title: Sex bias in response to hepatitis B vaccination in end-stage renal disease patients: Meta-analysis.
abstract: OBJECTIVE
  To systematically review the literature for studies investigating the potential effect of gender of dialysis patients on the immunogenicity of hepatitis B virus vaccines.
  
  
  METHODS
  Literature searches were conducted by the MEDLINE and Google Scholar. The key words used included "hepatitis B (HB)", "vaccine", "dialysis", "hemodialysis", "sex", "male" and "female". Data of seroresponse to HB vaccine in clinical trials regarding sex of the recipients have been achieved and analyzed. Finally data from 19 clinical trials have been pooled and analyzed.
  
  
  RESULTS
  Analysis of response to HB vaccination in our dialysis population showed males significantly respond less to hepatitis B vaccination (P = 0.002, Z = 3.08) with no significant heterogeneity detected [P = 0.766; heterogeneity χ(2) = 14.30 (df = 19); I (2) = 0%]. A reanalysis of the pooled data was conducted regarding the dialysis mode to evaluate potential differential impact of sex on HB vaccine response. Hemodialysis was the only subgroup that showed a significant difference regarding dialysis mode in response to HB vaccination regarding sex (P = 0.042, Z = 2.03).
  
  
  CONCLUSIONS
  This Meta-analysis showed significant effect for the sex of chronic kidney disease and dialysis patients on the immunogenicity of HB vaccine. This sex discrimination was most prominent among hemodialysis patients.
authors.affiliation: Hossein Khedmat, Aghdas Aghaei, Mohammad Ebrahim Ghamar-Chehreh, Baqiyatallah Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences, Tehran 14155-3651, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Khedmat
authors.affiliation: Hossein Khedmat, Aghdas Aghaei, Mohammad Ebrahim Ghamar-Chehreh, Baqiyatallah Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences, Tehran 14155-3651, Iran.
authors.forename: Aghdas
authors.initials: A
authors.lastname: Aghaei
authors.affiliation: Hossein Khedmat, Aghdas Aghaei, Mohammad Ebrahim Ghamar-Chehreh, Baqiyatallah Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences, Tehran 14155-3651, Iran.
authors.forename: Mohammad Ebrahim
authors.initials: ME
authors.lastname: Ghamar-Chehreh
authors.affiliation: Hossein Khedmat, Aghdas Aghaei, Mohammad Ebrahim Ghamar-Chehreh, Baqiyatallah Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences, Tehran 14155-3651, Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Agah
keywords: Dialysis patients; Gender; Hepatitis B virus; Hepatitis B virus vaccination; Immunogenicity; Sex