Response rates to HB vaccine in CKD 3-4 and hemodialysis patients

Abstract

• Background: Hepatitis-B virus (HBV) infection is a big problem in chronic kidney disease (CKD) population. We attempted to compare the response rate to HB vaccine in CKD stages3-4 patients with that in hemodialysis (CKD stage-5; HD patients) and medical staff.
• Materials and Methods: Three hundred and three participants were enrolled into the study to test the seroconversion rate after vaccination. Participants formed three groups: GroupA:HD patients, GroupB: diagnosed with CKD stages34, and GroupC: healthy medical staff. CKD stages34 participants were vaccinated from February to November 2010. HD patients were vaccinated at the time of initial HD and medical staff at the time of being hired. GroupA, GroupB and GroupC received four 40μg(in 0,1,2 and 6 months), three 40μg(0, 1 and 6 months) and three 20μg(0, 1and 6 months) doses of HB vaccine, respectively. Three months after completion of the vaccination schedule, seroconversion and seroprotection rates in each group were investigated.
• Results: Seroconversion rates were 44.3%, 89.7%, and 96.2% for groups A, B and C, respectively. CKD stages 34 patients showed higher response rate than dialysis patients [χ2(1):30.6, P <0.001]. But a significant difference in the seroconversion rate between CKD stages34 patients and medical staffs was not observed [χ2(1):3.4, P = 0.064]. Multivariate analyses showed patients with more advanced CKD and who were older had less seroconversion rates [odds ratio: 0.09(95%CI: 0.040.25) and [odds ratio: 0.39(95% CI: 0.180.85)], respectively. But sex was not associated with seroconversion (P>0.05).
• Conclusion: Stages34 patients with higher dosages of routine HB vaccine had higher seroconversion rate than HD patients. Future studies should evaluate the recommended dosage of HB vaccine among these patients.
• Key words: Chronic kidney disease, hemodialysis, Hepatitis-B vaccine, seroconversion