Accelerated HBV vaccine regimen may aid rapid seroconversion in adults with CKD
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Key takeaways:
- At 12 weeks, the accelerated group had higher rates of seroconversion.
- Findings suggest acceleration may be useful before hemodialysis or kidney transplantation.
An accelerated hepatitis B virus vaccine regimen may be effective in reaching rapid seroconversion for adults with advanced chronic kidney disease, according to a study.
The results suggest this method may be beneficial before hemodialysis or kidney transplantation, researchers led by Jathurong Kittrakulrat, MD, of the department of medicine and faculty of medicine at Chulalongkorn University in Bangkok, Thailand, wrote.
“Hepatitis B virus (HBV) vaccination is crucial for seronegative advanced (CKD) patients, for protection during dialysis while preparing for transplantation,” the authors wrote. “A standard regimen for HBV vaccination requires 24 weeks, [whereas] ... an accelerated HBV vaccination regimen completed within 8 weeks has shown early effective seroconversion.”
Researchers conducted a controlled trial to determine the efficacy and safety of standard HBV vaccination regimen vs. the accelerated treatment, in which 133 patients were randomly selected to receive either four doses of Engerix B (GlaxoSmithKline Biologicals), administered at 0, 4, 8 and 24 weeks; or the fast-tracked option of four doses at 0, 1, 2 and 8 weeks.
Participants included those with an eGFR below 30 mL/min/1.73 m2 and patients on dialysis. The main outcome was the seroconversion rate, defined as the presence of anti-HBs antibodies of 10 IU/L or higher. Seroconversion was measured at 12, 28 and 52 weeks.
At 12 weeks, the 65 patients in the accelerated group had higher rates of seroconversion vs. the 68 patients in the standard group. In the intention-to-treat analysis, the seroconversion rate in the accelerated group was 83.08%, while that figure was 63.24% in the standard group (P = .01).
Additionally, in the per-protocol analysis of 125 patients, the accelerated group had a seroconversion rate of 85.71% vs. 69.35% in the standard group (P = 0.03). At 28 and 52 weeks, the rates were similar between the groups.
“The accelerated HBV vaccination regimen demonstrated significantly higher seroconversion rates ... compared with standard HBV vaccination,” according to Kittrakulrat and colleagues. “This approach can be considered as an effective option for achieving rapid seroconversion, particularly before hemodialysis initiation and in preparation for kidney transplantation.”
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