Halil İbrahim Erdoğdu1, Eray Atalay2, Gül Gürsoy3, Başol Canbakan4, Serkan Aktürk5, Canan Yazıcı6, Orhan Yücel5, Sinan Mersin7, Sengül Üçer8, Özgür Merhametsiz9, Can Öner10, Merve Erat2. 1. Department of Internal Medicine, Health Research Center, Kafkas University, Kars, Turkey. halil-dr@hotmail.com. 2. Department of Internal Medicine, Health Research Center, Kafkas University, Kars, Turkey. 3. Department of Internal Medicine and Endocrinology, Kafkas University, Kars, Turkey. 4. Department of Internal Medicine and Neprology, Kafkas University, Kars, Turkey. 5. Department of Hemodialysis and Nephrology, Kars Harakani State Hospital, Kars, Turkey. 6. Departement of Internal Medicine, Ardahan State Hospital, Ardahan, Turkey. 7. Department of Internal Medicine, Kartal Lütfi Kırdar Education and Research Hospital, Istanbul, Turkey. 8. Department of Clinical Microbiology and Infectious diseases, Kafkas University, Kars, Turkey. 9. Department of Hemodialysis and Nephrology, Iğdır State Hospital, Iğdır, Turkey. 10. Department of Family Medicine, Kartal Lütfi Kırdar Education and Research Hospital, Istanbul, Turkey.
Abstract
BACKGROUND: In hemodialysis patients Hepatitis B virus (HBV) infection is one of the problems. Because of HBV vaccine response is lower than in the general population, in this study it is aimed to determine the factors that may cause inadequate HBV vaccine response in hemodialysis patients. METHODS: In study, HBsAg, anti-HBs, anti-HBc IgG data belonging to 278 patients were obtained from file and computer records. It was seen that seronegative cases had been given recombinant HBV vaccine. Anti-HBs titers were monitored 1 month after vaccination was completed. According to this, the patients are divided into two groups. Those with anti-HBs < 10 IU/mL were identified as non-responders and with anti-HBs ≥ 10 IU/mL as responders. Factors such as age, serum albumin and urea reduction rate which may affect inadequate response to HBV vaccine were evaluated. As statistical examination, Chi-square test was used for the analysis of the data determined by counting, and logistic regression was used for statistically significant independent variables in chi-square test. p value of < 0.05 was considered statistically significant (Confidence interval: 95%). RESULTS: Out of 278 patients, according to exclusion criteria 81 patients were excluded. 13.2%(26/197) of HBV vaccinated patients had insufficient response. The inadequate response rate to HBV vaccination was found to be higher in patients with age ≥ 65 (p = 0.039), serum albumin < 3.5 g/dL (p = 0.024) and urea reduction rate ≤ 65 (p = 0.028). No statistically significant relationship was found between inadequate response to HBV vaccine and anti-HCV positivity, presence of diabetes mellitus, anemia status, vitamin D therapy and vascular access pathway variability. CONCLUSION: We conclude that relatively high patient age, low albumin level and insufficient urea reduction rate may cause inadequate HBV vaccine response. Taking these factors into consideration may provide a useful insight for an adequate response to vaccination.
BACKGROUND: In hemodialysis patientsHepatitis B virus (HBV) infection is one of the problems. Because of HBV vaccine response is lower than in the general population, in this study it is aimed to determine the factors that may cause inadequate HBV vaccine response in hemodialysis patients. METHODS: In study, HBsAg, anti-HBs, anti-HBc IgG data belonging to 278 patients were obtained from file and computer records. It was seen that seronegative cases had been given recombinant HBV vaccine. Anti-HBs titers were monitored 1 month after vaccination was completed. According to this, the patients are divided into two groups. Those with anti-HBs < 10 IU/mL were identified as non-responders and with anti-HBs ≥ 10 IU/mL as responders. Factors such as age, serum albumin and urea reduction rate which may affect inadequate response to HBV vaccine were evaluated. As statistical examination, Chi-square test was used for the analysis of the data determined by counting, and logistic regression was used for statistically significant independent variables in chi-square test. p value of < 0.05 was considered statistically significant (Confidence interval: 95%). RESULTS: Out of 278 patients, according to exclusion criteria 81 patients were excluded. 13.2%(26/197) of HBV vaccinated patients had insufficient response. The inadequate response rate to HBV vaccination was found to be higher in patients with age ≥ 65 (p = 0.039), serum albumin < 3.5 g/dL (p = 0.024) and urea reduction rate ≤ 65 (p = 0.028). No statistically significant relationship was found between inadequate response to HBV vaccine and anti-HCV positivity, presence of diabetes mellitus, anemia status, vitamin D therapy and vascular access pathway variability. CONCLUSION: We conclude that relatively high patient age, low albumin level and insufficient urea reduction rate may cause inadequate HBV vaccine response. Taking these factors into consideration may provide a useful insight for an adequate response to vaccination.
Entities:
Keywords:
Hemodialysis; Hemodialysis adequacy; Hepatitis B vaccines; Humoral immune response
Authors: Sandra S Chaves; Danni Daniels; Brian W Cooper; Susan Malo-Schlegel; Susan Macarthur; Karen C Robbins; John F Kobetitsch; Aimee McDaniel; John F D'Avella; Miriam J Alter Journal: Vaccine Date: 2011-10-30 Impact factor: 3.641