μg Euvax B recombinant Hepatitis B surface Antigen (HBs Ag) vaccine administered to predialysis patients with chronic kidney disease (CKD).


METHODS
In an open, randomized clinical trial, we compared seroconversion rates in 51 predialysis patients with mild and moderate chronic renal failure who received either 4 doses of 40 μg or 3 doses of 20 μg of Euvax B recombinant hepatitis B vaccine administered at 0, 1, 2, 6 and 0, 1, 6 months, respectively.


RESULTS
Differences in seroconversion rates after 4 doses of 40 μg (80.88%) compared to 3 doses of 20 μg (92%) were not significant (P = 0.4124). The mean HBs antibody level after 4 doses of 40 μg at 0, 1, 2, and 6 months (182.2 ± 286.7) was significantly higher than that after 3 doses of 40 μg at 0,1, and 6 months (96.9 ± 192.1) (P = 0.004). Seroconversion after 4 doses of 40 μg (80.8%) was also significantly higher than that after 3 doses of 40 μg (77%) (P = 0.004). Multivariable analysis showed that none of the variables contributed to seroconversion.


CONCLUSIONS
We found that 4 doses of 40 μg did not lead to significantly more seroconversion than 3 doses of 20 μg.
Nephrology Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IR Iran.
Farokhlagha
F
Ahmadi
Morteza
M
Ramezani
Effat
E
Razeghi
Neda
N
Ranjbarnovin
Zahra
Z
Khazaeipour