The Immune Response after Double Dose Hepatitis B Vaccination in Hemodialysis Patients: Influence of Age and Hepatitis C Virus

Abstract

Objective: To determine the efficacy of Hepatitis B vaccination among the candidates of maintenance hemodialysis due to chronic kidney disease and to measure the impact of ageing and Hepatitis C infection upon immune seroconversion.

Study Design: Cross-sectional study.

Place and Duration of Study: Nephrology Department, Multan Institute of Kidney Diseases (MIKD), Multan Pakistan from Jan to Jun 2020.

Methodology: Two hundred male and female patients diagnosed with end-stage kidney disease on maintenance dialysis (more than three months) with the range of age, 15 to 70 years, were selected by non-probability consecutive sampling. Already treated patients of HB virus and those with HB virus detectable by ELISA were excluded from the study. Data was accessed through hospital management software records. Three months after the three or four completed doses, antiHBs titer was assessed by ELISA. Cut off the value of anti-Hbs titer was 10U/L to differentiate between responders and non-responders of HBV.

Results: Among the 117 responders, 109 (93%) cases received four double doses of the vaccine, while only 8 (7%) were those who received three double doses. Among 83 non-responders, 52 (63%) were above age 40 years, while 31 (37%) were of age 40 years or below. In addition, among the non-responders, 63 (76%) were Hep C positive, while 20 (24%) were Hep C negative patients.

Conclusions: Four double-dose vaccines have been effective for haemodialysis patients with end-stage kidney disease. Vaccine response is inversely correlated with age and Hepatitis C virus.