[Does efficient haemodialysis improve the response to hepatitis B virus vaccination?]

Patients on chronic haemodialysis (PCHD) elicit a weaker response to vaccination with recombinant hepatitis B virus vaccine. We conducted this study to demonstrate factors which could affect response to HBV vaccination. Subjects were 30 PCHD. All subjects were vaccinated with 4x40 microg recombinant HBV vaccine given i.m. at intervals 0, 1, 2, and 6 months. Subjects were divided into groups according to the level of antibody (HbsAb): nonresponders (<10 i.u./L), weak responders (10-100 i.u./L), and good responders (>100 i.u./L). A statistically significant difference was found between responders and nonresponders in the dialysis efficiency (Kt/V) (p=0.027). A multivariate analysis of variance unveiled a significant difference between the groups of nonresponders, weak and good responders in the Kt/V value (p=0.028), and the subject age (p=0.080). Positive correlation between HBsAb level and Kt/V (r=0.46; p=0.006), and negative correlations between HBsAb and: subject age (r=-0.40; p=0.026), existence of diabetes (r=-0.32; p=0.041), blood leukocyte number (r=-0.31; p=0.050), and body mass index (r=-0.42; p=0.011) were demonstrated. A multiple linear regression analysis demonstrated the most significant positive correlation between HBsAb level and the Kt/V values (p=0.002), and negative correlation between HBsAb level and the subject age (p=0.047). The HBV vaccination response was weaker in PCHD with inefficient dialysis and older age. Efficient haemodialysis most significantly improves the response to vaccination.