Vaccination against hepatitis B infection in patients with end stage renal disease.
نویسندگان
چکیده
BACKGROUND Experience of hepatitis B vaccination in a contemporary renal replacement programme is reported. METHODS A total of 406 patients were involved: 214 on haemodialysis, 97 on continuous ambulatory peritoneal dialysis, 67 predialysis (serum creatinine >400 micromol/l), and 28 with a failing transplant. Primary vaccination comprised recombinant hepatitis B vaccine (Engerix B) 40 microg intramuscularly at 0, 1, 2, and 3 months. Booster doses were administered three monthly if anti-HBs titre was <100 IU/l. RESULTS Uptake of vaccine was 61% (haemodialysis 70%, continuous ambulatory peritoneal dialysis 62%, predialysis 31%, transplant 61%, p<0.0001). Primary seroconversion occurred in 64% of vaccinated patients (anti-HBs; 10-100 U/l, 33%; >100 U/l, 31%). Booster doses led to further improvement in immunity in 66/115 (57%) patients after a first and 8/20 (40%) patients after a second booster dose, but uptake was again poor (first booster 74%, second 31%). Seroprotection declined unexpectedly rapidly; after a mean of 16 months 71/115 patients (62 %) had a significant fall in their anti-HBs titres; 30/115 (26%) lost detectable antibody. CONCLUSIONS Routine hepatitis B vaccination of patients with end stage renal failure is logistically difficult to administer on a large scale; primary seroconversion is relatively poor, but improves after repeated booster doses; protective anti-HBs titres decline rapidly, and yearly antibody checks with selective booster doses will be required to maintain seroprotection. The cost effectiveness of a vaccination programme will vary greatly depending on the prevalence of hepatitis B in the population at risk.
منابع مشابه
Occult Hepatitis B Virus Infection in Chronic Hemodialysis Patients in Panje-Azar Hospital, Gorgan
Abstract Background and objectives: Hepatitis B virus infection is a major health problem in worldwide. The prevalence of Occult and chronic HBV in hemodialysis patients is higher than standard in developing countries. People with occult HBV are negative for HBV surface antigen (HBsAg) but positive for HBV-DNA. We aimed to evaluate occult hepatitis B infection in patients under hemodialysis in ...
متن کاملPrevalence of hepatitis C, hepatitis B, and HIV infection among hemodialysis patients in Jenin District (Palestine)
Background and Aims: End-stage renal disease patients treated by hemodialysis (HD) are more susceptible for infection by viral hepatitis and human immunodeficiency virus (HIV) infections. Infection by these viruses is promoted by the characteristic immunological dysfunction that develops in renal failure and interferes with the patient's ability to eliminate these viruses. Prevalence of these v...
متن کاملبررسی تأثیر عفونت هپاتیت ویروسی B و C بر بقای کلیه پیوندی در بیماران دریافت‌کننده کلیه
Background and Aim: Chronic liver disease and its complications are major problems in renal transplant recipients. Hepatitis B and C virus infections are currently the main causes of chronic liver disease in this group, and these may affect allograft outcome. Whether hepatitis B and C virus infections after renal transplantation adversely affect graft and patient survival, remains controver...
متن کاملHepatitis B Vaccination in End-Stage Pulmonary Disease Patients Evaluated for Lung Transplantation: A Retrospective Single-Center Evaluation.
BACKGROUND In times of limited organs for transplantation, anti-HBc-positive organs can be accepted for lung transplantation to increase the number of donors. Transplant recipients should be vaccinated against hepatitis B to prevent HBV infection. However, response after HBV vaccination has only been poorly evaluated in patients with end-stage pulmonary disease. MATERIAL AND METHODS Anti-HBs ti...
متن کاملAssessment of vaccination against hepatitis B and infection control compliance among dentists participated in 42nd international congress of Iranian dentists
Assessment of vaccination against hepatitis B and infection control compliance among dentists participated in 42nd international congress of Iranian dentists Dr. SM. Alavian* - Dr. H. Akbari ** - Dr. M. Ahmadzad asl*** - Dr. M. Kazem**** - A. Davoodi***** * - Associate Professor of Internal Medicine Dept. Faculty of Medicine, Baqyiatollah University of Medical Sciences. ** - Endodontist. *** - ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Postgraduate medical journal
دوره 78 923 شماره
صفحات -
تاریخ انتشار 2002