Hepatitis B vaccination in human immunodeficiency virus-infected adults receiving hemodialysis

Tejinder S. Ahuja, Sajal Kumar, Hadi Mansoury, Hector Rodriguez, Yong Fang Kuo

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background. The Centers for Disease Control and Prevention (CDC) recommends hepatitis B virus (HBV) immunization for all hemodialysis (HD) patients because they are at high risk of infection. Several studies have shown that the development of protective antibody titers after HBV vaccination is much lower in HD patients. We hypothesized that human immunodeficiency virus (HIV) infection in patients with end-stage renal disease (ESRD) would further impair the immune response to hepatitis B vaccination. Methods. We performed a retrospective cohort study of patients undergoing long-term hemodialysis from 1990 to 2002 at the United States-based dialysis facilities of Gambro Corporation, North America. The response rate defined as an increase in anti-HBs levels >10 mIU/L after a month of the third dose of HBV vaccination was determined in HIV-infected and a randomly selected group of ESRD patients. The demographic information, laboratory data, and hepatitis B surface antibody (anti-HBs) titers were recorded from the Gambro Corporation database on these patients. Results. Of the 347 adult HIV ESRD patients, 116 received three doses of recombinant hepatitis B vaccination. Seventy percent were male, and the majority (86%) were black. Of the 116 patients who received three doses of HBV vaccination, 62 (53.4%) developed protective antibody titers. This was comparable to the response rate of 50.4% in the randomly selected 220 non-HIV hemodialysis patients. Among HIV ESRD patients, the mean hemoglobin (Hgb) was higher in patients who developed protective antibody titers (Hgb 11.61 ±2 vs. 10.55 ± 1.86, P value <0.01). On multivariate logistic regression analysis, higher Hgb was associated with protective antibody titers (odds ratio: 1.34, 95% CI 0.99-1.72). Seventy percent of the HIV-infected responders maintained protective antibody titers 6 months after vaccination. Conclusion. Hepatitis B vaccination should be offered to all HIV-infected ESRD patients because over half of the patients with HIV and ESRD can develop protective antibodies.

Original languageEnglish (US)
Pages (from-to)1136-1141
Number of pages6
JournalKidney International
Volume67
Issue number3
DOIs
StatePublished - Mar 2005
Externally publishedYes

Fingerprint

Hepatitis B
Renal Dialysis
Vaccination
HIV
Chronic Kidney Failure
Hepatitis B virus
Antibodies
Hemoglobins
Hepatitis B Antibodies
Virus Diseases
Centers for Disease Control and Prevention (U.S.)
North America
Dialysis
Immunization
Cohort Studies
Retrospective Studies
Logistic Models
Odds Ratio
Regression Analysis
Demography

Keywords

  • Chronic kidney disease
  • Hemodialysis
  • Hepatitis B
  • Human immunodeficiency virus
  • Vaccination

ASJC Scopus subject areas

  • Nephrology

Cite this

Hepatitis B vaccination in human immunodeficiency virus-infected adults receiving hemodialysis. / Ahuja, Tejinder S.; Kumar, Sajal; Mansoury, Hadi; Rodriguez, Hector; Kuo, Yong Fang.

In: Kidney International, Vol. 67, No. 3, 03.2005, p. 1136-1141.

Research output: Contribution to journalArticle

Ahuja, Tejinder S. ; Kumar, Sajal ; Mansoury, Hadi ; Rodriguez, Hector ; Kuo, Yong Fang. / Hepatitis B vaccination in human immunodeficiency virus-infected adults receiving hemodialysis. In: Kidney International. 2005 ; Vol. 67, No. 3. pp. 1136-1141.
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abstract = "Background. The Centers for Disease Control and Prevention (CDC) recommends hepatitis B virus (HBV) immunization for all hemodialysis (HD) patients because they are at high risk of infection. Several studies have shown that the development of protective antibody titers after HBV vaccination is much lower in HD patients. We hypothesized that human immunodeficiency virus (HIV) infection in patients with end-stage renal disease (ESRD) would further impair the immune response to hepatitis B vaccination. Methods. We performed a retrospective cohort study of patients undergoing long-term hemodialysis from 1990 to 2002 at the United States-based dialysis facilities of Gambro Corporation, North America. The response rate defined as an increase in anti-HBs levels >10 mIU/L after a month of the third dose of HBV vaccination was determined in HIV-infected and a randomly selected group of ESRD patients. The demographic information, laboratory data, and hepatitis B surface antibody (anti-HBs) titers were recorded from the Gambro Corporation database on these patients. Results. Of the 347 adult HIV ESRD patients, 116 received three doses of recombinant hepatitis B vaccination. Seventy percent were male, and the majority (86{\%}) were black. Of the 116 patients who received three doses of HBV vaccination, 62 (53.4{\%}) developed protective antibody titers. This was comparable to the response rate of 50.4{\%} in the randomly selected 220 non-HIV hemodialysis patients. Among HIV ESRD patients, the mean hemoglobin (Hgb) was higher in patients who developed protective antibody titers (Hgb 11.61 ±2 vs. 10.55 ± 1.86, P value <0.01). On multivariate logistic regression analysis, higher Hgb was associated with protective antibody titers (odds ratio: 1.34, 95{\%} CI 0.99-1.72). Seventy percent of the HIV-infected responders maintained protective antibody titers 6 months after vaccination. Conclusion. Hepatitis B vaccination should be offered to all HIV-infected ESRD patients because over half of the patients with HIV and ESRD can develop protective antibodies.",
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AB - Background. The Centers for Disease Control and Prevention (CDC) recommends hepatitis B virus (HBV) immunization for all hemodialysis (HD) patients because they are at high risk of infection. Several studies have shown that the development of protective antibody titers after HBV vaccination is much lower in HD patients. We hypothesized that human immunodeficiency virus (HIV) infection in patients with end-stage renal disease (ESRD) would further impair the immune response to hepatitis B vaccination. Methods. We performed a retrospective cohort study of patients undergoing long-term hemodialysis from 1990 to 2002 at the United States-based dialysis facilities of Gambro Corporation, North America. The response rate defined as an increase in anti-HBs levels >10 mIU/L after a month of the third dose of HBV vaccination was determined in HIV-infected and a randomly selected group of ESRD patients. The demographic information, laboratory data, and hepatitis B surface antibody (anti-HBs) titers were recorded from the Gambro Corporation database on these patients. Results. Of the 347 adult HIV ESRD patients, 116 received three doses of recombinant hepatitis B vaccination. Seventy percent were male, and the majority (86%) were black. Of the 116 patients who received three doses of HBV vaccination, 62 (53.4%) developed protective antibody titers. This was comparable to the response rate of 50.4% in the randomly selected 220 non-HIV hemodialysis patients. Among HIV ESRD patients, the mean hemoglobin (Hgb) was higher in patients who developed protective antibody titers (Hgb 11.61 ±2 vs. 10.55 ± 1.86, P value <0.01). On multivariate logistic regression analysis, higher Hgb was associated with protective antibody titers (odds ratio: 1.34, 95% CI 0.99-1.72). Seventy percent of the HIV-infected responders maintained protective antibody titers 6 months after vaccination. Conclusion. Hepatitis B vaccination should be offered to all HIV-infected ESRD patients because over half of the patients with HIV and ESRD can develop protective antibodies.

KW - Chronic kidney disease

KW - Hemodialysis

KW - Hepatitis B

KW - Human immunodeficiency virus

KW - Vaccination

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