Hepatitis B vaccination in human immunodeficiency virus-infected adults receiving hemodialysis

Ahuja, Tejinder S.; Kumar, Suman; Mansoury, Hadi; Rodriguez, Hector J.; Kuo, Yong Fang

doi:10.1111/j.1523-1755.2005.00180.x

Cited by 31 publications

(18 citation statements)

References 31 publications

(37 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many clinical factors may be responsible for the lower seroconversion rate to recombinant hepatitis B vaccine in patients with CKD including older age [25], nutritional status [26], HIV infection [27], possession of the major histocompatibility complex haplotype HLA-B [28], and diabetes mellitus [29], among others. Controversial evidence exists about the effect of rHuEPO therapy on the outcome of the immune response to four doses of recombinant HBV vaccine in a CKD population.…”

Section: Discussionmentioning

confidence: 99%

Erythropoietin Use and Immunogenicity of Hepatitis B Virus Vaccine in Chronic Kidney Disease Patients: A Meta-Analysis

Fabrizi

Dixit

Martin

2012

Kidney Blood Press Res

View full text Add to dashboard Cite

Background: It is known that the immunogenicity of hepatitis B virus (HBV) vaccine is lower in uremic patients than healthy subjects. Numerous inherited or acquired factors have been implicated in this lowered response, and the high frequency of recombinant human erythropoietin use among patients on maintenance dialysis has been suggested to play a pivotal role. However, the impact of therapy with recombinant erythropoietin on the immune response to HBV vaccine in patients with chronic kidney disease (CKD) is not appropriately detailed. Aim: To evaluate the influence of human recombinant erythropoietin therapy on the immunological response to HBV vaccine in CKD patients by performing a systematic review of the literature with a meta-analysis of clinical studies. Methods: We used the random-effects model of DerSimonian and Laird with heterogeneity and sensitivity analyses. The end-point of interest was the rate of patients showing seroprotective anti-hepatitis B titers at completion of a hepatitis B vaccine schedule among human erythropoietin users versus those who did not receive the drug in a CKD population. Results: We identified 11 studies involving 862 unique patients with CKD. Aggregation of study results did not show a significant increase in response rates among erythropoietin user versus non-user patients (pooled odds ratio = 1.431; 95% CI 0.954; 2.146), according to a random-effects model. No heterogeneity was found, the p value was 0.1 for our test of study heterogeneity (Q = 14.147). Stratified analysis in various subgroups of interest did not significantly change these findings. Conclusions: Our meta-analysis showed no link between immunological response to HBV vaccine and therapy with human recombinant erythropoietin among individuals on long-term dialysis. We suggest the use of recombinant vaccine towards hepatitis B in patients on regular dialysis irrespective of erythropoietin treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

Erythropoietin Use and Immunogenicity of Hepatitis B Virus Vaccine in Chronic Kidney Disease Patients: A Meta-Analysis

Fabrizi

Dixit

Martin

2012

Kidney Blood Press Res

View full text Add to dashboard Cite

show abstract

“…One limitation of our study is the uncertain generalizability given the relatively low hemoglobin levels of the patients. Of note, it has been suggested that higher hemoglobin levels may have favorable effects on hepatitis B vaccine immunogenicity [18,19,20]. …”

Section: Discussionmentioning

confidence: 99%

Antibody Response to Hepatitis B Vaccine in End-Stage Renal Disease Patients

Chow¹,

Law²,

Leung³

et al. 2006

Nephron Clin Pract

View full text Add to dashboard Cite

Background: This retrospective and comparative study evaluated the relationship between different factors which may contribute to suboptimal immunological response to intramuscular recombinant hepatitis B vaccine in end-stage renal disease (ESRD) subjects. Methods: From a cohort of 64 dialysis subjects undergoing primary vaccination with Engerix-B^®, we determined the predictive factors that impinged on patients’ response to vaccine, as defined by anti-HBs level ≧10 mIU/l. Dose efficacy was further evaluated by comparing three historical cohorts vaccinated by the regimens of 20, 40 and 80 µg/dose, respectively. Results: We identified 64 ESRD patients (mean age 43 ± 12 years, 81% receiving peritoneal dialysis) who received primary vaccination from April 1997 to September 2004. Median follow-up was 6.5 years. They achieved 81% seroconversion rate. Older age, diabetes mellitus, obesity and low Engerix-B dose were risk factors of inadequate anti-HBs response by univariate analysis. By stepwise logistic regression analysis, hepatitis B vaccine dose was the only independent predictive factor of impaired antibody response. An Engerix-B vaccine dose of 20 µg was associated with more than tenfold increase in risk of non-response to hepatitis B vaccine (hazards ratio 32.2 (95% CI 3.85–250.0)). Immunization with 80 µg of Engerix-B increased the likelihood of persistent protective antibody (log-rank test, p = 0.014). Immunization with Engerix-B 80-µg dose is estimated to prevent one extra ESRD subject who would lose seroprotective anti-HBs level at 1 year for every 5.6 patients treated (number needed to treat to benefit, 5.6 (95% CI 5.4–5.8)). Conclusions: Our results suggest the potential for the three-dose schedule of recombinant vaccine Engerix-B 80 µg to prolong the immune response among ESRD population.

show abstract

“…For example, Sasaki et al [29] obtained a 72% response rate with a double-dose regimen (40 μg per dose) of ENGERIX-B ® , plus an adjuvant, Rh granulocyte-macrophage colony-stimulating factor (GM-CSF; Novartis Pharmaceuticals, Basel, Switzerland) [29]. A recent clinical trial in HIV-positive patients receiving hemodialysis demonstrated a 50% response rate to vaccine [30]. As HIV affects CD4+ cell count, cell function, and Th1/Th2 balance, the observed response rates to vaccine are not surprising.…”

Section: Vaccine Efficacy In Hiv-positive Patientsmentioning

confidence: 96%

Vaccination against hepatitis a and b in patients with hiv

Shire

Sherman

2006

Curr hepatitis rep

View full text Add to dashboard Cite

Hepatitis B vaccination in human immunodeficiency virus-infected adults receiving hemodialysis

Abstract: Hepatitis B vaccination should be offered to all HIV-infected ESRD patients because over half of the patients with HIV and ESRD can develop protective antibodies.

Cited by 31 publications

References 31 publications

Erythropoietin Use and Immunogenicity of Hepatitis B Virus Vaccine in Chronic Kidney Disease Patients: A Meta-Analysis

Erythropoietin Use and Immunogenicity of Hepatitis B Virus Vaccine in Chronic Kidney Disease Patients: A Meta-Analysis

Antibody Response to Hepatitis B Vaccine in End-Stage Renal Disease Patients

Vaccination against hepatitis a and b in patients with hiv

Contact Info

Product

Resources

About