Factors Associated with Long‐Term Antibody Production Induced by Hepatitis B Vaccine in Patients Undergoing Hemodialysis: A Retrospective Cohort Study

Elwell, Rowland J.; Neumann, Marianne; Bailie, George R.

doi:10.1592/phco.23.15.1558.31954

Cited by 11 publications

(9 citation statements)

References 16 publications

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“…Our results were similar to the results of Fabrizi et al. (7), but were different from the results reported by Elwell (8), Kausz (6), and Buti et al. (5).…”

Section: Discussioncontrasting

confidence: 67%

“…In cohort 2 (40 patients), 15 (37.5%) were seropositive at 24 months. Comparison of seropositive and seronegative patients revealed no statistically significant differences in mean age, sex, serum albumin level, or eKt/V (8).…”

Section: Discussionmentioning

confidence: 81%

“…Some scholars showed that after two years from primary HBV vaccination, 78% of HD patients maintained protective levels of HBV surface antibodies (anti‐HBs), and 45% of them are high responders (7). Another study showed that 36.4% of HD patients were seropositive at 12 months after HBV vaccination (8).…”

mentioning

confidence: 99%

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Persistence of Hepatitis B Vaccine Immunity in Hemodialysis Patients

Ramezani¹,

Velayati²,

Eslamifar³

et al. 2008

Ther Apher Dial

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Although the efficacy of hepatitis B vaccines in patients undergoing chronic hemodialysis (HD) treatment has been documented, the persistence of immunity in this population remains largely unknown. In this study we evaluated the persistence of hepatitis B vaccine immunity in HD patients. We followed 37 hepatitis B vaccinated HD patients (following a four-dose vaccination schedule of 40 mug injections intramuscularly in the deltoid muscle at 0, 1, 2, and 6 months) for up to one year to evaluate the persistence of immunity (as indicated by serum levels of hepatitis B surface antibody (anti-HBs) equal to or higher than 10 IU/L). One year after vaccination, 18.9% of patients had lost their anti-HBs (transient responders), while 81.1% still had detectable antibodies in the serum (persistent responders). From 81.1% of persistent responders 11.5% and 88.5% were weak and high responders, respectively. There was no significant difference between persistent and transient responders regarding age, sex, or nutritional factors. We did not find any factors that related to maintaining protective levels of anti-HBs in HD patients. It seems that an antibody titer above 100 IU/L following vaccination is necessary in order to maintain that level of antibody one year later.

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“…Our results were similar to the results of Fabrizi et al. (7), but were different from the results reported by Elwell (8), Kausz (6), and Buti et al. (5).…”

Section: Discussioncontrasting

confidence: 67%

Section: Discussionmentioning

confidence: 81%

See 1 more Smart Citation

Persistence of Hepatitis B Vaccine Immunity in Hemodialysis Patients

Ramezani¹,

Velayati²,

Eslamifar³

et al. 2008

Ther Apher Dial

View full text Add to dashboard Cite

show abstract

“…These studies were not included in our study due to a lack of a modern statistical analysis. On the other hand, four reports [27][28][29][30] did not demonstrate a relationship between failure to seroconvert after HBV vaccine and low serum albumin.…”

Section: Discussionmentioning

confidence: 89%

Meta-Analysis: The Impact of Nutritional Status on the Immune Response to Hepatitis B Virus Vaccine in Chronic Kidney Disease

et al. 2011

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“…The diagnosis of diabetes mellitus in patient on hemodialysis is an independent risk factor of being non-responder to the vaccine in our study as shown in the multivariate analysis with an odd ratio of 3.15. Elwell et al [15] have shown that diabetic patients are 2.5 times more likely to respond to the vaccine. There is a discrepancy in the results between Elwell study and our study, thus additional studies and particularly prospective studies will be needed to clarify this association.…”

Section: Discussionmentioning

confidence: 99%

Variability in Response to Hepatitis B Vaccine in Hemodialysis Patients

et al. 2015

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BackgroundHemodialysis patients are exposed to blood and blood products more than the general population and are also at higher risk for hepatitis B (HB) contamination. For these reasons, it is highly recommended that this patient population gets the HB vaccine. The efficacy of the vaccine is measured by measuring titers of antibody in the serum of the patient. A minimum titer of 10 mIU/mL is considered to be a response. The conversion rate in hemodialysis patients ranges from 50% to 80%, as compared to the general population where the conversion rate is over 95%. As opposed to the general population, end-stage renal patients on hemodialysis do not always respond to the vaccine. The main objective in this study was to try to identify factors that may hinder the response. Correction of these factors in the future may help non-responders.MethodsThis was a retrospective chart review at a single hemodialysis center to compare the laboratory and clinical differences between responders and non-responders. Inclusion criteria are hemodialysis patients who received the HB vaccine and patients with concomitant hepatitis C. Exclusion criteria are patients who refused the vaccine and patients who did not complete the vaccine course.ResultsThere are a total of 108 subjects included in the study, out of which 44 (42.3%) are responders to the HB vaccine. A multivariate logistic regression was performed using the statistically significant risk factors as identified by the univariate logistic regression, including age range, albumin, hemodialysis vintage, vascular access and diabetes status. The results from the multivariate logistic regression show that advanced age (P = 0.005) and diabetes status (P = 0.003) are found to be strong independent risk factors of responder status. The type of vascular access (AVF or other types) is also marginally statistically significant (P = 0.05).ConclusionsIn this retrospective chart review comparing HB vaccine in responders versus non-responders, we found that advanced age and a history of diabetes are independent risk factors in predicting responder status.

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Factors Associated with Long‐Term Antibody Production Induced by Hepatitis B Vaccine in Patients Undergoing Hemodialysis: A Retrospective Cohort Study

Cited by 11 publications

References 16 publications

Persistence of Hepatitis B Vaccine Immunity in Hemodialysis Patients

Persistence of Hepatitis B Vaccine Immunity in Hemodialysis Patients

Meta-Analysis: The Impact of Nutritional Status on the Immune Response to Hepatitis B Virus Vaccine in Chronic Kidney Disease

Variability in Response to Hepatitis B Vaccine in Hemodialysis Patients

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