FP751FACTORS AFFECTING THE RESPONSE TO HEPATITIS B VACCINATION IN HEMODIALYSIS PATIENTS

Abstract

Introduction and Aims: Hepatitis B (HBV) infection has declined as a result of improved prevention applications and widespread use of vaccination. Hemodialysis patients are at high risk for HBV infection because their response rate to HBV vaccination is lower than normal population. Additionally, they are also at risk of HBV transmission through shared hemodialysis equipments. We studied factors affecting HBV vaccination response in patients undergoing hemodialysis. Methods: In this study 217 hemodialysis patients at two hemodialysis units records were investigated retrospectively. Anti‐HBs responses one year after first vaccine were evaluated in patients who received four times double doses vaccination schedule (0., 1., 2. and 6. months). Patients with anti‐HBs titer more than 10 IU/mL were accepted responders and less than 10 IU/mL were non‐responders. Age, gender, presence of DM and serum hemoglobin, ferritin, BUN, creatinine, albumin, calcium, phosporus, parathormon, C ‐ reactive protein levels and also Kt/V values were compared for these groups. Results: Of the 217 adult hemodialysis patients, 72 received four doses recombinant HBV vaccination. Sixtyone percent were male (n: 44) and 39% (n:28) were female. Of the 72 patients who received four doses of HBV vaccination, 53 (73.6%) developed protective antibody titers. Male gender (p:0,033), older age ( p:0,029), hypoalbuminemia ( p:0,002) and Kt/V ( p:0.021) were significiantly associated with non‐responsiveness to vaccination. These factors except male gender remained significant in multivariable regression analysis (Table 1). There were no significiant relationship between response to vaccination and other parameters. Conclusions: The reason of impaired response to HBV vaccination in hemodialysis patients were multifactorial. In this study hypoalbuminemia, inadequate hemodialysis and older age were significantly associated with non‐responsiveness to HBV vaccination. Provision of sufficient nutrition and implementation of adequate hemodialysis may improve response rate in hemodialysis patients. Application of different vaccination schedules and methods may be useful for older age. The factors affecting the response to HBV vaccination in hemodialysis patients need to be further examine in prospective and controlled studies. (Table presented).