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Open Access Research article

Association of response to hepatitis B vaccination and survival in dialysis patients

Shih-Yi Lin12, Jiung-Hsiun Liu23, Shu-Ming Wang23, I-Kuan Wang123, Chen-An Tsai4, Yao-lung Liu23*, Hsin-Hung Lin12, Chiz-Chung Chang23 and Chiu-Ching Huang23

Author Affiliations

1 Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan

2 Division of Nephrology and Kidney institute, China Medical University Hospital, Taichung, Taiwan

3 School of Medicine, China Medical University, Taichung, Taiwan

4 Department of Agronomy, National Taiwan University, Taipei, Taiwan

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BMC Nephrology 2012, 13:97  doi:10.1186/1471-2369-13-97

Published: 30 August 2012

Abstract

Background

The status of immunocompromised patients is well recognized in end stage renal disease (ESRD). As described recently, this acquired immune dysfunction in the uremic milieu may be one of the main pathogenic factors for mortality in ESRD. The aim of this study was to determine the relationship between the immune response following a hepatitis B vaccination (HBV vaccination) and the survival of maintenance dialysis patients.

Methods

A total of 156 patients (103 on hemodialysis and 53 on continuous ambulatory peritoneal dialysis) were recruited. After receiving a full dose of the HBV vaccination, all patients were followed up for to 5 years to evaluate the association of patient survival, cause of mortality, and immune response.

Results

The response rate to the hepatitis B vaccination was 70.5%. There was no significant association between the immune response and the 5-year survival rate (p =0.600) or between the post-vaccination anti-HBs titers and the 5-year survival rate (p = 0.201). The logistic prediction model with the coefficient as non-response following HBV vaccination, diabetes mellitus, old age, and low albumin level could significantly predict infection-cause mortality (sensitivity = 0.842, specificity = 0.937).

Conclusion

There was no significant association between the immune response to HBV vaccination and the 5-year survival rate. However, non-response following HBV vaccination might be associated with infection-cause mortality in dialysis patients.

Keywords:
Hepatitis B vaccination; Immune response; Post-vaccination anti-HBs titers