Funda Sari1, Hulya Taskapan. 1. Division of Nephrology, Antalya Education and Research Hospital, Ministry of Health, Antalya, Turkey. fundasari@ymail.com
Abstract
OBJECTIVE: Chronic renal failure is accompanied by various abnormalities of innate and acquired, cellular and humoral immunity. We aimed to investigate whether positive Candida skin test results, CD4+ and CD8+, before the first dose of vaccination could be a predictor for antibody response to hepatitis B vaccination and the relation of these parameters with hepatitis B antibody levels 1 month after the last dose of vaccination. MATERIALS AND METHODS: The present study was carried out in 57 dialysis patients. All patients received recombinant hepatitis B vaccine (40 μg) given intramuscularly in the deltoid muscle in a four-dose schedule at 0, 1, 2, and 6 months. Candida skin test and lymphocyte subsets (CD4+ and CD8+) were determined before the first dose of vaccination and 1 month after the fourth inoculation of hepatitis B vaccine. RESULTS: Ten patients (17.5%) were non-responders (HBsAb < 10 IU/L), while 47 patients (82.5%) were responders (HBsAb ≥ 10 IU/L). However, 29 patients (50.9%) were weak responders (HBsAb:10-100 IU/L), 18 patients (31.6%) good responders (HBsAb > 100 IU/L), which was determined 1 month after the fourth dose of vaccination. Thirty-nine patients (68.4%) and 44 patients (77.2%) were anergic to Candida skin test before the first dose and 1 month after fourth inoculation of hepatitis B vaccine, respectively. There was no relationship between Candida skin test and response to hepatitis B vaccination. Mean age was lower, and CD4+/CD8+ ratio measured both before and after vaccination was higher in good responders compared with that of weak responders and that of non-responders. Females were better responders than males. CONCLUSION: High skin test anergy rate and low seroconversion rate after hepatitis B vaccination are important problems in patients on dialysis. Females, younger patients, and patients with higher CD4+/CD8+ ratio have better HBsAb antibody response to hepatitis B vaccination.
OBJECTIVE:Chronic renal failure is accompanied by various abnormalities of innate and acquired, cellular and humoral immunity. We aimed to investigate whether positive Candida skin test results, CD4+ and CD8+, before the first dose of vaccination could be a predictor for antibody response to hepatitis B vaccination and the relation of these parameters with hepatitis B antibody levels 1 month after the last dose of vaccination. MATERIALS AND METHODS: The present study was carried out in 57 dialysis patients. All patients received recombinant hepatitis B vaccine (40 μg) given intramuscularly in the deltoid muscle in a four-dose schedule at 0, 1, 2, and 6 months. Candida skin test and lymphocyte subsets (CD4+ and CD8+) were determined before the first dose of vaccination and 1 month after the fourth inoculation of hepatitis B vaccine. RESULTS: Ten patients (17.5%) were non-responders (HBsAb < 10 IU/L), while 47 patients (82.5%) were responders (HBsAb ≥ 10 IU/L). However, 29 patients (50.9%) were weak responders (HBsAb:10-100 IU/L), 18 patients (31.6%) good responders (HBsAb > 100 IU/L), which was determined 1 month after the fourth dose of vaccination. Thirty-nine patients (68.4%) and 44 patients (77.2%) were anergic to Candida skin test before the first dose and 1 month after fourth inoculation of hepatitis B vaccine, respectively. There was no relationship between Candida skin test and response to hepatitis B vaccination. Mean age was lower, and CD4+/CD8+ ratio measured both before and after vaccination was higher in good responders compared with that of weak responders and that of non-responders. Females were better responders than males. CONCLUSION: High skin test anergy rate and low seroconversion rate after hepatitis B vaccination are important problems in patients on dialysis. Females, younger patients, and patients with higher CD4+/CD8+ ratio have better HBsAb antibody response to hepatitis B vaccination.
Authors: Kia E Armstrong; Heather M Bush; Jana D Collins; Dave J Feola; Glyn C Caldwell; Alice C Thornton Journal: J Int Assoc Physicians AIDS Care (Chic) Date: 2010 May-Jun
Authors: C U Casciani; C De Simone; S Bonini; M T Gallucci; G Matteucci; G Valesini; D Meli; C Masala Journal: Kidney Int Suppl Date: 1978-06 Impact factor: 10.545