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Hepatitis B Immunization Status in Children with Chronic Kidney Disease: Experience at a Single Center, Egypt

Doaa Mohammed Youssef1, Amal S El-Shal2,3, Rabab M Elbehidy1

  • 1Pediatrics Department, Faculty of Human Medicine, Zagazig University, Zagazig 44519, Egypt.

Journal of Clinical Medicine
|March 11, 2023
PubMed

Insights

Children on hemodialysis (HD) show poor response to the hepatitis B virus (HBV) vaccine. Longer dialysis duration and hepatitis C virus (HCV) infection significantly impact vaccine effectiveness in these pediatric patients.

Area of Science:

  • Pediatric Nephrology
  • Immunology
  • Infectious Diseases

Background:

  • Children with chronic kidney disease (CKD) on hemodialysis (HD) face a high risk of hepatitis B virus (HBV) infection.
  • A significant proportion of these children exhibit a non- or hypo-response to the HBV vaccine, necessitating investigation into contributing factors.

Purpose of the Study:

  • To determine the pattern of HBV vaccination response in pediatric patients undergoing HD.
  • To analyze the influence of clinical and biomedical factors on the immunological response to HB vaccination in this vulnerable population.

Main Methods:

  • A cross-sectional study involving 74 children (aged 3-18 years) on maintenance HD.
  • Clinical examinations and laboratory investigations were conducted, including assessment of hepatitis C virus (HCV) antibody status and HBV vaccine response (anti-HBs levels).

Main Results:

  • 70% of children on HD were non-/hypo-responders (≤100 IU/mL) to the HBV vaccine.
  • Hepatitis C virus (HCV) antibody positivity (33.8%) and dialysis duration exceeding 5 years were significantly associated with non-/hypo-response.
  • Sex, dialysis duration, and HCV infection were identified as significant factors influencing vaccine response.

Conclusions:

  • Pediatric patients with CKD on regular HD demonstrate suboptimal seroconversion rates following HBV vaccination.
  • Dialysis duration and concurrent HCV infection are critical independent predictors of poor immunological response to the HBV vaccine in children on HD.

Keywords:
childrenhemodialysishepatitis B virusseroconversionvaccine

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