RESPONSIVENESS TO HEPATITIS B VACCINE IN HEMODIALYSIS, CAPD, AND PREDIALYSIS PATIENTS BY DOUBLING THE DOSE SCHEDULING

Hepatitis B vaccine is effective in producing protection against hepatitis B virus infection in uremic patients, but these patients respond less well than do the healthy. In this study, we vaccinated 29 hemodialysis patients, 11 continuous ambulatory peritoneal dialysis patients, and 15 predialysis patients. The anti-HBs antibody-seronegative patients followed a four-dose vaccination schedule (0,1,2, and 6 months) with 40 μg DNA-recombinant hepatitis B vaccine. The rate of total seroconversion was 78%. No differences could be found between responders and nonresponders concerning dialysis type or erythropoietin therapy. In conclusion, unresponsiveness to hepatitis B vaccine in uremic patients was related to factors such as older age, male sex, the presence of HCV-infection.