This article is more than 5 years old. Information may no longer be current.
Chronic kidney disease led to poor response to HBV vaccine
Click Here to Manage Email Alerts
Hemodialysis patients with chronic kidney disease produce inferior immune responses to hepatitis B vaccine, with 41% of dialysis patients classified as nonresponders, results of a recent study revealed.
Researchers evaluated 83 patients undergoing treatment at two hemodialysis clinics in southeastern Brazil in 2009 and 2010. The patients were initiating hemodialysis treatment 30 days after completing a HBV vaccination schedule. The vaccines administered utilized recombinant DNA technology from GlaxoSmithKline (Engerix-B) or by the Butantan Institute of São Paulo. Vaccines were given in double doses of 40 mg each based on the recommendations of the National Immunization Program. The dialysis patients were stratified by age, etiology of renal disease (primary cause of disease), smoking status and the presence or absence of comorbidities, such as diabetes, hypertension or autoimmune disease. Blood was taken every 2 months for 1 year to test for antibody titers. Testing began 1 month after completion of the vaccination schedule.
The researchers found that 41% of patients, labeled “nonresponders,” had antibody titers <10 mIU/mL; 21.7%, classified as “poor responders,” had antibody titers of 10 mIU/mL to 100 mIU/mL; and 37.3%, labeled “good responders,” had antibody titers >100 mIU/mL. A poorer response to vaccination was observed in patients with diabetes and/or hypertension.
Moreover, all study participants showed a reduction in antibody titers during the observation period, and 11.1% of those in the poor responders group were negative for antibodies against the HBV surface antigen by the 6-month follow-up.
The researchers said, based on these findings, different hepatitis B vaccination protocols should be used for this vulnerable population.
“A new serologic test should be performed each year for individuals who respond adequately, whereas a booster dose should be offered to those with antibody titers below 10 mIU/mL,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts