Response to Hepatitis B Vaccination and Associated Factors in Patients Undergoing Hemodialysis

The aim of this study was to investigate the response rate to the hepatitis B vaccine and the factors affecting it in people with advanced kidney failure undergoing hemodialysis.

This cross-sectional study was conducted from 2019 to 2021 at Ziyaian Hospital in Tehran. For patients undergoing hemodialysis, serum levels of the nutritional, inflammatory, and bone and mineral markers were measured before hepatitis B vaccine injection. They then received hepatitis B vaccine, and 6 months later the serum level of hepatitis B antibody was measured. In case of no immune response to the vaccine, a second injection was given. Then the rate of lack of immune response to the vaccine in the subjects under study was determined and the levels of nutritional, inflammatory, and bone factors were compared between those who responded to the vaccine and those without an immune response.

54 people were included in the study. In the first round of vaccination, 45 people participated, of whom 62.2% responded to the vaccine and 37.8% did not respond. 26 people participated in the second round of vaccination, in which 69.2% (18 people) responded to the vaccine and 30.8% (8 people) did not respond to the second round of the vaccine. In the non-response group to the vaccine, the serum levels of albumin, and cholesterol were significantly lower and the serum level of neutrophils and the ratio of neutrophils to lymphocytes was significantly higher than in the patients with response to the vaccine.

Inflammatory and nutritional factors can affect the immune response to hepatitis B vaccine. Therefore, it is recommended to check the nutritional status of these patients and encourage them to follow up on the results of the vaccine.