بررسی ارتباط میزان روی سرم و پاسخ ایمنی هومورال به واکسیناسیون هپاتیت B در بیماران دیالیزی

Introduction: Zinc deficiency causes abnormalities in immune response. In chronic hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients, impaired immune responses to vaccination have been reported. Therefore, we performed a study to determine the correlation between serum zinc levels and immune response to hepatitis B vaccination in patients on dialysis. Methods: A cross-sectional study including 95 CRF patients on dialysis (70 HD and 25 CAPD), (63 male and 32 female) with three dose regimens of vaccination against HBV was performed. Results: Four months after vaccination, there were 34 (36%) patients with sufficient HBs Antibody response (HBs Ab≥ 10 mU/mL ) and 61 ( 64% ) patients with insufficient HBs antibody response( HBs Ab< 10mU/mL ). The mean serum zinc level was 23.35±3.87 micmol/L (13.20-33 micmol/L). The mean serum zinc concentration was significantly higher in patients with sufficient HBs antibody level than patients with insufficient HBs antibody levels ( 24.94±4.17 versus 22.15±3.46, P= 0.005 ). In logistic regression analysis, independent variables that correlated with sufficient HBs Ab level ≥ 10 mU/mL included higher mean serum zinc level [OR=1.44 (1.02-2.02), P=0.006 ] and female gender [OR=1.8 (1.01-4.01), P=0.048] . Factors found to be insignificant included type of dialysis, age, diabetes mellitus as a cause of ESRD, serum creatinine and albumin levels. Conclusion: We conclude that failure to respond to HBV vaccination is significantly related to a low levels of serum zinc. However, clinical trial studies should be performed in order to confirm this finding.