EVALUATION OF ANTI-BODY RESPONSE OF HEMODIALYSIS AND PERITONEAL DIALYSIS PATIENTS TO HEPATITIS-B VACCINE
Journal Name:
- İstanbul Tıp Fakültesi Dergisi
Keywords (Original Language):
Abstract (2. Language):
Objective: Hemodialysis patients are at higher risk for Hepatitis B virus (HBV) infection when compared with the
rest of the population. Adequate antibody response (approximately 90%) is achieved when healthy individuals are
immunized with HBV vaccine; however, the response is about 50% and 70% in chronic renal failure (CRF) patients.
In this study, it is aimed to assess the influence of different factors and the type of renal replacement, for antibody
response to double dose of recombinant HBV-vaccine in dialysis patients.
Materials and methods: In this retrospective study, we included 37 patients (19 males, 18 females) who were in
the schedule of hemodialysis and continuous ambulatory peritoneal dialysis (CAPD) at the Dialysis Center of Düzce
University Hospital between 2004 and 2005. The patients were administered double doses of recombinant DNA
derived HBV vaccine IM for four times at 0, 1, 2, and 6 months. The patients’ antibody responses were determined one month after the last dose of HBV-vaccine administration, according to the Anti-HBS titrations that are evaluated
by ELISA test.
Results: Six of the 37 patients (16.2%) had no response to the vaccine, while 15 patients (40.5%) had low response
and 16 patients (43.2%) had complete response. There was no difference between hemodialysis patients and peritoneal
dialysis patients in terms of the antibody response (p>0.05). Levels of hemoglobin, total cholesterol, triglyceride
and albumin, type and duration of dialysis, and gender were not correlated with the antibody response
(p>0.05).
Conclusion: As a result, for dialysis patients, antibody response to the HBV-vaccine is lower than that in the healthy
population and this decline in response seems to be multifactorial.
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Abstract (Original Language):
Amaç: Hemodiyaliz hastalar›, Hepatit B virüs (HBV) infeksiyonu yönünden toplumun di¤er kesimlerine göre daha
yüksek risk alt›ndad›r. Hepatit B afl›s› ile sa¤l›kl› insanlarda afl›ya karfl› yeterli antikor yan›t› (yaklafl›k %90) al›-
n›rken, kronik böbrek yetmezli¤i (KBY) hastalar›nda bu oran %50–70 düzeylerinde kalmaktad›r. Bu çal›flmada, diyaliz
hastalar›nda çift doz rekombinant hepatit B afl›s›na karfl› yan›t oranlar›n›n ve antikor oluflmas›nda rol olabilecek
çeflitli faktörlerle renal replasman türünün etkisinin araflt›r›lmas› amaçlanm›flt›r.
Gereç ve yöntem: Bu retrospektif çal›flmaya, 2004-2005 y›llar› aras›nda Düzce Üniversitesi T›p Fakültesi Hastanesi
Diyaliz Merkezi’nde hemodiyaliz ve sürekli ayaktan periton diyalizi (SAPD) program›nda olan 37 (19 erkek,
18 kad›n) hasta dahil edilmifltir. Hastalara 0, 1, 2, ve 6. aylarda çift doz (40μg) olmak üzere toplam dört kez rekombinant
DNA kökenli HBV afl›s› intramusküler olarak yap›lm›flt›r. Hastalar›n antikor yan›tlar› son doz afl›lamadan bir
ay sonra ELISA testi ile saptanan Anti-HBs titrasyon düzeylerine göre belirlenmifltir.
Bulgular: Otuz yedi hastan›n 6 (%16,2)’s›nda afl› yan›t› al›nmazken; 15 (%40,5) hastada düflük yan›t, 16 (%43,2)
hastada tam yan›t saptand›. Hemodiyaliz hastalar› ile periton diyalizi hastalar› aras›nda antikor yan›t› aç›s›ndan fark
saptanmad› (p>0,05). Hemoglobin, total kolesterol, trigliserit, albumin düzeyleri, diyaliz türü, diyaliz süresi ve cinsiyet
ile antikor yan›tlar› aras›nda korelasyon izlenmedi (p>0,05).
Sonuç: Hepatit B afl›s›na yan›t oran› normal popülasyona göre düflük olup yan›ts›zl›k nedeni multifaktöriyel gibi
gözükmektedir.
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