Vaccinated Hemodialysis Patients

Abstract

Objectives: Determine the status of immunity against the hepatitis B virus amongvaccinated hemodialysis patients at a tertiary care hospital. Study Design: Cross sectionalstudy. Place and Duration of Study: All medical wards of Civil Hospital and Ojha campus, DowUniversity of Health Sciences, Karachi, Pakistan from May 2013 to January 2015. Methodology:Patients with chronic kidney disease on hemodialysis attending out-patient department wereenrolled. Patients with either gender and aged 18-70 years, who give consent for participation,who are on HD for more than 9 months with a proven diagnosis of ESRD who have receiveda complete course of 4 doses of hepatitis B vaccination atleast 2 months back were includedin this study. Non-consenting patients, present/past history of viral hepatitis, patients whowere hepatitis B surface antigen (HBsAg) positive, patients on immunosuppressive agents,pregnant patients were excluded from this study. Results: Out of the 103 patients, 69 (67%)males and 34 (33%) females with mean age of study population was 51.1 ± 14.3 years (17 to70 years), mean duration post vaccination was 7.6 ± 0.9 months (6 to 9 months), mean antiHBs antibody level was 184.6 ± 293.4 (level rang 0 to 1000) and mean hemodialysis durationwas 26.4 ± 12 months (10 to 50 month). Out of 37 non-responders 28 (75.7%) had twice weeklyschedule of hemodialysis and 09 (24.3%) had thrice weekly schedule of hemodialysis, out of 19weak responders 13 (68.4%) had twice weekly schedule of hemodialysis and 06 (31.6%) hadthrice weekly schedule of hemodialysis and out of 47 high responders 29 (61.7%) had twiceweekly schedule of hemodialysis and 18 (38.3%) had thrice weekly schedule of hemodialysis(p=0.395). Conclusion: Excellent response of HbsAg B vaccination for those patients, undergodialysis procedure that is not associated with age, systemic inflammation or nutritional. Effectivedialysis procedure associated with excellent response to the vaccine hepatitis B.