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Intradermal hepatitis B vaccination in patients with advanced chronic renal failure: immunogenicity and follow-up
E O Morais1, M R Resende, A M Oliveira
1Disciplina de Infectologia, Departamento de Clínica Médica, Faculdade de Ciências Médicas, Unicamp, Campinas, SP, Brazil.
Background:
Patients undergoing dialysis usually have a poor response to conventional hepatitis B vaccination.
Aim:
To observe the effects of intradermal hepatitis B (HB) vaccination in a 13-month prospective study of adult patients with end-stage renal failure. The patients were with or without previous hepatitis B vaccination, but all had antibody titres <10 mUI/mL.
Methods:
Patients were allotted to two groups: previous hepatitis B virus vaccination and no previous hepatitis B virus vaccination or anti-HBs titres <10 mUI/mL. Patients in both groups received 16 i.d. injections of 0.1 mL of hepatitis B virus vaccine over an eight-week period. Patients had antibody titres assessed before vaccination, 1 month after and every 3 months for a year. Antibody titres >/=10 mUI/mL were considered protective.
Results:
Seventy patients completed the protocol. Protective titres were elicited in 82% of each group. Age, time under dialysis, diabetes, smoking and body-mass index were not associated with seroconversion. Persistent protective titres >12 months occurred in 27 (58.7%). Adverse events were trivial.
Conclusion:
Intradermal hepatitis B virus vaccination is an alternative in end-stage renal failure.
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