title: A randomized pilot trial on the effect of granulocyte-colony stimulating factor on antibody response in hemodialysis patients who had not responded to routine hepatitis B virus vaccine.
abstract: BACKGROUND
  Various strategies have been applied to improve the response to hepatitis B virus (HBV) vaccination in hemodialysis patients.
  
  
  OBJECTIVE
  The present study was under taken to compare the seroconversion rate of hemodialysis patients who had not respond to 3 intramuscular (IM) doses (40 μg each) of HBV vaccine , after a fourth IM dose (40 μg) of HBV vaccine that was administered alone or with subcutaneous granulocyte-colony stimulating factor (G-CSF) (5 μg/kg).
  
  
  METHODS
  Twenty six hemodialysis patients who had not responded to 3 IM injections of HBV vaccine were randomized into 2 groups: Group 1 received a booster dose of 40 μg HBV vaccine IM, group 2 received a booster dose of 40 μg HBV vaccine IM plus 5 μg/kg subcutaneous G-CSF. Antibody to hepatitis B surface antigen was measured 1 month after the booster dose.
  
  
  RESULTS
  Seroconversion rate in group 1 was 40%. There was a trend towards a higher seroconversion rate at 60% in group 2 patients; however, because of the small number of patients it did not reach statistical significance.
  
  
  CONCLUSIONS
  Larger number of patients and other innovative strategies should be applied for vaccination of this group of patients. More prolonged follow up of the patients is needed to evaluate the duration of protection induced by each method of vaccination.
authors: Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Jamshid
authors: J
authors: Roozbeh
authors: Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Kamran
authors: K
authors: Bagheri-Lankarani
authors: Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Poopak
authors: P
authors: Mohaghegh
authors: Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Ghanbarali
authors: G
authors: Raeesjalali
authors: Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Saeed
authors: S
authors: Behzadi
authors: Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Mehdi
authors: M
authors: Sagheb
authors: Department of Dental Public Health, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Mehrdad
authors: M
authors: Vossoughi
authors: Division of Nephrology, Saint Louis University, School of Medicine, Saint Louis, Missouri, USA.
authors: Bahar
authors: B
authors: Bastani
keywords: Granulocyte-colony stimulating factor; Granulocyte-macrophage colonystimulating; Hemodialysis; Hepatitis B; Vaccination