Effect of Dialysis Prescription Dose on Hepatitis B Vaccination Immunological Response in Hemodialysis Patients

Abstract

This cross sectional study was performed on 100 patients ESRD on HD therapy aimed to determine the immunological response after HBV vaccination, and its relation to dialysis prescription dose in hemodialysis patients. Our patients were selected from Shebin Elkom Teaching Hospital and Ain Shams university hospital, hemodialysis units during the period from November 2019 to November 2020. A total of patients were enrolled in our study (59 males and 41 females).The mean age was 56.1±10.1(range 23-76 years), All patients were ESRD on regular HD sessions thrice weekly, 3-4 hours for each session using bicarbonate dialysate. The blood flow rate ranged from 220-350 ml/min, the dialysate flow rate was 500 ml/min, and polysulfone dialyzers. All of the patients were negative for all serological markers of HBV infection, including HBsAg and anti-HBc antibodies. 14 Patients received 4 doses of hepatitis B vaccine (the second generation recombinant DNA-HB vaccine (Energix HB) with dose 2.0 mL (40 μg HBVsAg), administered at 0, 1, 2 and 6 months period by intramuscular (deltoid) injection (according to infection control program in dialysis units in EGYPT), 86 patients were previously completed their course of vaccination so received a booster dose then HBV antibody titer was measured a month after for both groups. Patients with age < 18 years, pregnant,have active neoplasm and who receive any immunosuppressive drugs were excluded from the study.