MP586RESPONSE TO THE VACCINATION AGAINST HEPATITIS B VIRUS IN CHILDREN ON HEMODIALYSIS

Gulnar Chingayeva, Abay M. Shepetov, Б. А. Абеуова, S.A. Dikanbaeva, Saule Dosym, Д. Б. Исмаилова

2016

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DOI 10.1093/ndt/gfw198.03
Data confidence 70 medium
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Abstract

Introduction and Aims: Hepatitis B remains a serious problem, particularly relevant for patients on hemodialysis (HD). Vaccination against hepatitis B virus (HBV) infection is recommended for all patients with renal insufficiency.The purpose of this research was to assess the effectiveness of the vaccination against hepatitis B in patients on HD, conducted by the standard method. Methods: 34 children aged from 2 to 18 years who were treated on HD were retrospectively examined. The patients analysed HbS Ag-, HbS Ab- and HCV Ab-negative at the beginning of the HD treatment received HBV-recombinant vaccine under the following scheme: 0-1-6 months in a single-dose intramuscularly in the deltoid muscle, with the establishment of seroconversion and seroprotection rate after 3 and 7 months after the beginning of the vaccination. The absence of response was determined by the insufficient seroconversion (> 10 mIU / L). Results: We have found that the frequency of positive response after 3 and 7 months after the beginning of the vaccination was 10.5 and 18.4%, while with the seroprotective level of antibodies - respectively 31.5 and 21%. The number of patients with high titres of anti-HBs, equal to or exceeding 500 mIU / ml was only 18.4 and 13.1% respectively. While the frequency of negative titres of anti-HBs was 36.8 and 34.2%.An analysis of the dynamics of the production of antibodies revealed that an interim response after 3 months after the beginning of the vaccination largely determines the final results in the 7th month. Among patients (14) with a negative response to the vaccination after 3 months, the titre did not change by the end of the vaccination in 10 (71.4%). The seroconversion rate reached seroprotection only in 1 (7.1) and in 3 (21.4%) in the 7th month of the examination. In the group of patients (8) with a poor response to the vaccination in the 7th month, the titre of protective antibodies decreased in 5 (62.5%), the titre remained unchanged in 1 (12.5), and the titre of antibodies reached seroprotection in 2 (25%). Among children (12) with sufficient seroprotective level after the completion of the antibodies course, the titre of antibodies decreased in 7 (58.3%).