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HBV infection in hemodialysis patients: monitoring and prevention
P Carletti1, L Bibiano, R Boggi
1Divisione di Nefrologia e Dialisi, Ospedale Regionale, Torrette, Ancona, Italy.
Nephron
|January 1, 1992
Insights
Hepatitis B virus (HBV) infection is prevalent in dialysis patients. A 4-dose vaccination strategy and regular antibody testing can improve immunization rates and manage HBV immunity effectively.
Area of Science:
- Nephrology
- Hepatology
- Immunology
Background:
- Hepatitis B virus (HBV) infection poses a significant risk to patients undergoing hemodialysis.
- Previous studies indicated a substantial prevalence of prior HBV infection and chronic carriage among dialysis populations.
Purpose of the Study:
- To evaluate the prevalence of HBV infection markers in dialysis patients.
- To assess the effectiveness of a 3-dose vaccination regimen.
- To propose an improved vaccination strategy and monitoring protocol.
Main Methods:
- A cohort of 174 dialysis patients was studied between 1986 and 1991.
- Prevalence of previous HBV infection and chronic carriers was determined.
- Immunization rates after a 3-dose vaccination were assessed.
Main Results:
- The prevalence of previous HBV infection was 33.3%, with 4.6% identified as chronic carriers.
- The immunization rate following a standard 3-dose vaccination was 63%.
- A revised 4-dose vaccination protocol was proposed in 1991.
Conclusions:
- Dialysis patients exhibit a high burden of HBV infection.
- The standard 3-dose vaccination shows moderate efficacy.
- A 4-dose regimen combined with 6-monthly anti-HBs monitoring is recommended for optimal HBV prevention in dialysis patients.
Abstract:
From 1986 to 91, 174 dialysis patients were studied. The prevalence of previous HBV infection and of chronic carriers was 33.3 and 4.6%, respectively. Immunization rate after vaccination (3 doses) was 63%. In 1991, we proposed a vaccination with 4 doses and recommend a 6-monthly anti-HBs evaluation to assess the timing of any booster dose needed.