Siriraj Medical Journal (Apr 2016)
Hepatitis B Vaccination in Patients with Chronic Kidney Disease
Abstract
Hepatitis B infection is a serious global health problem. Chronic kidney disease patients with hepatitis B infections are associated with high rates of mortality and morbidity. The problems with vaccinating hemodialysis patients are that they have been shown to have lower seroconversion rates, lower peak antibodies, and antibody decline faster than in healthy persons. Patients with chronic kidney disease should be vaccinated as early as possible. Four double doses of vaccination are recommended. Anti-HBs should be monitored every 12 months in vaccinated hemodialysis patients. Additional strategies to improve seroconversion rates are third generation hepatitis B vaccine, combined hepatitis B and hepatitis A vaccine, intradermal injection, and adjuvants. Keywords: Hepatitis B vaccinations, chronic kidney disease, adjuvants