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

Abstract

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.

Table_1.DOC

“…Our survey showed that the incidence rate of new hepatitis B infection for males was significantly higher than that for females (684.88 vs. 536.68 per 100,000 person-years, p < 0.001), and 31-40, 41-50, 51-60 age groups had lower new infection rate than younger and elder age groups (Table 1). The phenomenon that males were more likely to have been infected with HBV than females reported by many previous studies could mainly be explained by behavioral differences (11,(21)(22)(23)(24)(25)(26)(27). In this research it may relate to the relatively conservative ideology in this county.…”