Predictors of immune response to hepatitis B vaccine and clinical outcomes in dialysis patients

Abstract

OBJECTIVE: The aim of our study was to examine factors associated with response to the hepatitis B virus (HBV) vaccine in incident dialysis patients and verify whether a lack of HBV immune response is associated with adverse clinical outcomes. PATIENTS AND METHODS: This was a retrospective cohort study of 133 patients initiated on dialysis at an outpatient dialysis facility who received the HBV vaccine series. Vaccine responsiveness was defined as a hepatitis B surface antibody titer equal to or greater than 10 IU/L. RESULTS: Sixty-nine (52.3%) patients were non-responders to the HBV vaccine. Compared to accine responders, vaccine non-responders were significantly older (66.5 ± 14.4 vs. 71.3 ± 12.7 years old; p = 0.04) and had a lower serum creatinine (7.9 ± 29 vs. 6.4 ± 2.3; p = 0.002). All-cause and infection-related hospitalization, as well as 1-year mortality rate, was not significantly different between HBV vaccine responders and non-responders. CONCLUSIONS: Studies with larger sample sizes are required to address the association between non-response to the HBV vaccine and clinical outcomes in dialysis patients.

Keywords

• hepatitis
• dialysis
• infection
• vaccine