Immune Response to Hepatitis B Vaccine in Patients on Hemodialysis: Experience from Liaquat University Hospital

Abstract: Background: Patients on hemodialysis (HD) are at risk for HBV transmission due to the frequent exchange of blood products and contact with contaminated dialysate or dialysis equipment. There is reduced immunogenic response to the standard hepatitis B vaccine often occurs. Objective: To determine the response of hepatitis B vaccine in patients among hemodialysis dependent patient. Materials and Methods: This is an interventional study conducted for one year duration from December 17, 2021, to December 16, 2022 at Department of Nephrology Liaquat University Hospital in Hyderabad/Jamshoro, Sindh. The study included patients on hemodialysis for at least 3 or more than 3 months, aged between 18 and 60 years, including both males and females. Four doses of the Hepatitis B vaccine were administered. The doses were given on a schedule of 0, 1, 2, and 6 months and then six-week later antibody titer levels measured against the hepatitis B surface antigen. An adequate responder to the Hepatitis B vaccine was defined as having an anti-Hepatitis B surface antigen level of 100 IU/L or higher, while an inadequate responder defined as having a level below 100 IU/L. Result: Among the 96 patients, 64 (74%) were male, and 32 (26%) were female with a mean age of 42.92years (±9.76). Type II diabetes mellitus was observed in 42 (43.8%) patients, and hypertension was prevalent in 73 (76%) patients. Out of 96 patients, 53 (55.2%) and 43 (44.8%) had adequate and inadequate response. Conclusion: A significant proportion of patients showed an inadequate antibody response, despite completing the full vaccination schedule, confirming reduced vaccine efficacy in this population Keywords: Hepatitis B virus (HBV) vaccination, Chronic kidney disease, Hemodialysis (HD), End stage renal disease (ESRD).