Loss of hepatitis B immunity in hemodialysis patients acquired either naturally or after vaccination

Tsouchnikas, Ioannis; Dounousi, Evangelia; Xanthopoulou, Kiriaki; Papakonstantinou, Stamatina; Thomoglou, Vasileios; Tsakiris, Dimitrios

doi:10.5414/cnp68228

Cited by 48 publications

(33 citation statements)

References 2 publications

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“…Similarly to recent studies in which the frequency of patients who could not achieve seroconversion on the 12th and 24th month was 5-26% [2], we found a proportion of 16.8%. Duration of HD may cause accumulation of middle and high molecular weight toxins and loss of residual renal functions necessary for their clearance [6].…”

Section: Discussionsupporting

confidence: 80%

“…Compared to other studies, anti-HBs seroconversion rates in our study were better for all patients on the 12th and 24th month from the beginning of the vaccination schedule at 90.4 and 83.2%, respectively [2][3][4]. Similarly to recent studies in which the frequency of patients who could not achieve seroconversion on the 12th and 24th month was 5-26% [2], we found a proportion of 16.8%.…”

Section: Discussionsupporting

confidence: 54%

“…Increasing compliance to vaccination schedules, strict adherence to universal precaution measures, and routine utilization of erythropoietin are likely the major causes for the decreasing prevalence of HBV infection in HD patients [1]. Although vaccination is the most effective prevention method with a rate of protective antibodies in healthy subjects of 95%, its effect is significantly limited by the impact of ESRD an important decrease to a 50-80% rate of protective antibodies response [2][3][4]. Impaired humoral and cellular immune responses in HD patients are the most important reasons for the insufficient seroconversion response to HBV vaccination [1,5].…”

Section: Introductionmentioning

confidence: 98%

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Modulation of the immune response to HBV vaccination by hemodialysis membranes

et al. 2009

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 54%

Section: Introductionmentioning

confidence: 98%

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Modulation of the immune response to HBV vaccination by hemodialysis membranes

et al. 2009

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“…Despite application of the advanced vaccination regimen, as many as 23.9-55.7% dialysis patients do not respond to this primary vaccination [1,17,38,43,51], which is much more compared with 5-7% shown in the general population, which is vaccinated using the 3-dose regimen, consisting of 20-mg doses of the recombinant hepatitis B vaccine [1,2]. Additional vaccine doses lead to improvement in immunity of immunocompromised groups (HD, PD, TXT).…”

Section: Vaccination In Ckd Stagementioning

confidence: 99%

Hepatitis B vaccination in chronic kidney disease patients: a call for novel vaccines

Grzegorzewska

2014

Expert Review of Vaccines

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The protective immunization rates in response to hepatitis B vaccination in chronic kidney disease (CKD) patients are lower than response rates in the general population because of genetic and CKD-related factors as well as logistic problems with a proper providing of the recommended vaccination schedules. This review focuses on third-generation vaccines and adjuvanted vaccines commercially introduced in some countries, investigated in clinical trials, especially involving CKD patients or used only in the experimental studies. In order to improve the immunization rate, the use of third-generation vaccines (yeast-derived pre-S2/S HBV vaccines, mammalian cell-derived pre-S2/S HBV vaccines, mammalian cell-derived pre-S1/pre-S2/S HBV vaccines), novel adjuvants (AS04, AS02, phosphorothioate oligodeoxyribonucleotide, hemokinin-1, a polysaccharide based on delta inulin, nano-complex Hep-c, cyclic diguanylate) or immunostimulants for enhancement of immunogenicity of existing recombinant hepatitis B vaccines is tried to improve results of hepatitis B vaccination prior to dialysis commencement or already on renal replacement therapy.

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“…In some HBsAg-negative anti-HBcAg-positive patients, anti-HBsAg production could be enhanced or induced by vaccination when a result of anti-HBcAg testing was not known before vaccination. Patients naturally infected in the past redeveloped protective anti-HBsAg titers more easily [26,27] . In some patients with a long course of renal disease, a history of vaccination effectiveness revealed periods with or without antiHBsAg 1 10 IU/l.…”

Section: Patientsmentioning

confidence: 99%

<i>Interleukin-18</i> Promoter Polymorphism and Development of Antibodies to Surface Antigen of Hepatitis B Virus in Hemodialysis Patients

Grzegorzewska¹,

Wobszal²,

Jagodzińśki³

2011

Kidney Blood Press Res

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Background: Interleukin (IL)-18 is involved in hepatitis B virus (HBV) clearance and augments antibodies against surface antigen of HBV (anti-HBsAg) production during DNA vaccination. The IL-18 –1297C>T (rs360719) polymorphism may modulate the IL-18 expression. Aim: To determine the potential association of IL-18 –1297C>T polymorphism with development of anti-HBsAg in hemodialysis (HD) patients. Methods: The frequency of IL-18 –1297C>T alleles and genotypes was identified by polymerase chain reaction restriction fragment length polymorphism in 435 HD patients. Group 1 (n = 219) developed an anti-HBsAg titer >10 IU/l as a result of vaccination or HBV transmission. Group 2 (n = 216) included patients who did not develop an anti-HBsAg titer >10 IU/l in response to at least one full series of vaccination or HBV transmission. The significance of genotype frequency was tested using the Fisher exact test. Results: In group 1, the frequencies of –1297CC, –1297CT and –1297TT genotypes were 7.3, 39.7 and 53.0%, respectively, and in group 2 they were 1.9, 42.1 and 56.0%, respectively. The odds ratio for CC versus CT + TT was 0.239 (95% CI 0.079–0.728, p = 0.010), and for CC versus TT it was 0.240 (95% CI 0.078–0.738, p = 0.009). Conclusion: In HD patients, the IL-18 –1297CC genotype may play a role in anti-HBsAg development in response to HBV surface antigen.

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Loss of hepatitis B immunity in hemodialysis patients acquired either naturally or after vaccination

Cited by 48 publications

References 2 publications

Modulation of the immune response to HBV vaccination by hemodialysis membranes

Modulation of the immune response to HBV vaccination by hemodialysis membranes

Hepatitis B vaccination in chronic kidney disease patients: a call for novel vaccines

<i>Interleukin-18</i> Promoter Polymorphism and Development of Antibodies to Surface Antigen of Hepatitis B Virus in Hemodialysis Patients

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