SP765RESPONSE TO HEPATITIS B VACCINE AMONG HEMODIALYSIS PATIENTS. A SINGLE CENTRE EXPERIENCE

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Introduction and Aims: Hemodialysis patients are particularly vulnerable to hepatitis B virus (HBV) and have less sustained and lower antibody response to HBV vaccination. The aim of this study was to identify factors that could affect this response. Methods: We retrospectively studied n=105 patients (42 women and 63 men) on chronic hemodialysis, who had initial titer of antibodies against the surface antigen of HBV (HBsAb) less than 10 IU/l. All patients received initially four doses of recombinated vaccine at months 0,1,2 και 6. Results: After the initial vaccination 52 patients (49,5%) developed HBsAb ≥10 IU/l, 29 of which (27,6%) developed very high HbsAb levels (≥100 IU/l). Responders (HBsAb ≥10 IU/l) were younger (54,7 ± 16 versus 62,5 ± 13 years, p=0,026). The achieved HBsAb titer correlated to the age of the patients (r=-0,353, p=0,002) and to dialysis adequacy (urea reduction ratio, r=0,294, p=0,024). Lower response rates were observed among smokers (32,1% versus 55,8%, p=0,032). Furthermore, men tended to respond more frequently (55,6%) than women (40,5%, p=0,130). Finally, obese patients tended to achieve less frequently high titers HBsAb (≥100 IU/l, 17,9% versus 32,4%, p=0,140). Five out of 18 (27,8%) non-responders responded to an additional dose of HBV vaccine, whereas 11 out of 18 non-responders (61,1%) responded to a second course of four doses. The mean drop of the HbsAb titer after succeful vacination was -49,3% ± 32% per year. Men tended to have a faster rate of decline of the HbsAb titer (-56,2% ± 33%) compared to women (-41,8% ± 28% per year, p=0,062).

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