Responsiveness to Hepatitis B Vaccine in Immunocompromised Patients by Doubling the Dose Scheduling

Abstract

The protective efficacy of three schedules of a recombinant hepatitis B vaccine was evaluated in 42 patients undergoing dialysis at a teaching hospital. The rate of seroconversion after vaccination was highest (82.3%) among the recipients of three 20-μg doses (i.e. double the conventional dose for healthy adult) at 0, 1 and 2 months (group II). The response was satisfactory (80%) among the recipients of three 20-μg doses at 0, 1 and 6 months (group III) but was lowest with the single dose schedule of three 10-μg doses at 0, 1 and 2 months (group I). Seroconverters from all the three groups received a booster dose (each equal to his scheduled dose) at 12 months. Those who did not seroconvert from groups I and II were shifted to group III. The rate of seroconversion was higher in female (88.9%) than in male patients (66.7%) and in younger patients less than 30 years (83.3%) than in elderly patients more than 50 years. Patients undergoing peritoneal dialysis also responded much better (93.3%) than the hemodialysis patients (66.7%). In conclusion, a schedule of double the conventional dose of the vaccination for healthy adults at 0, 1, 2, and 12 months seems to give a better seroconversion and higher response to the HB vaccine, but a further large-scale study is needed to confirm this finding and also to look into the difference in response between male and female, younger and older patients and the difference in response between HD and PD patients.

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

“…We provide evidence for the close relation between the immunogenicity and other non-modifiable host factors, which are consistent with those of previously published studies that showed impaired immune response to hepatitis B virus vaccine in subjects with older age [5,6,7,8,9,10], obesity [9, 11, 12] and diabetes mellitus [13, 14]. The hepatitis B antibody response rate had also been shown to diminish with increasing severity of renal failure [14, 15] and ineffective dialysis [16].…”

Antibody response following Hepatitis B vaccination in peritoneal dialysis patients: does normalized urea clearance matter?

“…In the present study, we found an overall response rate of 84.8%, which is comparable to the rates reported in the literature for peritoneal dialysis patients (53% to 93.3%) 2,10,11,17,18. Delivered clearance measured by weekly peritoneal Kt/V, total clearance measured by weekly total Kt/V, and residual GFR did not predict response to HBV vaccination in the study's patients treated with CAPD.…”

Serological and Vaccination Profile of Hemodialysis Patients during an Outbreak of Hepatitis B Virus Infection

“…The OR were not very different in the univariate and multivariate analysis, but the statistical significance was lost due to the small numbers. Several studies have demonstrated associations of gender, age, HD time, HCV infection, and number of vaccine doses with nonresponsiveness to HBV vaccine [17, 21, 22, 23]. Increased age has been shown to decrease vaccine response rate not only in healthy individuals but also in HD patients [23, 24, 25].…”