Response to single dose hepatitis B vaccine in Congolese non-HIV hemodialysis patients: a prospective observational study

Pitchou Yemasai Kengibe, Jean-Robert Risassy Makulo, Yannick Mayamba Nlandu, François Bompeka Lepira, Ernest Kiswaya Sumaili, Justine Busanga Bukabau, Charles Nlombi Mbendi, Steve Mundeke Ahuka, Antoine Wola Tshimpi, Patrick Kisoko Ngoma, Nseka Nazaire Mangani, Sebastien Nsukini Mbendi, Pitchou Yemasai Kengibe, Jean-Robert Risassy Makulo, Yannick Mayamba Nlandu, François Bompeka Lepira, Ernest Kiswaya Sumaili, Justine Busanga Bukabau, Charles Nlombi Mbendi, Steve Mundeke Ahuka, Antoine Wola Tshimpi, Patrick Kisoko Ngoma, Nseka Nazaire Mangani, Sebastien Nsukini Mbendi

Abstract

Introduction: Because of the cost, in the hemodialysis centers of Kinshasa, the double dose of hepatitis B (HBV) vaccine is administered only to HIV infected patients while other patients receive a single dose. This study aimed to evaluate the single-dose vaccination Protocol and identify determinants of seroconversion's lack of anti-HBs after vaccination schedule.

Methods: 56 non-HIV chronic hemodialysis patients serologically negative for HBs Ag, anti-HBs and anti-HBc were selected between January 2014 and December 2016. The recombinant DNA vaccine (Euvax B®20 μg) was administered intramuscularly in the deltoid muscle at days 0, 30, 60 and 180. Serum anti-HBs titer was assayed at day 240. The endpoint was seroconversion, defined as anti-HBs titer ≥ 10 IU/l (10-99 IU/l = low protective vaccine response; ≥ 100 IU/l = highly protective vaccine response). Anti-HBs titer < 10 IU/l defined a lack of seroconversion. A Logistic regression model was used to identify factors associated with the lack of seroconversion.

Results: In the study group (mean age 55.6± 15.1 years; 73 % men, 36% diabetic and 86% hypertensive), low and highly protective vaccine responses were seen in 32% and 50% respectively versus 18% of patient had a lack of seroconversion. CRP > 6 mg/L (aOR: 8.96), hypoalbuminemia (aOR: 6.50) and KT/V < 1.2 (aOR: 3.70) were associated with the lack of seroconversion.

Conclusion: Half of the patients in the study had either a lack or low protective vaccine response. Patient-related factors and hemodialysis parameters were the main factors associated with the lack of anti-HbS seroconversion. These results highlight the need to maximize doses of vaccine in all patients.

Keywords: Hemodialysis; antibodies seroconversion; hepatitis B virus; vaccination.

Conflict of interest statement

The authors declare no competing interests.

© Pitchou Yemasai Kengibe et al.

