Hepatitis B Vaccines in Patients with Chronic Renal Failure Before Dialysis

Abstract

Hepatitis B remains a significant risk to patients receiving chronic hemodialysis, but no certain method of prevention has been identified. We tested two vaccines, plasma-derived vaccine (40-micrograms dose) and recombinant-derived vaccine (40-micrograms and 20-micrograms doses), in 61 patients with chronic renal failure who were not yet dependent on dialysis. Patients were followed up clinically and with laboratory tests of kidney function and hepatitis B virus serology for one year. Significantly more recipients of plasma-derived vaccine responded to vaccination; they also achieved a higher titer of antibody to hepatitis B virus than did recipients of recombinant-derived vaccine when evaluated at 6, 7, 9, and 12 mo after vaccination. No serious side effects were observed with any vaccine preparation, nor were excessive adverse effects observed in any group. Compared with the dialysis patients previously studied, patients with renal failure who were not yet dependent on dialysis responded more favorably to the hepatitis B virus vaccine.

Preventing Hepatitis B and Hepatitis C Virus Infections in End–Stage Renal Disease Patients: Back to Basics

“…2,8 Higher rates of protection can be achieved by vaccinating end-stage renal disease patients before they begin dialysis. 9 Despite the success of long-standing infection control practices for preventing HBV infections among chronic hemodialysis patients, HBV transmission in this setting remains problematic. Recently, five hepatitis B outbreaks in chronic hemodialysis units were reported during 1 year in the United States.…”

Hemodiyaliz ve periton diyalizi hastalarının Hepatit B aşısına karşı cevaplarının karşılaştırılması

“…Bu hastalarda T-lenfosit ve antijen sunan hücrelerde fonksiyon bozukluğu olduğu düşünülmektedir [13][14][15]. Bazı çalışmalarda diyalizsiz takip edilen KBH hastalarında daha yüksek antikor cevabının elde edilmesi, böbrek yetmezliğinin şiddeti ile immün cevabın korele olduğunu düşündürmektedir [13,16,17]. KBH hastalarında hepatit B aşılamasına yeterli cevap alınabilmesi için yüksek doz ve daha sık enjeksiyon yapılması önerilmiştir [10,18].…”

Hepatitis B virus infection and related factors in hemodialysis patients in China – systematic review and meta-analysis

“…Recommendations include increasing the vaccine dose and/or the frequency of vaccination to maintain high levels of anti-HBs. Seaworth et al 66 reported that recombinant HBV vaccine given intramuscularly in the deltoid muscle in a three-dose schedule at 0, 1, and 6 months provided a seroconversion rate of 42%. After the dose was increased to 40 μg, the anti-HBs seroconversion rate increased to 69%.…”