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Response rates to HB vaccine in CKD stages 3-4 and hemodialysis patients
Mohammad H Ghadiani1, Shahin Besharati, Nouraddin Mousavinasab
1Department of Nephrology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
Chronic kidney disease (CKD) patients in stages 3-4 showed a higher Hepatitis B (HB) vaccine response rate compared to hemodialysis patients. Older age and advanced CKD were associated with lower seroconversion rates.
Area of Science:
- Nephrology
- Immunology
- Vaccinology
Background:
- Hepatitis B virus (HBV) infection poses a significant risk to the chronic kidney disease (CKD) population.
- Assessing the immune response to Hepatitis B (HB) vaccination is crucial for vulnerable patient groups.
Purpose of the Study:
- To compare the seroconversion rates of the HB vaccine in patients with CKD stages 3-4 versus those on hemodialysis (CKD stage-5; HD) and healthy medical staff.
- To evaluate factors influencing vaccine response in different CKD populations.
Main Methods:
- A study involving 303 participants divided into three groups: HD patients (Group A), CKD stages 3-4 patients (Group B), and healthy medical staff (Group C).
- Vaccination schedules varied: Group A received four 40μg doses, Group B received three 40μg doses, and Group C received three 20μg doses.
- Seroconversion and seroprotection rates were assessed three months post-vaccination.
Main Results:
- Seroconversion rates were significantly higher in CKD stages 3-4 patients (89.7%) and medical staff (96.2%) compared to HD patients (44.3%).
- CKD stages 3-4 patients demonstrated a better response than dialysis patients (P < 0.001), with no significant difference compared to medical staff (P = 0.064).
- Advanced CKD and older age were linked to reduced seroconversion rates (OR: 0.09 and 0.39, respectively).
Conclusions:
- CKD stages 3-4 patients achieve a higher HB vaccine seroconversion rate than HD patients, particularly with higher vaccine dosages.
- Further research is recommended to determine optimal HB vaccine dosages for CKD populations.
- Age and CKD progression negatively impact HB vaccine efficacy.
Background:
Hepatitis-B virus (HBV) infection is a big problem in chronic kidney disease (CKD) population. We attempted to compare the response rate to HB vaccine in CKD stages3-4 patients with that in hemodialysis (CKD stage-5; HD patients) and medical staff.
Materials And Methods:
Three hundred and three participants were enrolled into the study to test the seroconversion rate after vaccination. Participants formed three groups: Group-A:HD patients, Group-B: diagnosed with CKD stages 3-4, and Group-C: healthy medical staff. CKD stages 3-4 participants were vaccinated from February to November 2010. HD patients were vaccinated at the time of initial HD. While the medical staffs were vaccinated at the time they started working at the hospital. Group-A, Group-B and Group-C received four 40μg (in 0,1,2 and 6 months), three 40μg (0, 1 and 6 months) and three 20μg (0, 1and 6 months) doses of HB vaccine, respectively. Three months after completion of the vaccination schedule, seroconversion and seroprotection rates in each group were investigated.
Results:
Seroconversion rates were 44.3%, 89.7%, and 96.2% for groups A, B and C, respectively. CKD stages 3-4 patients showed higher response rate than dialysis patients [χ(2)(1):30.6, P <0.001]. But a significant difference in the seroconversion rate between CKD stages 3-4 patients and medical staffs was not observed [χ(2)(1):3.4, P = 0.064]. Multivariate analyses showed patients with more advanced CKD and who were older had less seroconversion rates [odds ratio: 0.09(95%CI: 0.04 - 0.25) and [odds ratio: 0.39(95% CI: 0.18-0.85)], respectively. But sex was not associated with seroconversion (P>0.05).
Conclusion:
Stages 3-4 patients with higher dosages of routine HB vaccine had higher seroconversion rate than HD patients. Future studies should evaluate the recommended dosage of HB vaccine among these patients.
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