Meta‐analysis: the effect of age on immunological response to hepatitis B vaccine in end‐stage renal disease

Fabrizi, F.; Martin, Paul; Dixit, Vivek; Bunnapradist, Suphamai; Dulai, Gareth S.

doi:10.1111/j.1365-2036.2004.02264.x

Cited by 80 publications

(53 citation statements)

References 59 publications

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“…Age is an important contributing factor of responsiveness to HBV vaccination in ESRD patients as well as during the pre-ESRD period (6,9,(12)(13)(14). Jadoul et al in a study involving HD patients, showed that seroconversion rates after 12 months were 100%, 75%, and 50% in patients aged < 60 years, 60-75 years, and > 75 years, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with seroconversion were younger (66 ± 14 years) than those without seroconversion (76 ± 9 years) (P = 0.048) (15). In a meta-analysis of 17 clinical trials of hepatitis B vaccine in patients with ESRD, Fabrizi et al showed a clear association between advanced age and impaired response to HBV vaccine in ESRD patients (RR: 0.74; P = 0.0139) (13).…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of HBV Vaccination in Various Stages of Chronic Kidney Disease: Is Earlier Better?

et al. 2011

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Background: Despite improvement in hepatitis B infection prevention through national vaccination programs, implementation of compulsory and thorough blood donor screening, and reduction of transfusion numbers due to erythropoietin administration, hepatitis B remains a major concern in hemodialysis (HD) centers (1). Compared to a response rate of over 90% in the normal population, only 50 to 60% of those with endstage renal disease (ESRD) achieve protective antibody levels following immunization against hepatitis B (2, 3). Various strategies have been developed to overcome the low seroconversion rate in ESRD patients, including co-administering zinc, gamma-interferon, thymopentin, interleukin-2, and levamisole as immunostimulants or adjuvants (3, 4), changing the injection mode (intradermal versus intramuscular), or doubling the vaccine dose (5). Objectives: Previous studies demonstrated that renal failure patients benefit from HBV vaccination; however, not all studies have demonstrated this. Therefore, we compared the rates of seroconversion (hepatitis B surface antibody [HBsAb] titer > 10 IU/mL) in patients at various stages of chronic kidney disease (CKD) (estimated glomerular filtration rate [eGFR] < 60 mL/min/1.73 m2) who received HBV vaccination. Patients and Methods: A total of 167 patients in 3 different stages of CKD were vaccinated against HBV. Each patient received the vaccine according to a standardized vaccination schedule consisting of 40 μg of the recombinant vaccine "Engerix" at 0, 1, and 6 months. Eight to 12 weeks after the last dose of vaccination, anti-HBsAb levels were measured. Results: Mean age and eGFR were 57.4 ± 16.5 years and 26.7 ± 14.7 mL/min/1.73 m2, respectively. The overall seroconversion rate was 78%. Although a significant correlation between HBsAb titer and eGFR (r = 0.265, P = 0.001) was observed, in the multivariate analysis using age, CKD stage, diabetes mellitus, and gender as independent variables, the degree of renal function did not significantly contribute to seroconversion. In contrast, higher age (> 60 years) showed a significant negative correlation to seroconversion (odds ratio = 0.22; P = 0.004). Conclousions: CKD patients of advanced age should be vaccinated against HBV. Although higher eGFR was not associated with improved seroconversion, the persistence of seroconversion was not evaluated; future studies should be conducted to develop recommendations for earlier or later vaccination.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy of HBV Vaccination in Various Stages of Chronic Kidney Disease: Is Earlier Better?

et al. 2011

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“…Diabetes mellitus [37] and older age [38] were also significantly associated with poorer response to HB vaccination. Very limited data coming from the previous clinical trials proposes that gender is a major interfering factor in the context of HB vaccine immunogenicity [9] .…”

Section: Khedmat H Et Al Sex and Hbv Vaccine Immunogenicitymentioning

confidence: 89%

Sex bias in response to hepatitis B vaccination in end-stage renal disease patients: Meta-analysis

Khedmat

Aghaei

Ghamar-Chehreh

et al. 2016

WJN

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AIM:To systematically review the literature for studies investigating the potential effect of gender of dialysis patients on the immunogenicity of hepatitis B virus vaccines. METHODS:Literature searches were conducted by the MEDLINE and Google Scholar. The key words used included "hepatitis B (HB)", "vaccine", "dialysis", "hemodialysis", "sex", "male" and "female". Data of seroresponse to HB vaccine in clinical trials regarding sex of the recipients have been achieved and analyzed. Finally data from 19 clinical trials have been pooled and analyzed. RESULTS:Analysis of response to HB vaccination in our dialysis population showed males significantly respond less to hepatitis B vaccination (P = 0.002, Z = 3.08) with no significant heterogeneity detected [P = 0.766; heterogeneity χ 2 = 14.30 (df = 19); I 2 = 0%]. A reanalysis of the pooled data was conducted regarding the dialysis mode to evaluate potential differential impact of sex on HB vaccine response. Hemodialysis was the only subgroup that showed a significant difference regarding dialysis mode in response to HB vaccination regarding sex (P = 0.042, Z = 2.03). CONCLUSION:This Meta-analysis showed significant effect for the sex of chronic kidney disease and dialysis patients on the immunogenicity of HB vaccine. This sex discrimination was most prominent among hemodialysis patients.

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“…Fabrizi et al -in a meta-analysis on 8 trials that had assessed the HB vaccine response rate according to the age, with cutoff point of 40 years old -found that dialysis subjects who were over 40 years old have 0.7 of probability of subjects younger than 40 years to develop sero-protection after hepatitis B vaccination. 5 There are several reports of trials that compared effect of using different routes of vaccination on hepatitis B vaccine sero-protection in dialysis subjects with renal failure. The cost and side effects of vaccination should be considered in our conclusion.…”

Section: Hepatitis B Vaccination In Hemodialysis Patients: Different mentioning

confidence: 99%

Hepatitis B vaccination in hemodialysis patients: different points of view for conclusion

Alavian¹

2011

J. Bras. Nefrol.

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Meta‐analysis: the effect of age on immunological response to hepatitis B vaccine in end‐stage renal disease

Cited by 80 publications

References 59 publications

Efficacy of HBV Vaccination in Various Stages of Chronic Kidney Disease: Is Earlier Better?

Efficacy of HBV Vaccination in Various Stages of Chronic Kidney Disease: Is Earlier Better?

Sex bias in response to hepatitis B vaccination in end-stage renal disease patients: Meta-analysis

Hepatitis B vaccination in hemodialysis patients: different points of view for conclusion

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