VACCINATED HEMODIALYSIS PATIENTS

THE STATUS OF IMMUNITY AGAINST THE HEPATITIS B VIRUS, AT A TERTIARY CARE HOSPITAL

Abstract

Objectives: Determine the status of immunity against the hepatitis B virus among
vaccinated hemodialysis patients at a tertiary care hospital. Study Design: Cross sectional
study. Place and Duration of Study: All medical wards of Civil Hospital and Ojha campus, Dow
University of Health Sciences, Karachi, Pakistan from May 2013 to January 2015. Methodology:
Patients with chronic kidney disease on hemodialysis attending out-patient department were
enrolled. Patients with either gender and aged 18-70 years, who give consent for participation,
who are on HD for more than 9 months with a proven diagnosis of ESRD who have received
a complete course of 4 doses of hepatitis B vaccination atleast 2 months back were included
in this study. Non-consenting patients, present/past history of viral hepatitis, patients who
were hepatitis B surface antigen (HBsAg) positive, patients on immunosuppressive agents,
pregnant patients were excluded from this study. Results: Out of the 103 patients, 69 (67%)
males and 34 (33%) females with mean age of study population was 51.1 ± 14.3 years (17 to
70 years), mean duration post vaccination was 7.6 ± 0.9 months (6 to 9 months), mean anti
HBs antibody level was 184.6 ± 293.4 (level rang 0 to 1000) and mean hemodialysis duration
was 26.4 ± 12 months (10 to 50 month). Out of 37 non-responders 28 (75.7%) had twice weekly
schedule of hemodialysis and 09 (24.3%) had thrice weekly schedule of hemodialysis, out of 19
weak responders 13 (68.4%) had twice weekly schedule of hemodialysis and 06 (31.6%) had
thrice weekly schedule of hemodialysis and out of 47 high responders 29 (61.7%) had twice
weekly schedule of hemodialysis and 18 (38.3%) had thrice weekly schedule of hemodialysis
(p=0.395). Conclusion: Excellent response of HbsAg B vaccination for those patients, undergo
dialysis procedure that is not associated with age, systemic inflammation or nutritional. Effective
dialysis procedure associated with excellent response to the vaccine hepatitis B.