Vaccination against Hepatitis B Virus in a Hemodyalisis Unit: comparative analysis between two different schemes

Abstract

Introduction: Vaccination against hepatitis B virus (HBV) is more effective in pre-dialysis, but sometimes the patient has to start treatment in an unscheduled way, without full immunization coverage. We try to establish the immune response rate against HBV in hemodialysis with different vaccination schemes. Methods: We studied 30 patients in hemodialysis program with 2 different vaccination schemes against HBV. One group performed a 3-doses scheme (0, 1 and 6 months) (PATTERN 3) and the other group performed a 4-doses scheme (0, 1, 2 and 6 months) (PATTERN 4). Results: 56.7% performed pattern 3, with immune response of 26.7%. 43.3% performed pattern 4, with immune response of 23.3%, without significant differences between them (p=0.06). Anti-hepatitis surface antibodies (anti-HBs) rate after vaccination was significantly higher with pattern 4 (p<0.05) as well as the antibodies counts maintained within 1 year. After 2 years, anti-HBs rates were not significantly different between both patterns. In other statical analysis, vaccination carried out in patients who have been for a long time in hemodialysis treatment, was more responsive with pattern 4 (p<0.05) although anti-HBs levels were similar in patients that had response with each pattern. Conclusions: There are no differences in immune response between 3-doses scheme and 4-doses scheme in HBV vaccination for hemodialysis patients. There is greater response with 4-doses scheme in hemodialysis patients who have not been vaccinated previously.