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Efficient haemodialysis improves the response to hepatitis B virus vaccination
Vedran Kovacic1, Milenka Sain, Valentina Vukman
1Centre for Touristic and Domestic Haemodialysis, Health Centre, Trogir, Croatia. vedkovac@inet.hr
Background:
As patients on chronic haemodialysis (PCHD) elicit a weaker response to vaccination with recombinant hepatitis B virus surface antigen (HBsAg), we conducted this study to see how dialysis efficacy affects response to hepatitis B virus (HBV) vaccination.
Methods:
Study subjects consisted of 30 PCHD. All subjects were vaccinated with 4 x 40 microg HBsAg i.m. at 0, 1, 2, and 6 months. If a subject had an HBsAg antibody (HBsAb) level <10 IU/l after vaccination, he or she received a booster dose. Subjects were divided into groups according to the level of HBsAb: non-responders (<10 IU/l), weak responders (10-100 IU/l), and good responders (>100 IU/l).
Results:
The group of responders had a significantly more efficient dialysis (Kt/V) than the group of non-responders (p = 0.027). This difference was not observed between groups of non-responders and weak responders. The group of good responders had a significantly better Kt/V than the group of non-responders (p = 0.012). Good responders had a significantly better Kt/V than weak responders (p = 0.019). Kt/V values showed a significantly positive correlation with the HBsAb level (r = 0.47; p = 0.006).
Conclusions:
The HBV vaccination reaction was weaker in PCHD with inefficient dialysis. Efficient haemodialysis significantly improves the response to vaccination with recombinant HBsAg.