title: [New vaccination protocol against hepatitis B for hemodialysis patients--a single-centre experience].
abstract: Patients with end stage renal disease (ESRD) have a reduced response to vaccination against hepatitis B infection. The aim of the study has been to determine the adequacy of immune response with new protocol of vaccination against hepatitis B infection.
  
  
  METHODS
  The study included incident hemodialysis patients since 2008 until 2011 at the Clinic of Hemodialysis of the Clinical Center of the University of Sarajevo. We started the new vaccination protocol in September 2009. New protocol implied vaccination six month before starting renal replacement therapy (RRT) and "ic" (intracutaneously) application vaccine vs. "sc" (subcutaneously) application. Vaccination was carried out for over 12 months. The follow up period lasted from 2009 to 2011.
  
  
  RESULTS
  The study included 64 patients, men were represented with 57,81% (37), and 42,19% women (27), who were divided in two groups. The first group included patients from the period from 2008 to 2009, who have been vaccinated under the old vaccination protocol, while the second group included patients with the new protocol from September 2009 to 2011. The first group had 28 patients, mean age of patients was 55,17 +/- 11.84 and mean duration of hemodialysis was 24,65 +/- 5,32 months. The second group had 36 patients, mean age of patients was 62,79 +/- 15,88 years, and mean duration of hemodialysis was 22,16 +/- 24,53 month. Neither group of patient has been previously vaccinated, nor these had positive in serum antiHBs before vaccination in second group. Five patients received a booster dose of vaccine, after which 4 showed adequate responses to anti HbS. In the first group of patients, out of total of 28 patients, 15 patients did not respond response with the adequate anti-HbS titer at the end of vaccination. In the second group of patients, out of 36 patients 31 of them responded to the vaccination with the new protocol, which was statistically significant (p<0,005). The total percentage of patients with adequate titer of antiHBs after vaccination towards a new protocol was 97.43% and the percentage of patients who required booster dose of vaccines was 12.82%.
  
  
  CONCLUSIONS
  Vaccination of patients in ESRD,six months before renal replacement therapy and intradermal application of vaccine vs. subcutaneously, improved immune response of our patients.
authors.affiliation: Clinic of Hemodialysis, Clinical Center of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina. halima.resic@undt.ba
authors.forename: Halima
authors.initials: H
authors.lastname: Resić
authors.forename: Nihad
authors.initials: N
authors.lastname: Kukavica
authors.forename: Fahrudin
authors.initials: F
authors.lastname: Masnić
authors.forename: Nejra
authors.initials: N
authors.lastname: Prohić
authors.forename: Vahidin
authors.initials: V
authors.lastname: Sahović
authors.forename: Selma
authors.initials: S
authors.lastname: Ajanović
authors.forename: Aida
authors.initials: A
authors.lastname: Corić
authors.forename: Emir
authors.initials: E
authors.lastname: Avdić
authors.forename: Dzana
authors.initials: D
authors.lastname: Helać-Cvijetić
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006509:Hepatitis B / Q000276:immunology / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006801:Humans; D007271:Injections, Intradermal; D007676:Kidney Failure, Chronic / Q000276:immunology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D055815:Young Adult
chemical_list: D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines