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Hepatitis B virus infection and vaccination in children undergoing hemodialysis
Insights
Hepatitis B virus (HBV) infection is common in children on hemodialysis. Vaccination against HBV is safe and effective, inducing high antibody levels similar to healthy adults.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Immunology
Background:
- Hepatitis B virus (HBV) infection poses a significant risk for patients with severe chronic renal failure undergoing hemodialysis.
- Prevalence of HBV markers was 66.7% and HBsAg was 13.0% in pediatric hemodialysis patients.
Purpose of the Study:
- To evaluate the efficacy and safety of hepatitis B vaccine in children on hemodialysis.
- To assess the immune response to HBV vaccination in this vulnerable population.
Main Methods:
- Fifty-four pediatric patients (2-18 years) on hemodialysis were assessed for HBV markers.
- Eighteen children without prior HBV infection were vaccinated with a standard HBV vaccine regimen.
- Humoral immune response, including anti-HBs titers, was measured post-vaccination.
Main Results:
- The HBV vaccine was well tolerated in pediatric hemodialysis patients.
- A high seroconversion rate of 87.5% was achieved, with geometric mean anti-HBs titers exceeding 4,000 Ausab Units.
- No correlation was found between immune response intensity and patient demographics or dialysis duration.
Conclusions:
- Hepatitis B vaccination is safe and highly immunogenic in children with chronic renal failure on hemodialysis.
- The vaccine elicits protective antibody levels comparable to those in healthy adults, reducing HBV infection risk.
Abstract:
Among 54 patients, between 2 and 18 years of age, submitted to hemodialysis due to severe chronic renal failure, the prevalence of hepatitis B virus markers was 66.7% and that of HBsAg was 13.0%. Eighteen children, with no evidence of hepatitis B virus infection, were vaccinated. Following three vaccine injections, only 2 patients did not respond and a third one developed low anti-HBs titers. The vaccine was well tolerated. No relationship was observed between the intensity of the humoral immune response and age, sex, type of renal disease and time on dialysis. Seroconversion rates (87.5%) and geometric means of anti-HBs titers (greater than 4 000 Ausab Units) of these patients are similar to those observed following vaccination of healthy adults.