Monitoring of the efficacy of Hepatitis B vaccination and infection in renal disease and transplantation patients

Sanaa Ghazi AlAttas

Journal of Nephrology and Renal Transplantation, Vol 4, No 1 (2012)

Abstract

Background: Reports show that patients with end stage renal failure and transplants present with reduced immunity to infections especially with Hepatitis B Virus. This may make the patients respond poorly to hepatitis B vaccine with resultant poor seroconversion rate. This study examines the efficacy of hepatitis B vaccine, in chronic renal failure (CRF), Post Kidney Transplantation (PKT), and renal patients as compared to controls healthy.

Methods: A total of 303 subjects participated: One hundred and thirty-three immunocompetent and immunocomprised individuals and 170 controls were enrolled in this study. They were categorized into four groups. Group I: Comprised 54 Chronic Renal Failure, Group II: Comprised 21 End Stage Renal Disease patients, Group III:Comprised 38 Post Kidney Transplant patients, Group IV: Control group comprised 170 vaccinated blood donors and hospital staff. Detection of serological markers - HB_sAg, Anti-HBs, HB_eAg, Anti-HBe, HB_cI_gG, and HB_cI_gM were performed by enzyme immune assays (EIA). The vaccination schedule comprised recombinant hepatitis B vaccine (Engerix B) 40 μg intramuscularly at 0, 1, and 6 months.

Results: Our results have documented successful vaccination in only group I, and III, with primary seroconversion 20.4% and 15.8% respectively while none in group II, seroconvert and 100% of group lV demonstrated successful vaccination. The remaining patients were HBV infected.

Conclusions: It was concluded that controlling HBV infection in end stage of renal disease still pose a great deal of challenges. Based upon this study results, we highly recommend stating vaccination strategy at an earlier stage of chronic renal disease. Furthermore, regular serological testing and booster injections are necessary for hypo-responders.