A LECAMWASAM1, P. TAN1, D BARIT1
1Department of Nephrology, Northern Health, Victoria, Australia
Aim: This observational study compared the seroprotection rate between dialysis and pre dialysis chronic kidney disease (CKD) patients following intramuscular administration of hepatitis B vaccines as per the Northern Health (TNH) renal unit protocol.
Background: CKD and dialysis patients are at increased risk of acquiring Hepatitis B virus (HBV). The response to hepatitis B vaccination has been shown to be better in patients vaccinated before becoming dialysis dependent.
Methods: TNH pharmacy electronic database was searched to identify patients dispensed with hepatitis B vaccines between March 2013 and 2015. Clinical data including mean age, estimated glomerular filtration rate (eGFR), completed course of vaccination, total course of vaccines administered and follow up hepatitis B surface antibody (HBsAB) titres post vaccination were included. Patients were stratified into stage IV, V CKD and dialysis groups according to their renal function at time of vaccination. Seroprotection rates, mean age and HBsAB titres attained were compared between CKD and dialysis cohorts.
Results: Fifty-two patients were included in this study. Thirty patients (57.69%) were on dialysis whilst twelve (52.5%) and ten (45.5%) patients had stage IV and V CKD respectively at time of vaccination. There was a trend to higher seroprotection rate observed in the CKD group compared with dialysis cohorts (72.7% vs 50%) following either one or two course of vaccination, albeit not statistically significant (p=0.1529). A nonsignificant trend was also observed in the correlation between age and seroprotection rate within CKD cohort.
Conclusion: Higher seroprotection (HBsAB>10) was observed amongst patients with better renal function at time of vaccination. Larger prospective studies are required to evaluate the correlation between immune response rate, age of vaccination and renal function.