P-70 hepatitis b immunity among chronic renal disease under hemodialysis

Introduction and Objectives: Hepatitis B Virus (HBV) has been a cause of acute and chronic hepatitis with progression to cirrhosis and hepatocellular carcinoma. Individuals with chronic kidney disease (CKD) are especially susceptible to HBV infection. Some studies have shown high rates of positivity for the HBV infection marker in this population and therefore, vaccination becomes a safe method for Hepatitis B prevention. CKD patients are generally immunosuppressed and have a lower response to the Hepatitis B vaccine when compared to healthy individuals. Some factors associated with vaccine non-response are older age and immunosuppression. This study aimed to evaluate the humoral immune response through the titration of antibodies against HBsAg (anti-HBs) after hepatitis B vaccination in chronic renal disease patients. Material and Methods: This is a cross sectional study conducted in two hemodialysis units serving individuals with CKD in Rio de Janeiro State, where 98 patients were included. All of them consented to participate and donated blood samples. All individuals have fulfilled a questionnaire about demographic characteristics, including information about previous HBV vaccination. Serum samples were tested for anti-HBSs employing chemiluminescent immunoassay (CLIA) technology with the commercial kit (LIAISON®XL, DiaSorin). Results: Among 98 patients studied so far, the mean age was 51.9 years, 54/98 (56.8) female. With regard to the presence of anti-HBs, 56/98 (57.1%) individuals tested positive. Among those individuals, 45 had taken at least one dose of the hepatitis B vaccine. On the other hand, 9/42 (21,4%) seronegative patients all reported having taken the hepatitis B vaccine. Conclusions: The vaccine remains the best and most effective method of preventing and controlling hepatitis B. This study demonstrated low HBV immunity in this population, reinforcing the need for four-dose booster schedules for this population. In addition, host factors should be investigated in non-responder to the vaccine.