The Effect of Inflammatory Reactions on Antibody Unresponsiveness to Hepatitis B Vaccine in Hemodialysis Patients

In this study, the effect of infections and inflammation developed during hepatitis B vaccination program on antibody response in hemodialysis (HD) patients was evaluated. In total, 94 patients who had hepatitis B surface antigen (HBsAg) (-), antibody to hepatitis B surface (antiHBs) (-), antibody against hepatitis B core immunoglobulin G (antiHBcIgG) (-) (Group A) and who were previously vaccinated but having antibody titer levels lower than 10 mIU/mL (Group B), on maintenance HD program were included in this study. In group A, 40 |μ|g intramuscular vaccine on 0, 1, 2 and 6 months and in group B, 40 μ|g of intramuscular booster dose vaccine were administered. Antibody titer of 10 mIU/mL was considered as positive. Group A was then divided into two subgroups with respect to antibody response (Group A1 and Group A2). Eighty-one patients completed the study (Group A; n=64, mean age=42.3±11.4 years; Group B: n=17, mean age=53.6±10.6 years). In Group A, antibody response was positive in 82.8% (Group A1), negative in 17.2% (Group A2) and it was positive in 100% of Group B. Inflammatory parameters, nutritional and demographic features were found similarly in all groups. Throughout the study, infections developed most frequently in Group A. We concluded that acute infections and inflammations developed in patients vaccinated according to vaccination schedule recommended for HBV prophylaxis during HD treatment does not affect antibody response and acute phase reactants are not indicators for negative antibody response.