Low seroconversion with hepatitis B vaccination in peritoneal dialysis patients

Abstract

Objective: To compare seroconversion using hepatitis B vaccine between hemodialysis (HD) and peritoneal dialysis (PD) patients. Design: Data on PD patients vaccinated were collected retrospectively for the period 1992 to 1995. The data on HD patients were collected prospectively from 1991 to 1994. Setting: A university outpatient dialysis center. Participants: All adult patients who received all four doses of hepatitis B vaccine while on dialysis were included (47 PD and 50 HD patients). Intervention: Recombinant hepatitis B vaccine (Engerix), 40 μg IM was administered at 0, 1, 2, and 6 months. Main Outcome Measure: Seroconversion was measured after completion of the vaccination series. Results: 74% of the HD patients seroconverted compared to 53% of PD patients (p = 0.03). Older, heavier patients compared to all the other patients had a lower seroconversion rate in both the HD patients (55% vs. 78%) and PD patients (38% vs. 59%) (p = 0.03). Conclusion: The seroconversion rate to recombinant hepatitis B vaccine is lower in patients on PD than on HD for unclear reasons. Further studies are required to determine the etiology of this difference.