References

    1. Lee WM. Medical Progress: Hepatitis B Virus infection: review articles. N Engl J Med. 1997;337:1733–1745.
    1. Wright TL, Lau JYN. Clinical aspects of hepatitis B virus infection. Lancet. 1993 Nov 27;342(8883):1340–4.
    1. Zampino R, Boemio A, Sagnelli C. hepatitis B virus burden in developing countries. World J Gastroenterol. 2015;21(42):11941–11953.
    1. Kramvis A, Kew MC. Epidemiology of hepatitis B virus in Africa, its genotypes and clinical associations of genotypes. Hepatol Res. 2007;37(s1):S9–S19.
    1. Kondili LA, Genovese D, Argentini C, Chionne P, Toscani P, Fabro R, Cocconi R, et al. Nosocomial transmission in simultaneous outbreaks of hepatitis C and B virus infections in a haemodialysis center. Eur J Clin Microbiol Infect Dis. 2006;25(8):527–531.
    1. Burdick RA, Bragg-Gresham JL, Woods JD, Hedderwick SA, Kurokawa K, Combe C, et al. Patterns of hepatitis B prevalence and Seroconversion in hemodialysis units from three continents: the DOPPS. Kidney Int. 2003;63(6):2222–2229.
    1. Peces R, De La Torre M, Alcazar R, Urra JM. Prospective analysis of the factors influencing the antibody response to hepatitis B vaccine in hemodialysis patients. Am J Kidney Dis. 1997;29(2):239–245.
    1. Grzegorzewska AE. Prophylactic vaccinations in chronic kidney disease: Current status. Hum Vaccine Immunother. 2015;11(11):2599–2605.
    1. Rangel MC, Coronado VG, Euler GL, Strikas RA. Vaccine recommendations for patients on chronic dialysis. Semin Dial. 2000;13(2):101–107.
    1. Sit D, Esen B, Atay AE, Kayabasi H. Is hemodialysis a reason for unresponsiveness to hepatitis B vaccine? Hepatitis B virus and dialysis therapy. World World J Hepatol. 2015 Apr 18;7(5):761–768.
    1. Tele SA, Martins RM, Lopes CL, dos Santos Carneiro MA, Souza KP, et al. Immunogenicity of a recombinant hepatitis B vaccine (Euvax-B) in haemodialysis patients and staff. Eur J Epidemiol. 2001;17(2):145–149.
    1. Kara IH, Yilmaz ME, Suner A, Kadiroglu AK, Isikoglu B. The evaluation of immune responses that occur after HBV infection and HBV vaccination in hemodialysis patients. Vaccine. 2004;22(29-30):3963–3967.
    1. Igetei R, Awobusuyi JO, Wright OK, Olaleye DO. Occult Hepatitis B Virus Infection in Nigerian Patients on Hemodialysis. Trop J Nephrol. 2015;10(2):79–85.
    1. Bernieh B. Viral hepatitis in hemodialysis: An update. J Transl Intern Med. 2015;3(3):93–105.
    1. Naicker S. End-stage renal disease in sub-Saharan and South Africa. Kidney Int Suppl. 2003 Feb;83:S119–22.
    1. Kidney Disease Improving Global Outcomes (KDIGO) CKD Work Group KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney IntSuppl. 2013;3:1–150.
    1. Jack AD, Hall AJ, Maine N, Mendy M, Whittle HC. What level of hepatitis B antibody is protective? J Infect Dis. 1999;179(2):489–492.
    1. Boumansour N, Midoun N. Vaccination préventive contre l'hépatite virale B chez les insuffisants rénaux chroniques à Oran, Algérie. Revue d'épidémiologie et de santé publique. 2014 Sep;62(5):S231.
    1. Feriani H, Chaker H, Habib S, Aguerbi I, Toumi S, Mnif K, et al. Vaccination intradermiquecontrel'hépatite B chez les hémodialyséschroniques. Nephrol Ther. 2015;11(5):327.
    1. Ibrahim S, El-din S, Bazzal Antibody level after Hepatitis-B vaccination in Hemodialysis Patients: Impact of Dialysis Adequacy, Chronic Inflammation, Local Endemicity and Nutritional Status. J Natl Med Assoc. 2006;98(12):1953–7.
    1. Ayub MA, Bacci MR, Fonseca FLA, Chehter EZ. Hemodialysis and hepatitis B vaccination: a challenge to physicians. Int J Gen Med. 2014;7:109–114.
    1. Schiller A, Timar R, Siriopol D, Timar B, Bob F, Schiller O, et al. Hepatitis B and C virus infection in the hemodialysis population from three Romanian regions. Nephron. 2015;129(3):202–8.
    1. Grzegorzewska AE. Hepatitis B Vaccination in Chronic Kidney Disease: Review of Evidence in Non-Dialyzed Patients. Hepat Mon. 2012;12(11):e7359.
    1. Crosnier J, Jungers P, Courouce A, Laplanche A, Benhamou E, Degos F, et al. Randomised placebo-controlled trial of hepatitis B surface antigen vaccine in frenchhaemodialysis units. Lancet. 1981 Apr 11;1(8224):797–800.
    1. Schiffl H, Lang S, Stratakis D, Fischer R. Effects of ultrapure dialysis fluid on nutritional status and inflammatory parameters. Nephrol Dial Transplant. 2001;16(9):1863–1869.
    1. Kaysen G. The microinflammatory state in uremia: Causes and potential consequences. J Am Soc Nephrol. 2001;12(7):1549–1557.
    1. Fernandez E, Betriu MA, Gomez R, Montoliu J. Response to the hepatitis B virus vaccine in hemodialysis patients: influence of malnutrition and its importance as a risk factor for morbidity and mortality. Nephrol Dial Transplant. 1996;11(8):1559–1563.
    1. Kovacic V, Sain M, Vukman V. Efficient haemodialysis improves the response to hepatitis B virus vaccination. Intervirology. 2002;45(3):172–176.
    1. Jadoul M, Goubau P. Is anti-hepatitis B virus (HBV) immunization successful in elderly hemodialysis (HD) patients? Clin Nephrol. 2002;58(4):301–304.

Source: PubMed

3
구독하다